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Managing Menopause with CBT and Hypnotherapy

Updated: Dec 1, 2022

Menopause, rather like puberty, is a transitional phase marked by wildly fluctuating hormones and often strange and disruptive symptoms.

On average, women enter the menopause around the age of 50. However, around 1 in 100 women experience premature menopause in their 40s, 30s, and even as early as their 20s.




When one of my friends had her second daughter in her early 30’s , she went through menopause. Unfortunately, there still seems to be a stigma attached to the menopause. Generally, women can talk with their friends or family when they experience the symptoms at an age which is typical for women. However, this is not the case for those who experience it prematurely. They can feel isolated and anxious about the symptoms and whether they are ‘normal’. So, they often end up struggling through the menopausal symptoms in silence.


It is vitally important that women experiencing perimenopause or menopause do consider all options of treatment, so that they can minimise the impact of this time of transition on their work, social and intimate relationships.


There are many common symptoms that women experience during the menopause but for the purpose of this blog post, I’m going to talk about the most common symptoms, hot flushes and night sweats, as well as anxiety which affect 60-70% of women during the menopause.


CBT

Over the past 15 years in particular, there has been significant research conducted to look for ways to reduce hot flushes in menopausal women. This has allowed a more in-depth and scientific approach to be reached as to why they occur, what causes them and how we control them.

One of these studies was conducted with a randomise control group called MENOS2 where they looked at a group of CBT and guided self-help CBT for women with problematic hot flushes during the menopause transition. Participants experienced a significant reduction in the problem rating of hot flushes, improved mood and quality of life including memory and emotional and physical functioning. These improvements were maintained for 6 months (which was when the study was completed) (Ayers et al, 2012)

An evaluation was carried out comparing CBT with HRT and no treatment. They concluded that CBT and HRT significantly reduced hot flush frequency, but CBT also significantly reduced anxiety and hot flush problem ratings. Changes were maintained at 3 months follow-up. (Hunter & Liao, 1996)


Another randomised controlled trial which looked at CBT for working women with problematic hot flushes and night sweats in 2018 showed significant results. Participants experienced significantly reduced hot flushes and night sweats, improved work and social adjustment, sleep. These beliefs and improved behaviours were still maintained at the 6 week and 20-week reviews with additional improvements in wellbeing, reduced work impairment due to menopausal-related presenteeism at 20 weeks (Hardy et al, 2018)


There are more studies being done out there, but looking at these three, there is good news for proactivley getting these symptoms under control. These studies show that there is a reduction in problem rating for hot flushes, improved mood and quality of life. And these improvements can be maintained long term too. Showing that the techniques were effective regardless of age, BMI, menopausal status, and psychological distress at the beginning of the trials.


Research has also shown that when hypnosis is used in conjunction with CBT, it enhances its effectiveness (Schoenberger et al, 1997). Which is why I use a wide range of Cognitive Behavioural Techniques with my clients in conjunction with hypnotherapy.


Hypnotherapy

A randomised controlled trial was conducted on clinical hypnosis in the treatment of postmenopausal hot flushes. Participants experienced a 74% reduction in hot flushes, an 80% reduction in hot flush problem rating as well as improved sleep quality and less daily interference from hot flushes. (Etkins et al, 2013)

Randomised, controlled trials of clinical hypnosis demonstrated the approach was significantly better than a ‘structured attention” therapy approach in postmenopausal women with frequent hot flashes and more effective than acupuncture, herbal supplements, and yoga.


By way of example, Hypnotherapy for hot flashes works in a few ways. Firstly, it calms down this cooling response, before it even happens.

Have you ever noticed that your hot flashes feel similar to your body's reaction to stress or anxiety. This is your ‘sympathetic nervous’ system in action, stimulating your fight-or-flight-or-freeze response.

Hypnotherapy for hot flashes helps you calm the body's stress response—actively reversing the raised heart rate, the rush of blood, and the sweating.

