NHS should offer women therapy for the menopause, new guidance says
Cognitive behavioural therapy can help ease physical symptoms of the menopause including night sweats and hot flushes, it has been revealed.
Friday 17 November 2023 01:11, UK
Women should be offered therapy on the NHS to help ease the symptoms of the menopause, according to new guidance.
Cognitive behavioural therapy (CBT) is commonly used to help mental health issues but it can also reduce menopausal symptoms such as hot flushes and night sweats, the National Institute for Health and Care Excellence (NICE) has said.
The watchdog has recommended that CBT should be offered alongside, or instead of, hormone replacement therapy (HRT).
Women should also have a better understanding of the risks and benefits of HRT, according to NICE, in order to make informed decisions about their care.
Menopause is a natural part of ageing and usually happens between the ages of 45 and 55.
HRT replaces the hormones the body produces - either oestrogen, progesterone or both - and comes in forms such as gels, pessaries, tablets and sprays.
NHS England has said serious side effects from HRT are rare but it has been linked to an increase in risk of blood clots and strokes, as well as breast cancer and dementia in those over 65.
The new guidance says patients should be offered face-to-face or online therapy, group sessions and additional advice on self-help.
Professor Jonathan Benger, chief medical officer at NICE, said: "The impact of menopause symptoms on quality of life can vary hugely.
"It is important that healthcare practitioners take a personalised approach when discussing treatments, using evidence-based information tailored to individuals' circumstances."
NICE's menopause guidance has not been updated since 2015 and evidence around HRT has become clearer since, they said.
The update has not gone down well with everyone and GP and menopause specialist Dr Louise Newson said the document "is a disappointing draft update".
"We must address the long-term health risks of low hormones," she said.
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"There is good quality, established evidence about the protective effects of HRT in relation to osteoporosis, heart disease, clinical depression and colon cancer, and there is emerging evidence around dementia risk also being reduced.
"These are ignored in this document, and the perceived risks of breast cancer stated in these draft recommendations are not based on good quality evidence."
The draft guidance is open to public consultation until 5 January 2024.