Efficacy of cognitive therapy and behavior therapy for menopausal symptoms: a systematic review and meta-analysis.
Level 1 - systematic review of randomized trials
Systematic review and meta-analysis of randomized controlled trials
PubMed 35199638 · doi:10.1017/S0033291721005407
What was done
A systematic review and meta-analysis of randomized controlled trials (RCTs) searched across Cochrane Library, EMBASE, PsycINFO, PubMed, and Web of Science up to November 1, 2021. The review evaluated cognitive therapy and behavior therapy (CTBT) compared to control conditions for menopausal symptoms. Standardized between-group effect sizes (Hedges' g) were pooled using random-effects models.
What was found
Across 14 RCTs comprising 1,618 participants (mean trial sample size of 116), CTBT significantly outperformed control conditions for hot flushes (Hedges' g = 0.39, 95% CI 0.23–0.55, I² = 45%), depression (g = 0.50, 95% CI 0.34–0.66, I² = 51%), and anxiety (g = 0.38, 95% CI 0.23–0.54, I² = 49%). Significant improvements were also reported for night sweats, fatigue, and quality of life, but exact point estimates and confidence intervals for these outcomes were not reported in the abstract. Egger's test showed no evidence of publication bias. Efficacy was stronger for natural menopause than treatment-induced menopause, and benefits persisted long-term despite some attenuation over time.
Why it matters
This review provides quantitative evidence supporting non-pharmacological cognitive and behavioral interventions for managing vasomotor and psychological menopausal symptoms, reinforcing current guideline recommendations.
Limits
The abstract omits quantitative effect estimates and confidence intervals for night sweats, fatigue, quality of life, subgroup comparisons, and long-term durability metrics. Heterogeneity across reported outcomes was moderate (I² = 45–51%), individual trial sizes were relatively small (mean n = 116), and the exact nature of the comparator arms (active vs. passive controls) is not specified in the abstract.
Cited by
- supports Studies show that cognitive behavioral therapy produces decent results for treating hot flashes.