Cognitive behavioural interventions for premenstrual and menopausal symptoms

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Abstract
Bodily experiences and emotional changes occurring during the premenstrual phase of the cycle, and hot flushes and night sweats occurring during the menopause, are not uncommon. However, for some women these are troublesome and interfere with daily life. If women seek help for these problems medical treatments are usually offered, and while many prefer non-medical approaches, some frequently used non medical approaches have been found to be ineffective in recent clinical trials. This paper describes cognitive behavioural approaches for premenstrual and menopausal symptoms (hot flushes and night sweats). A cognitive behavioural model is presented and then cognitive behavioural therapy (CBT) is described with case examples. This approach is client centred, collaborative and relatively brief, and takes account of the social context, developmental influences, as well as cognitive appraisal of symptoms, cognitive assumptions and behavioural strategies. There is growing evidence for the effectiveness of these approaches as viable alternatives to medication (hormone replacement therapy or selective serotonin reuptake inhibitors). Further work is needed to clarify the effective components of the treatments and to consider optimum ways of service delivery.