Secondly, while you’re in this relaxed and focused state of attention, your subconscious mind can learn new ideas—like adjusting how your brain reacts to normal temperatures. This happens by listening to suggestions for hot flash management, and visualizing cooling situations.

A hypnotherapy session takes you into a focused state of relaxation where suggestions and cooling imagery can help you manage your internal temperature control and reduce hot flashes by up to 80%.

Hypnotherapy has been shown to also improve many other aspects of life during menopause. This includes improving sleep (by reducing night sweats and working on your night time routine), reducing stress, and improving mood. Reducing these pressures may also help reduce the number of hot flashes you experience.


Hypnotherapy and sleep

Menopause is often accompanied by sleeping difficulties, you may be experiencing hot flashes at night, and perhaps night sweats or anxious feelings.

Research by the Centre for Disease Control in the United States has shown that a third of menopausal women sleep an average of seven hours a night or less, and nearly half wake up without feeling rested at least four days a week.

In this study it was shown that one in four menopausal women found it difficult to fall asleep, and one in three had trouble staying asleep throughout the night.

The good news is that hypnotherapy has been shown to improve sleep quality and duration. This approach can allow you to feel relaxed and comfortable at bedtime, rather than feeling anxious and worried. As mentioned earlier in a study, 43% of those who received hypnotherapy reported improved sleep quality, compared to only 4% in the control group.



Hypnotherapy helps mild depression and anxiety

During menopause, it’s not unusual to experience changes to your mood or mental health. You may notice more feelings of anxiety or sadness. Mood swings may be brought about by significant shifts in hormone levels, which can in turn, be worsened by poor sleep and night sweats. These factors, plus general anxiety or failing quality of life due to severe symptoms, can all be factors leading to depression.

Many women who have used hypnotherapy to manage their hot flashes report feeling calmer and less stressed or anxious.

While this form of hypnotherapy is directed at reducing hot flashes, I use hypnotherapy and CBT to work with all aspects of you, as combined they provide effective change to empower you in your life.


Hypnotherapy has been recognised as one of the safest and most effective tools in managing menopausal symptoms. A hypnotherapy session takes you into a focused state of relaxation where suggestions and cooling imagery can help you manage your symptoms.


References:

  • Ayers, B., Smith, M., Hellier, J., Mann, E. & Hunter, M.S. (2012) Effectiveness of group and self-help cognitive behaviour therapy to reduce problematic menopausal hot flushes and night sweats (MENOS 2): a randomized controlled trial. Menopause 19,7:749-759

  • Elkins, G., Marcus, J., Stearns, V., Perfect, M., Rajab, M.Ruud, C. (2008) Randomized trial of a hypnosis intervention for treatment of hot flashes among breast cancer survivors. Journal of Clinical Oncology, 26: 5022–5026.

  • Elkins, G, Marcus, J, Bunn, J, Perfect, M, Palamara, L, Stearns, V & Dove, J. (2010) Preferences for Hypnotic Imagery for Hot-Flash Reduction: A Brief Communication. International Journal of Clinical and Experimental Hypnosis, Volume 58, Issue 3

  • Elkins GR, Fisher WI, Johnson AK, Carpenter JS, Keith TZ.Clinical hypnosis in the treatment of postmenopausal hot flashes: a randomized controlled trial. (2013) Menopause. Mar;20(3):291-8.

  • Hardy C, Griffiths A, Norton S, Hunter MS. (2018) Self-help cognitive behavior therapy for working women with problematic hot flushes and night sweats (MENOS@Work): a multicenter randomized controlled trial. Menopause. Jan 8.

  • Hunter, M. S. & Liao, K.L. (1996) Evaluation of a four-session cognitive–behavioural intervention for menopausal hot flushes. British Journal of Health Psychology. Volume 1, Issue 2 Pages 113–125

  • Schoenberger, N. E., Kirsch, I., Gearan, P., Montgomery, G., & Pastyrnak, S. L. (1997). Hypnotic Enhancement of a Cognitive Behavioral Treatment for Public Speaking Anxiety. Behavior Therapy (28), 127-140.

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