Skip to main content

Advertisement

SpringerLink
Log in

Cognitive–behavioral group treatment for menopausal symptoms: a pilot study

  • Short Communication
  • Published:
Archives of Women's Mental Health Aims and scope Submit manuscript

Abstract

The menopausal transition is frequently accompanied by adverse physical and emotional changes that can significantly impact a woman’s quality of life. Hormone replacement therapy has been the most commonly used menopause-related treatment to date, particularly for the alleviation of vasomotor symptoms; recent studies, however, have questioned its long-term safety for some women. We aimed to develop a cognitive–behavioral group treatment (CBGT) program as an alternative or complementary treatment option for reducing the frequency and intensity of debilitating menopausal symptoms in midlife women. Eight subjects participated in two, 10-week pilot groups (n = 4 participants per group) with participants being drawn from referrals through the Women’s Health Concerns Clinic and community advertising efforts. This pilot study confirmed a reduction in the frequency and interference associated with vasomotor symptoms, less depression and general anxiety, and an overall improvement in quality of life. Participants also reported high levels of satisfaction with this type of treatment for menopausal symptoms. Furthermore, there was a trend towards a reduction in sleep difficulties and sexual concerns over the course of treatment. This pilot CBGT program appears to be a promising alternative or complementary treatment for both the physical and emotional symptoms experienced during menopause. Further studies are needed on its efficacy through larger, controlled trials.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

References

  • Allen LA, Dobkin RD, Boohar EM, Woolfolk RL (2006) Cognitive behavior therapy for menopausal hot flashes: two case reports. Maturitas 54:95–99

    Article  PubMed  Google Scholar 

  • Avis NE, Crawford SL, McKinlay SM (1997) Psychological behavioural, and health factors related to menopause symptomatology. Womens Health 3:103–120

    Google Scholar 

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

    Article  PubMed  Google Scholar 

  • Barlow DH (1990) Long-term outcome for patients with panic disorder treated with cognitive–behavioural therapy. J Clin Psychiat 51:17–23

    Google Scholar 

  • Bieling PJ, McCabe RE, Antony MM (2006) Cognitive behavioral therapy in groups. Guilford, New York

    Google Scholar 

  • Bo K, Hagen RH, Kvarstein B, Jorgensen J, Laresen S, (1990) Pelvic floor muscle exercise for the treatment of female stress urinary incontinence: III. Effects of two different degress of pelvic floor muscle exercises. Neurourol Urodynam 9:489–502

    Google Scholar 

  • Bromberger JT, Kravitz HM, Chang Y, Cyranowski JM, Brown C, Matthews KA (2011) Major depression during and after the menopausal transition: Study of Women’s Health Across the Nation (SWAN). Psychol Med 41:1879–1888

    Article  PubMed  CAS  Google Scholar 

  • Buysse DJ, Reynolds CF, Monk TH, Berman SR, Kupfer DJ (1989) The Pittsburgh Sleep Quality Index: a new instrument for psychiatric practice and research. Psychiatr Res 28:193–213

    Article  CAS  Google Scholar 

  • Carpenter JS, Andrykowski MA, Freedman RR, Munn R (1999) Feasibility and psychometrics of an ambulatory hot flash monitoring device. Menopause 6:209–215

    Article  PubMed  CAS  Google Scholar 

  • Cohen LS, Soares CN, Vitonis AF, Otto MW, Harlow BL (2006) Risk for new onset of depression during the menopausal transition: the harvard study of moods and cycles. Arch Gen Psychiat 63:385–390

    Google Scholar 

  • Dennerstein L, Dudley EC, Hopper JL, Guthrie JR, Burger HG (2000) A prospective population-based study of menopausal symptoms. Obstet Gynecol 96:351–358

    Google Scholar 

  • DeRubeis RJ, Crits-Christoph P (1989) Empirically supported individual and group psychological treatment for adult mental disorders. J Consult Clin Psychol 66:37–52

    Google Scholar 

  • Desindes S, Belisle S, Graves G (2006) Canadian Consensus Conference on Menopause. J Obstet Gynecol Can 28:S21–S32

    Google Scholar 

  • Dobson KS (1989) A meta-analysis of the efficacy of cognitive therapy of depression. J Consult Clin Psychol 15:862–869

    Google Scholar 

  • Eichling PS (2002) Evaluating and treating menopausal sleep problems. Menopause Management 11:8–17

