CBT for Menopause

A Comprehensive Guide to Managing Symptoms with Cognitive Behavioural Therapy (CBT)

Menopause is a natural biological process that every woman experiences. Yet, it often comes with a range of challenging symptoms that affect physical, emotional and mental wellbeing. Understanding the changes that occur during perimenopause and menopause is essential to navigating this transition with confidence. Cognitive behavioural therapy (CBT) offers an evidence-based approach to managing menopause symptoms improving mental health and enhancing quality of life.

What Happens in the Body During Perimenopause and Menopause?

Perimenopause:

Perimenopause, meaning “around menopause”, typically begins in a woman’s 40s but can start earlier. This phase can last anywhere from a few months to over a decade before menopause officially begins. It is marked by fluctuating oestrogen and progesterone levels, leading to irregular menstrual cycles and various physical and emotional symptoms.

Key hormonal changes during perimenopause include:

• Declining Oestrogen Levels: Affects mood, sleep, and bone health.
• Progesterone Reduction: Can lead to heavier or irregular periods and impact sleep patterns.
• Increased Follicle-Stimulating Hormone (FSH): Signals the ovaries to produce eggs but with inconsistent effectiveness, causing cycle irregularities.
• Changes in Testosterone: Can influence libido and energy levels.

Menopause:

Menopause is officially diagnosed when a woman has not had a period for 12 consecutive months. The average age of menopause is 51, but it can occur earlier due to genetics, medical conditions or surgical interventions, such as: hysterectomy.

During menopause:

• Ovaries stop producing significant amounts of estrogen and progesterone.
• The body adjusts to lower hormone level leading to a variety of symptoms.
• Risks of osteoporosis, cardiovascular disease and cognitive decline may increase.

Symptoms of Perimenopause and Menopause

The symptoms of perimenopause and menopause can be categorised into physiological, psychological, cognitive and behavioural changes. Below is a table outlining these symptoms:

How can Cognitive-Behavioural Therapy (CBT) improve quality of life?

Cognitive Behavioural Therapy (CBT) is a structured, evidence-based psychological therapy that helps individuals recognise and manage unhelpful thoughts and behaviours. CBT has been shown to be highly effective in reducing many menopause-related symptoms, particularly those related to mood, sleep and stress.

1. Managing Anxiety and Depression

Menopausal women often experience increased anxiety and depressive symptoms due to hormonal fluctuations. CBT helps by:

• Identifying negative thinking patterns and replacing them with balanced perspectives
• Using relaxation techniques, such as: controlled breathing and progressive muscle relaxation
• Developing problem-solving strategies to manage stress effectively

2. Coping with Hot Flashes and Night Sweats

Hot flashes and night sweats are among the most common and disruptive menopause symptoms. CBT can help by:

• Teaching mindfulness and acceptance strategies to reduce distress during hot flashes
• Encouraging lifestyle adjustments, such as: avoiding triggers like caffeine and alcohol
• Using cognitive re-structuring techniques to shift focus away from discomfort

3. Improving Sleep Quality

Insomnia and frequent night time awakenings are common during menopause. CBT for insomnia (CBT-I) is a specialised form of CBT that focuses on improving sleep by:

• Establishing a consistent bedtime routine and sleep schedule
• Reducing anxiety about sleep through cognitive re-framing
• Encouraging relaxation techniques and sleep hygiene improvements

4. Enhancing Cognitive Function

Brain fog and memory lapses can be frustrating symptoms of menopause. CBT can help by:

• Encouraging structured daily routines to improve focus
• Reducing cognitive overload through stress management strategies

5. Boosting Self-Confidence and Social Connection

Menopause can impact self-image and confidence. CBT helps by:

• Challenging negative self-perceptions and reinforcing positive affirmations
• Encouraging social engagement and support-seeking behaviours
• Helping women re-define their sense of purpose and self-worth beyond caring for others

Additional Lifestyle Strategies to Support CBT

While CBT is highly effective, combining it with lifestyle changes can further enhance wellbeing. Consider the following:

• Balanced Nutrition
• Regular Exercise
• Mindfulness and Meditation
• Social Support

Rebalance & Renew: A CBT Approach to Menopause

Rewrite Your Menopause Story. 6 Weeks. 10 Women. Real Strategies That Make a Difference.

Perimenopause and menopause are significant transitions in a woman’s life, often accompanied by physical, emotional and cognitive challenges. However, by understanding the physiological changes and utilising effective interventions, such as Cognitive Behavioural Therapy (CBT), women can regain control over their symptoms and improve their overall wellbeing.

This is the reason my experienced colleague, Ilia Maltezou, and I developed a 6-week online group programme for women going through (peri)menopause.

As we are both interested in women’s health, we wanted to create a safe space for women to share their experiences, receive and offer support and, of course, learn practical strategies that they can put in place to manage their distressing symptoms, navigate this period of change and improve their quality of life.

Our 6-week programme, based on the principles of Cognitive-Behavioural Therapy, covers the following areas:

• Identifying and managing physical symptoms of (peri)menopause
• Self-compassion and acceptance
• Identifying and managing unhelpful thoughts related to (peri)menopause
• Managing change
• Self-perception and identity shifts
• Using menopause as an opportunity for growth
• Developing a helpful routine that prioritises values
• Sleep hygiene and relaxation

Our programme will take place online. In this way, it will be more accessible to women in the UK. Every session will last for 90 minutes and the duration of the programme will be 6 weeks.

Following every session, we will provide participants with written materials that they can re-visit at any point during or after the end of the programme.

In regards to the cost, it is £510 for 6 weeks (£85 per 90-minute session).

Considering that nowadays we might pay around £85 for a massage or a facial that could last for less than 90 minutes, we really hope that women will also invest in their mental health in a similar way by attending our 6-week programme.

Sign up to our programme by sending us an e-mail to: therapyforme@outlook.com