BACKGROUND AND PURPOSE:

• Van Driel et al. (BJOG, 2018) assessed the effectiveness of psychological interventions, including mindfulness, in reducing menopausal symptoms, both natural or treatment-induced

METHODS:

• Systematic review and meta-analysis
  • RCTs
  • Participants were women with natural or treatment-induced menopause
  • Studies investigated the impact of
    • Cognitive behavioral therapy | Behavioral therapy | Mindfulness-based therapies
  • Menopausal symptoms
    • Combined level of burden including psychosocial symptoms (e.g. irritability, forgetfulness), physical symptoms (e.g. headaches), genital symptoms, sexual dysfunction and vasomotor symptoms (hot flushes and night sweats)
  • Follow up
    • Short-term: <20 weeks
    • Medium-term: ≥20 weeks
  • Primary outcomes
    • Frequency of hot flushes
    • Hot flush ‘bother’
    • Other menopausal symptoms
    • Sexual functioning
  • Subgroup analysis
    • Treatment-induced menopause: Exclusively breast cancer populations
    • Natural menopause

RESULTS:

• 12 RCTs
• Short-term benefit of psychological interventions in comparison to no treatment or control
  • Hot flush bother: Standardized mean difference (SMD) −0.54 (95% CI, −0.74 to −0.35; P < 0.001)
  • Menopausal symptoms: SMD −0.34 (95% CI, −0.52 to −0.15; P < 0.001)
• Medium-term benefit of psychological interventions in comparison to no treatment or control
  • Hot flush bother: SMD −0.38 (95% CI, −0.58 to −0.18; P < 0.001)
• Subgroup analysis of both treatment-induced menopause and natural menopause demonstrated positive short-term and medium-term benefit of psychological interventions
  • Short-term induced: SMD −0.47 (95% CI, −0.69 to −0.25; P < 0.001)
  • Short-term natural: SMD −0.85 (95% CI, −1.11 to −0.59; P < 0.001)
• Too few studies to report accurately regarding sexual functioning

CONCLUSION:

• Psychological treatments such as mindfulness successfully reduced bother of hot flushes in short- and medium-term follow- up, as well as menopausal symptoms overall in the short-term
• Because hot flush frequency was not impacted, authors suggest the mechanism of these interventions is to enhance coping skills and thus reduce impact of symptoms

Learn More – Primary Sources:

Mindfulness, cognitive behavioural and behaviour‐based therapy for natural and treatment‐induced menopausal symptoms: a systematic review and meta‐analysis

Related ObG Topics:

North American Menopause Society: Hormone Therapy Statement

Insomnia in Menopause: How do Treatments Compare?

Managing Sexual Concerns in Patients with Ovarian Cancer

What Hormone Profile is Associated with Hot Flashes?