Cognitive-Behavior Therapy for Menopausal Symptoms (hot flushes and night sweats): Moderators and Mediators of Treatment Effects

New Study (1)Abstract


Cognitive-behavior therapy (CBT) has been found in recent randomized controlled trials (MENOS1 and MENOS2) to reduce the impact of hot flushes and night sweats (HFNS). In the MENOS2 trial, group CBT was found to be as effective as self-help CBT in reducing the impact of HFNS. This study investigates for whom and how CBT works for women in the MENOS2 trial.


This study performed a secondary analysis of 140 women with problematic HFNS who were recruited to the MENOS2 trial: 48 were randomly assigned to group CBT, 47 were randomly assigned to self-help CBT, and 45 were randomly assigned to usual care. Self-report questionnaires were completed at baseline, 6 weeks postrandomization, and 26 weeks postrandomization. Potential moderators and mediators of treatment effects on the primary outcome-hot flush problem rating-were examined using linear mixed-effects models and path analysis, respectively.


CBT was effective at reducing HFNS problem rating regardless of age, body mass index, menopause status, or psychological factors at baseline. Fully reading the manual in the self-help CBT arm and completing most homework assignments in the group CBT arm were related to greater improvement in problem rating at 6 weeks. The effect of CBT on HFNS problem rating was mediated by changes in cognitions (beliefs about coping/control of hot flushes, beliefs about night sweats and sleep) but not by changes in mood.


These findings suggest that CBT is widely applicable for women having problematic HFNS, regardless of sociodemographic or health-related factors, and that CBT works mainly by changing the cognitive appraisal of HFNS.


Norton, S., Chilcot, J., & Hunter., M.S. (2014). Cognitive-behavior therapy for menopausal symptoms (hot flushes and night sweats): moderators and mediators of treatment effects. Menopause, 21(6), 574-578. doi: 10.1097/GME.0000000000000095.


Every week, we receive various email alerts about new research studies in Cognitive Therapy and Cognitive Behavior Therapy. We’re going to start posting links to these research studies here on CT Today. Some research studies may be of interest only to professionals, but we think some of them may interest the layperson as well. Like this one, which shows that Cognitive Behavior Therapy (CBT) can actually help infertile women start ovulating again. When we post research studies, you’ll see them here as “Research Results,” followed by a sentence about what the study showed.

CBT can restore ovulation in infertile women describes a randomized, controlled trial in which 16 women who had not menstruated in six months were randomly assigned to one of two groups — half of them received CBT treatment for 20 weeks, and the other half were simply observed (no treatment was given to them). Amazingly, 80% of the women who received CBT treatment started ovulating again, compared to only 25% of the group under observation. The Emory University Professor who conducted the study, Professor Sarah L. Berga, M.D., attributes the results to CBT’s ability to reduce hormonal stressors, which had apparently been preventing ovulation. CBT may provide an alternative to costly medical procedures and medication for some infertile women. Results of this study were announced at the European Society of Human Reproduction and Embryology in Prague, Czech Republic on Tuesday 20 June 2006.