NEW guidance recommends that women experiencing menopausal symptoms, like night sweats and hot flushes, should be provided therapy on the NHS to alleviate their symptoms.
The National Institute for Health and Care Excellence (NICE) suggests that Cognitive Behavioural Therapy (CBT), commonly used for mental health issues, can effectively reduce menopausal symptoms, including hot flushes and night sweats.
NICE suggests that CBT should be considered as an option either alongside or instead of hormone replacement therapy (HRT).
The guidance highlights the importance of women having a clear understanding of the risks and benefits associated with HRT to make informed decisions about their care.
Menopause, a natural part of aging occurring typically between the ages of 45 and 55, varies among women.
Caroline Nokes, chair of the Commons’ women and equalities committee, welcomed the new guidance, stressing that there is no one-size-fits-all solution for women going through menopause.
She cautions against using these recommendations to dismiss women still facing drug shortages, recalling a major HRT drug shortage last year that led to restrictions and forced some women to resort to alternative sources.
Nokes called for the reinstatement of an HRT tsar, saying there were still problems with the drug Estradot.
“I very much welcome any offer of CBT which could help alleviate the worst challenges of the menopause. But it cannot be instead of having a focus on the ongoing challenges with HRT supply,” she said.
While serious side effects from HRT are rare, NHS England acknowledges links to increased risks of blood clots, strokes, breast cancer, and dementia in individuals over 65.
The new guidance suggests offering patients face-to-face or online therapy, group sessions, and additional self-help advice.
Prof Kamila Hawthorne, chair of the Royal College of GPs, said: “It’s always helpful for GPs to have access to a range of potential treatments and interventions to help women manage menopause.
“HRT has been shown to be safe and effective for some women, but it isn’t suitable for everyone, and it’s good to see Nice exploring other options, that evidence suggests may be of benefit, such as CBT.”
Despite some increased risks associated with HRT, NICE clarifies that it is unlikely to increase or decrease overall life expectancy.
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.”
For the first time, the draft guidelines explicitly cover trans men and non-binary individuals registered female at birth, expanding beyond the 2015 guidance that focused solely on women experiencing menopausal symptoms.
NICE recommends further research on menopause treatment for those who previously underwent gender-affirming hormone therapy due to a lack of evidence on its effects.
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