Amongst the many options to manage menopause symptoms, including diet, exercise, nutraceuticals (i.e. fish oil, Vitamin E and more), botanicals (i.e. black cohosh, maca, red clover, Rhapontic rhubarb, kava, valerian, St John’s wort and more), hormones, and over the counter and other pharmaceuticals, there are many situations for which another option is needed in addition to or instead of. This includes psychological interventions such as mindfulness-based, cognitive-behavioral, and behavior-based therapies for alleviating symptoms, especially hot flashes/night sweats, anxiety, irritability, insomnia and depression.
The current meta-analysis included 12 randomized controlled trials with a total of 1016 women. Researchers examined the above psychological interventions in the areas of bothersome hot flashes, general menopause symptoms and sexual activity. The results were compared to women who had the same symptoms and not receiving those interventions.
All the psychological therapies showed a modest, but statistically significant short term benefit of less than 20 weeks for bothersome hot flashes and general menopause symptoms. There was also a medium term (20 or more weeks) benefit for bothersome hot flashes but no short or medium term benefit for the frequency of the hot flashes. These results were similar for women with both induced or natural menopause. Only two studies amongst the 12, addressed sexual function, so it was not possible to determine if the psychological symptoms helped sexual function or not.
Commentary: Since women were not blinded to the intervention, the results of this study should be seen as potentially biased. Since the interventions helped bothersome aspects of hot flashes but not the actual number/frequency of them, this suggests that the interventions help women to cope with the symptoms rather than actually reduce them. Some women will be more interested in and able to follow through with these psychological interventions than others. They are you might say, labor intensive, but… their appeal lies in additional opportunities for their health benefits, beyond hot flashes and general menopause symptoms.
Reference: van Dreil C, et al. Mindfulness, cognitive behavioral and behavior-based therapy for natural and treatment-induced menopausal symptoms: A systematic review and meta-analysis. BJOG 2018; Mar 15; epub