    Google Scholar 

  • First MB, Spitzer RC, Gibbon M, Williams JBW (2002) Structured Clinical Interview for DSM IV-TR Axis I Disorders—Patient Edition (SCID I/P, 11/2002 revision). Biometrics Research Department, New York

    Google Scholar 

  • Freedman RR, Woodward S (1992) Behavioral treatment of menopausal hot flushes:evaluation by ambulatory monitoring. Am J Obstet Gynecol 167:436–439

    Article  PubMed  CAS  Google Scholar 

  • Germaine LM, Freedman RR (1984) Behavioral treatment of menopausal hot flashes: evaluation by objective measures. J Consult Clin Psychol 52:1072–1079

    Article  PubMed  CAS  Google Scholar 

  • Green SM, McCabe RE, Soares CN (2012) The cognitive behavioral workbook for menopause: a step by step program for overcoming hot flashes, mood swings, insomnia, depression, anxiety, and other symptoms. New Harbinger Publishers, Oakland

    Google Scholar 

  • Greene JG (1998) Constructing a standard climacteric scale. Maturitas 29:25–31

    Article  PubMed  CAS  Google Scholar 

  • Hamilton M (1959) The assessment of anxiety states by rating. Br J Med Psychol 32:50–55

    Article  PubMed  CAS  Google Scholar 

  • Hilditch, J. R., & Lewis, J. (1992) The menopause-specific quality of life questionnaire. Primary Care Research Unit Department of Family and Community Medicine, Sunnybrook Health Science Centre, University of Toronto

  • Hunter MS, Liao KLM (1996) Evaluation of a four session cognitive–behavioural intervention for menopausal hot flashes. Br J Heal Psychol 1:113–125

    Article  Google Scholar 

  • Hunter MS, O’Dea I (1999) An evaluation of a health education intervention for mid-aged women: five-year follow-up of effects upon knowledge, impact of menopause and health. Patient Educ Couns 37:249–255

    Article  Google Scholar 

  • Irvin JH, Domar AD, Clark C, Zuttermeister PC, Friedman R (1996) The effects of relaxation response training on menopausal symptoms. Psychosom Obstet Gynecol 17:202–207

    Article  CAS  Google Scholar 

  • Keefer L, Blanchard EB (2005) A behavioral group treatment program for menopausal hot flashes: results of a pilot study. Appl Psychophysiol Biofeedback 30:21–30

    Article  PubMed  Google Scholar 

  • Kronenberg F, Barnard RM (1992) Modulation of menopausal hot flashes by ambient temperature. J Therm Biol 17:43–49

    Article  Google Scholar 

  • Kronenberg F, Fugh-Berman A (2002) Complementary and alternative medicine for menopausal symptoms: a review of randomized, controlled trials. Ann Intern Med 137:805–813

    Article  PubMed  Google Scholar 

  • Larsen DL, Attkisson CC, Hargreaves WA, Nguyen TD (1979) Assessment of client/patient satisfaction: development of a general scale. Eval Program Plann 2:197–207

    Article  PubMed  CAS  Google Scholar 

  • LeVois ME, Nguyen TD, Attkisson CC (1981) Artifact in client satisfaction research: experience in community mental health settings. Eval Program Plann 4:139–150

    Article  PubMed  CAS  Google Scholar 

  • Maartens LW, Knottnerus JA, Pop VJ (2002) Menopausal transition and increased depressive symptomatology: a community based prospective study. Maturitas 42:195–200

    Google Scholar 

  • Mann E, Hunter MS (2011) Concordance between self-reported and sternal skin conductance measures of hot flushes in symptomatic perimenopausal and postmenopausal women: a systematic review. Menopause 18:709–722

    Article  PubMed  Google Scholar 

  • Matthews KA, Wing RR, Kuller LH, Meilahn EN, Owens JF (2000) Menopause as a turning point in midlife. In: Manuck SB, Jennings R, Rabin BS, Baum A (eds) Behavior, health, and aging. Lawrence Erlbaum, London, pp 43–57

    Google Scholar 

  • McFarland B, Bigelow D, Zani B, Newsom J, Kaplan M (2002) Complementary and alternative medicine use in Canada and the United States. Am J Publ Health 92:1616–1618

    Article  Google Scholar 

  • Montgomery SA, Asberg M (1979) A new depression scale designed to be sensitive to change. Br J Psychiatry 134:382–389

