A few sessions of behavioural therapy – even a "self-help" version – may help some women find relief from menopausal hot flashes, a new study suggests.
The study, reported online in Menopause, tested the effects of cognitive behavioural therapy in 140 women. After six weeks, more than two-thirds of women who had group sessions or self-help had clinically significant improvements.
Hot flashes and night sweats were "noticeably less problematic" and interfering less in the women's daily lives, said senior researcher Dr Myra S. Hunter, of King's College London in the UK.
Past research has shown that certain thoughts and reactions to hot flashes can make women feel worse, while other responses can help them feel better, Dr Hunter said.
Therapy not widely available
"We think that cognitive behavioural therapy works mostly by changing women's perception and interpretation of the (hot flashes) – as well as countering overly negative beliefs about menopause," she said.
When it comes to menopause symptoms, Hunter said, cognitive therapy "involves developing helpful, accepting approaches to hot flashes and also using breathing exercises to focus attention away from the flashes and negative thoughts."
But in the real world, behavioural therapy specifically aimed at menopause symptoms is not widely available.
For now, it's under study. For their trial, Dr Hunter and her colleagues’ recruited women who'd been having bothersome hot flashes and night sweats at least 10 times a week for a month or more.
Fewer hot flashes
They randomly assigned the women to either have group-based therapy, a self-help version or no treatment. Women who had group therapy went to four sessions over a month. The self-help therapy was not completely independent; women had one meeting and a phone call with a psychologist who guided the therapy. But otherwise, they used a book and CD to teach themselves tactics for dealing with hot flashes.
After six weeks, 65% of women who'd had group therapy reported a meaningful drop in how problematic their hot-flash symptoms were. The same was true of 73% of women in the self-help group - but of only 21% of women who'd had no treatment at all.
The benefit was still apparent after six months – although by then one-third of the untreated group had improved.
When it came to actual numbers, women in the therapy groups said they were having fewer hot flashes. But women who'd gotten no treatment reported a similar drop.
Women don’t notice hot flashes
Instead, the benefit seemed to come from changes in how women perceived their symptoms.
"Women say that they might still have hot flashes but not notice them, and that they feel more confident about coping with them," Dr Hunter said.
She and her colleagues are publishing their self-help book and plan to train health professionals in different countries so that behavioural therapy for menopausal symptoms can become more widely available.
In the US, the cost of cognitive behavioural therapy varies based on the specific programme, but a typical figure would be between R752 and R1, 500 an hour.
(Amy Norton, Reuters Health, March 2012)
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