Menopause symptoms can be curbed by cognitive behavioural therapy, trial finds

Debilitating symptoms of the menopause can be curbed by group cognitive behavioural therapy, according to new research.

The clinical trial, carried out by Breast Cancer Now, found menopausal women with breast cancer, who went through six weeks of group cognitive behavioural therapy (CBT) with a breast cancer nurse, said their symptoms of the menopause became substantially less difficult to cope with.

While the prevalence of their menopausal symptoms was curbed by just over a quarter after going through group CBT - a popular form of therapy that helps people change unhealthy patterns of behaviour and thinking.

The new research comes as a shortage of hormone replacement therapy - used to alleviate physical and psychological menopause symptoms - grips the UK. The majority of the 3.4 million women aged between 50 and 64 in the UK will be experiencing symptoms of the menopause – with these ranging from heart palpitations to hot flushes, vaginal pain, changes in mood and much more.

More than one million women in the UK are estimated to currently be dependent on some form of hormone replacement therapy by the National Institute for Health and Care Excellence (Nice).

Breast Cancer Now warned up to 85 per cent of women with breast cancer experience hot flushes and night sweats as a result of chemotherapy and hormone therapy treatments. The side effects are routinely harder to handle and go on for longer periods of time for women who have breast cancer than for other menopausal women, the charity said.

“Hormone replacement therapy may be offered to relieve menopausal symptoms, but is not usually recommended for women with breast cancer because it may increase their risk of the disease returning, therefore safe and effective alternatives to reduce side effects and ensure quality of life are urgently needed,” researchers at the charity said.

Menopausal symptoms for women with breast cancer are so unmanageable for some women that they halt treatment which can help stop their breast cancer from coming back, Breast Cancer Now added.

Women involved in the new research said after going through CBT their hot flushes and night sweats were almost twice as easy to handle, with women also saying their quality of sleep got better, while their depression and anxiety improved.

Natalie Richards was diagnosed with triple negative breast cancer in April 2019 and suffered extreme hot flushes and night sweats while going through chemotherapy.

The 39-year-old, who is from London, said: “I was shocked to be told I had breast cancer. Treatment began pretty quickly and as soon as I started chemotherapy my periods stopped. I hadn’t been aware of the side effects I’d experience.

“I had hot flushes all through the day and night. It felt like every half an hour. I was breaking out into full sweats no matter the time or weather, on top of all the other side effects of my chemotherapy, yet this side effect had never been mentioned or discussed with me.”

The mother-of-two said she felt “dismissed” after saying she was finding it hard to manage hot flushes - adding that she was given no guidance about how to soothe “this distressing side effect”.

Ms Richards added: “I became very down and anxious with my hot flushes and night sweats being all-consuming and overwhelming. I was so embarrassed when it happened in public. I don’t know how I managed, but I just tried to take one day at a time.”

She explained she did not know much about menopausal symptom side effects, adding that “they were just as distressing as hair loss”.

Ms Richards added: “Perhaps more so because they were so unexpected. I had such a wonderful breast care nurse, and I think if she’d been able to provide me with some support specifically for my menopausal symptoms that could’ve made a huge difference.”

The research was directed by Professor Deborah Fenlon from Swansea University, in conjunction with the University of Southampton and the Institute of Psychiatry, Psychology & Neuroscience at King’s College London.

Dr Simon Vincent, of Breast Cancer Now, said: “Menopausal symptoms, such as hot flushes and night sweats, can profoundly impact quality of life for women with breast cancer. It’s hugely exciting to see that CBT delivered by a breast care nurse can help to spare women, who’ve already had the difficult experience of a breast cancer diagnosis, this further anguish.”