Cognitive Behavioural Therapy (CBT) is a structured, goal oriented type of therapy that helps you identify and challenge unhelpful thoughts and feelings to bring out behaviour change to manage your problems.

How does it work?

Within a structured programme or with a therapist you’ll first identify and challenge negative thought patterns, replace them with balanced alternatives, and create actionable steps to foster lasting behaviour change.

How CBT Supports Menopause Symptoms: What NICE Now Recommends

The updated NICE guidelines* now recognise menopause‑specific CBT as an effective option for managing a range of menopause symptoms - not just mood, but physical symptoms too.

CBT for hot flushes and night sweats

NICE advises that CBT can be offered to help manage vasomotor symptoms such as hot flushes and night sweats. It can be used:

• Alongside HRT, or

• As an alternative when HRT isn’t suitable or isn’t preferred

This reflects strong evidence showing that CBT can reduce not only the symptoms themselves, but also how distressing and disruptive they feel.

CBT for sleep problems

Sleep disturbance is one of the most common menopause concerns, often made worse by night sweats. NICE highlights that menopause‑specific CBT - including CBT‑i approaches - can help women:

• Improve sleep quality

• Manage night‑time symptoms more effectively

• Develop healthier, more consistent sleep routines

CBT for anxiety and low mood

NICE continues to recommend CBT for emotional symptoms linked to menopause, including:

• Anxiety

• Low mood that doesn’t meet the threshold for clinical depression

• Situations where mood difficulties and vasomotor symptoms interact

CBT offers practical tools to help women feel more in control, improve resilience, and reduce the emotional impact of symptoms.

What else can it help me with?

• Memory and concentration (Brain fog)

• Stress

• Obsessive Compulsive Disorder (OCD)

• Mood changes and self-esteem

• Eating Disorders

• And much more

What are the benefits?

• Learn to identify and change negative thought patterns

• Gain practical tools to support your personal growth and menopause journey

• Boost self-esteem and confidence

• Improve emotional regulation and resilience

• Achieve long lasting positive effects

How long does it take CBT to be effective?

CBT is a short term therapy, typically lasting weeks to months, with significant improvements often seen in 6-8 sessions for mild conditions and 12-20 sessions for lasting effects, depending on the severity and session frequency.

BUT there can be:

• Long waiting times for CBT

• Limited availability of menopause‑specific CBT

HOWEVER, there is evidence to show the usefulness of online, group, or self‑help CBT based on the MENOS (Menopause-Optimising Symptoms) trials. The MENOS trials were a series of UK research studies that looked at how well menopause‑specific cognitive behavioural therapy (CBT) works for hot flushes and night sweats.

Researchers found that CBT can help women:

• Feel less bothered and overwhelmed by hot flushes and night sweats

• Sleep better

• Improve mood and emotional wellbeing

• Feel more in control of their symptoms

• Access support in different ways - including online, group sessions, or self‑help

These studies are the reason NICE now recommends CBT as an effective option for managing menopause symptoms, whether used on its own or alongside HRT.

Recommended reading:

An excellent self-help book to read is Living Well Through The Menopause: An evidence-based cognitive behavioural guide by Myra Hunter and Melanie Smith. This book helps you to learn practical behavioural and cognitive strategies to help you to manage any physical and/or emotional experiences that night occur and help you to to take a step back and take a broad perspective on this stage of life.

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