Cognitive behavioral therapy (CBT) is a structured, practical form of talking therapy that focuses on the links between thoughts, feelings, behaviour and physical sensations. It’s best known for treating anxiety and depression — and it’s also recommended for menopause symptoms.
What the evidence shows
The Menopause Society’s 2023 review of non-hormonal treatments recommends CBT for hot flashes and night sweats. CBT typically doesn’t reduce how often hot flashes happen, but it consistently reduces how bothersome they are and how much they interfere with daily life and sleep.
CBT also has strong evidence for insomnia (in the form of CBT-I), anxiety and low mood — all common during the transition.
What a CBT program for menopause involves
Programs are usually four to six sessions, in groups, individually, or through self-guided books and apps. They typically include:
- Understanding symptoms. Learning what causes hot flashes reduces fear and catastrophic thinking about them.
- Managing triggers. Identifying and adjusting situations that make hot flashes more likely.
- Paced breathing and relaxation at the start of a hot flash to stay calm.
- Reframing unhelpful thoughts, such as worry about others noticing a flush, which amplifies distress.
- Sleep strategies for night sweats and waking.
- Stress management for the broader load of midlife.
Who it’s good for
CBT has no medical side effects or drug interactions, which makes it an option for women who can’t or don’t want to use hormones or medication. It can also be combined with other treatments.
How to find it
Ask your clinician for a referral to a psychologist or therapist trained in CBT, ideally with experience in menopause or women’s health. Structured self-help programs based on published CBT protocols are a lower-cost starting point.