Mindfulness, cognitive behavioural and behaviour-based therapy for natural and treatment-induced menopausal symptoms: a systematic review and meta-analysis.
Level 1 - systematic review of randomized trials
Systematic review and meta-analysis of randomised controlled trials
PubMed 29542222 · doi:10.1111/1471-0528.15153
What was done
Researchers conducted a systematic review and meta-analysis of randomized controlled trials (searched through June 2017 across Medline, PsycINFO, EMBASE, and AMED) evaluating mindfulness, cognitive behavioural therapy, or behaviour-based therapy for natural or treatment-induced menopausal symptoms compared to no treatment or control. Two independent reviewers extracted data and pooled outcomes using standardized mean differences (SMD). Primary outcomes included hot flush frequency, hot flush bother, general menopausal symptoms, and sexual functioning.
What was found
Across 12 included RCTs: - Short-term (<20 weeks) hot flush bother was significantly reduced: SMD -0.54 (95% CI -0.74 to -0.35, P < 0.001, I² = 18%). - Short-term general menopausal symptoms were significantly reduced: SMD -0.34 (95% CI -0.52 to -0.15, P < 0.001, I² = 0%). - Medium-term (≥20 weeks) hot flush bother remained significantly reduced: SMD -0.38 (95% CI -0.58 to -0.18, P < 0.001, I² = 16%). - Subgroup analyses confirmed hot flush bother reductions in both natural menopause and treatment-induced menopause (exclusively breast cancer populations). - Too few studies evaluated sexual functioning to allow meta-analysis, and numerical findings for hot flush frequency were not reported in the abstract.
Why it matters
Psychological interventions provide an effective non-hormonal treatment option for hot flush bother and menopausal symptoms, offering a crucial alternative for breast cancer survivors for whom hormone replacement therapy is contraindicated.
Limits
Total participant sample size across the 12 trials and quantitative effect sizes for hot flush frequency are omitted from the abstract. Too few studies reported on sexual functioning to determine efficacy on psychosexual symptoms, and long-term durability beyond medium-term follow-up was not established.
Cited by
- supports Studies show that cognitive behavioral therapy produces decent results for treating hot flashes.