Sian Thrasher

Menopause & CBT

Posted by Sian Thrasher Cognitive Behavioural Therapist 82 Days Ago

A survey conducted on behalf of The British Menopause Society in 2016 revealed that half of women between the ages of 45-65 who had gone through the menopause in the preceding 10 years had done so without consulting their GP or other healthcare professional even though 42% of women described feeling their menopause symptoms were worse or much worse than they had expected.

Over 7.2 million women in the UK are in this age group, and with women living 30-40% of their lives post-menopause, the demand for effective treatment of emotional as well as physical symptoms during and following ‘the change’ is high.


The most common menopause symptoms include vasomotor symptoms (night sweats and hot flushes), decreased libido, vaginal dryness, insomnia, anxiety, depression, and brain fog (difficulty concentrating). 70-80% of women report night sweats and hot flushes, and 36% said that their symptoms impacted on their social life, with 51% reporting impacts on their sex life.


In addition to HRT (where suitable), NICE guidelines for menopause recommend CBT as a treatment option for symptoms.  CBT has long been established as an effective approach for anxiety and depression, and with long-standing physical problems. CBT’s effectiveness in supporting those with chronic pain and long-term physical health is already established, and its efficacy in the treatment of menopausal impacts is a common experience in clinical practise.

CBT for menopause can help with...

  • Symptoms of depression. Around 10% of women experience depressed or low mood during menopause. Menopause can impact a woman’s self-esteem and confidence, and with vasomotor symptoms affecting sleep, mood can dip. CBT is recommended by NICE as a treatment option for symptoms of depression and shows good efficacy in mood management.

  • Symptoms of anxiety. The unpredictability of vasomotor symptoms, in particular, hot flushes, along with the impact these can have in social and work functioning, can lead to anxiety and withdrawal from social and other activities. CBT can help patients manage fear and avoidance and improve confidence.

  • Sleep disturbance or anxiety. Night sweats and other symptoms can disrupt sleep for women experiencing menopause. Poor sleep can have a knock-on impact on mood and anxiety, as well cognitive functioning, and work performance, and a vicious circle can easily be set up. A CBT approach has been proven to be effective for managing sleep problems.

  • Hot flushes and night sweats. CBT specifically adapted for managing hot flushes and night sweats has been found to effective in helping women cope. In three clinical trials for women experiencing menopause and undergoing breast cancer treatment, improvements made in CBT treatment were shown to have been maintained at six-month follow up (Mann et al, 2012).

Accessing treatment

When exploring treatment options, look for practising CBT therapists who are fully trained and accredited, and specialised in treating the impacts of menopause.

There are some self-help options available, but NICE recommendations encourage self-help to be used in conjunction with guidance from the trained practitioner.

Sian Thrasher has personal and professional experience treating and managing menopause and works with medical specialists to support women going through difficulties at this time of life.

Further reading & self-help options

Living Well Through the Menopause, An evidence-based cognitive behavioural guide

Myra Hunter & Melanie Smith

Managing Hot Flushes and Night Sweats, A cognitive behavioural self-help guide to the menopause

Myra Hunter and Melanie Smith