    Article  PubMed  CAS  Google Scholar 

  • Morley S, Eccleston C, Williams A (1999) Systematic review and meta-analysis of randomized controlled trials of cognitive behaviour therapy and behaviour therapy for chronic pain in adults, excluding headaches. Pain 80:1–13

    Article  PubMed  CAS  Google Scholar 

  • Reynolds F (2002) Exploring self-image during hot flashes using a semantic differential scale: associations between poor self-image, depression, flash frequency and flash distress. Maturitas 42:201–207

    Article  PubMed  Google Scholar 

  • Soules MR, Sherman S, Parrot E, Rebar R, Santoro N, Utian W et al (2001) Executive summary (Stages of Reproductive Aging Workshop (STRAW). Fertil Steril 76:874–878

    Article  PubMed  CAS  Google Scholar 

  • Statistics Canada. (2005a). Population by sex and age group as of July 1st, 2005. Statistics Canada, Ottawa. http://www40.statcan.ca/101/cs01/demo10a.htm

  • Statistics Canada (2005b). Population projections for 2001, 2006, 2011, 2016, 2021 and 2026, at July 1. Based on2000 population estimates. Statistics Canada, Ottawa. http://www40.statcan.ca/101/cst01/demo23a.htm

  • Suvanto-Luukkonen E, Koivunen R, Sundstrom H, Bloigur R, Karjalainen E, Haiva-Mallinen L, Tapanainen JS (2005) Citalopram and fluoxetine in the treatment of postmenopausal symptoms: a prospective, randomized 9-month, placebo-controlled, double-blind study. Menopause 12:18–26

    Article  PubMed  Google Scholar 

  • Utian WH, Janata JW, Kingsberg SA, Schluchter M, Hamilton JC (2002) The Utian Quality of Life (UQOL) Scale: development and validation of an instrument to quantify quality of life through and beyond menopause. Menopause 9:402–410

    Article  PubMed  Google Scholar 

  • van Geelen JM, van de Weijer PH, Arnolds HT (1996) Urogenital verschijnselen en hinder daarvan bij thuiswonende Nederlandse vrouwen van 50–75 jaar (Urogenital symptoms and resulting discomfort in non-institutionalized Dutch women aged 50 to 75 years). Ned Tijdschr Genesk 140:713–716

    Google Scholar 

  • Wijma K, Melin A, Nedstrand E, Hammar M (1997) Treatment of menopausal symptoms with applied relaxation: a pilot study. J Behav Ther Exp Psychiatry 28:251–261

    Article  PubMed  CAS  Google Scholar 

  • Writing Group for the Women’s Health Initiative Investigators (2002) Risks and benefits of estrogen plus progestin in healthy postmenopausal women: principal results from the Women’s Health Initiative randomized controlled trial. JAMA 288:321–333

    Article  Google Scholar 

  • Zollner YF, Acquadro C, Schaefer M (2005) Literature review of instruments to assess health-related quality of life during and after menopause. Qual Life Res 14:309–327

    Article  PubMed  CAS  Google Scholar 

Download references

Acknowledgments

This research was funded in part by a Novice Researcher Grant awarded to Dr. Sheryl Green through the Father Sean O’Sullivan Research Centre, St. Joseph’s Healthcare Hamilton, ON, and an Alternative Funding Plan grant awarded to Drs. Soares, Green, and McCabe, through the Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON.

Conflicts of interest

None

Author information

Authors and Affiliations

  1. Department of Psychiatry and Behavioural Neurosciences, McMaster University and Women’s Health Concerns Clinic, St. Joseph’s Healthcare, Hamilton, Ontario, Canada

    Sheryl M. Green

  2. Women’s Health Concerns Clinic, St. Joseph’s Healthcare, Hamilton, Ontario, Canada

    Erika Haber & Claudio N. Soares

  3. Department of Psychiatry and Behavioural Neurosciences, McMaster University and Anxiety Treatment and Research Centre, St. Joseph’s Healthcare, Hamilton, Ontario, Canada

    Randi E. McCabe

Authors
  1. Sheryl M. Green
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Erika Haber
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Randi E. McCabe
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Claudio N. Soares
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Sheryl M. Green.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Green, S.M., Haber, E., McCabe, R.E. et al. Cognitive–behavioral group treatment for menopausal symptoms: a pilot study. Arch Womens Ment Health 16, 325–332 (2013). https://doi.org/10.1007/s00737-013-0339-x

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00737-013-0339-x

Keywords

Search

Navigation