Posts

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

New Study (1)Abstract

OBJECTIVE:

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.

METHODS:

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.

RESULTS:

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.

CONCLUSIONS:

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.

CBT Reduces Menopausal Symptoms Following Breast Cancer Treatment

According to a recent study published in The Lancet, CBT can help reduce menopausal symptoms among women following breast cancer treatment. Menopausal symptoms such as hot flushes and night sweats are fairly prevalent among female breast cancer patients (65-85%) following treatment.  In the current study, researchers sought to determine whether CBT can help breast cancer patients effectively manage menopausal symptoms. Participants included 96 women recruited from breast clinics in London, UK. They were randomly assigned to received either group CBT (90-minute weekly sessions for 6 weeks) or usual care. Assessments were conducted at baseline, 9 weeks, and 26 weeks following intervention. At the 9 week follow up, CBT significantly reduced menopausal symptoms, improved mood, sleep, and quality of life among group CBT participants. These results were maintained at 26 weeks. These findings suggest that incorporating CBT into breast cancer programs may be beneficial to breast cancer survivors with problematic menopausal symptoms.

Mann, E., Smith, M. J., Hellier, J., Balabanovic, J. A., Hamed, H., Grunfeld, E. A., & Hunter, M. S. (2012). Cognitive behavioural treatment for women who have menopausal symptoms after breast cancer treatment (MENOS 1): a randomised controlled trial. Lancet Oncology, 13, 3, 309-318.