Menopause and CBT: how can it help your symptoms?

What is CBT for menopause?

Cognitive behavioural therapy (CBT) is a talking therapy that explores how your thoughts, feelings, and behaviour affect one another. It helps you develop practical ways to manage difficulties, with skills you can practise between sessions.

Menopause-specific CBT adapts these techniques to help with menopause symptoms. Current NICE guidance recommends considering it for hot flushes and night sweats alongside HRT, when HRT isn’t suitable, or if you’d prefer not to take it. It can also be considered for associated sleep problems and some depressive symptoms.

CBT is among the most widely utilised therapeutic approaches. It is also easily adaptable as it can be delivered in a variety of ways. Specifically, CBT can be offered via face-to-face, over the phone or online (i-CBT) sessions, depending on symptom severity and personal preference.

How does menopause-specific CBT work?

Hot flushes and night sweats are physical symptoms, and the worry surrounding them can make them harder to cope with. For example, after waking with a night sweat, you might lie awake worrying about how you’ll manage the next day.

Menopause-specific CBT helps you recognise these patterns and try different responses. You might work on sleep habits, relaxation, or worries about symptoms happening in public. You’ll agree goals with your therapist and practise techniques between sessions.

Which menopause symptoms can CBT help with?

Menopause-specific CBT can help make hot flushes and night sweats feel less troublesome and reduce their impact on daily life. It may also help with sleep problems linked to these symptoms and low mood that occurs alongside them.

Persistent low mood or symptoms of depression deserve a separate assessment, so speak to your GP about the support that’s right for you.

Midlife can also bring extra challenges, including work demands, caring roles, and accumulated stress. Having persistent or troublesome menopausal symptoms can leave women feeling more stressed and irritable. This, in turn, can exacerbate these symptoms.

The stigma around aging and the taboo about discussing menopausal symptoms may also compound any negative feelings, leaving women feeling too isolated, anxious, or embarrassed to tell others how they feel. They may not want to be thought of as getting older, fear that this will somehow put them in a bad light, or that others will think that they are no longer able to cope. They may also believe that nothing can help, that others will laugh at them or dismiss their symptoms.

CBT helps you explore how your thoughts about menopause, past experiences, daily habits, and other people’s attitudes may affect how you cope with symptoms. You’ll also learn practical strategies to manage difficult feelings and reduce the impact of symptoms on everyday life.

How can I access CBT for menopause?

Ask your GP what’s available locally, including whether there’s a menopause-specific CBT service. Options may include individual appointments, group sessions, or supported self-help.

In England, you can refer yourself to NHS Talking Therapies for anxiety or depression, although menopause-specific provision varies. If you’re considering private therapy, ask about the therapist’s CBT qualifications and experience of supporting people through menopause.

Prefer to watch? Catch up on our recorded webinar about CBT and menopause.

If you experience troublesome menopausal symptoms, please speak to your GP or a health care professional, or one of our menopause doctors and nurses. They can discuss things with you in more detail and suggest available treatment or other support options, if appropriate.