A review of research suggests that meditation, yoga and talk therapies could be used alongside HRT to help relieve menopause symptoms.
Alternative therapies have been shown to be effective in relieving symptoms related to mood, memory, and concentration problems in women going through menopause.
While hormone replacement therapy (HRT) remains the gold standard, doctors should consider suggesting it along with pills and patches, experts said.
They suggest they could also be offered as an alternative for women who refuse to take the drug.
Researchers at University College London conducted an analysis of 30 studies involving 3,501 women from 14 countries, including the United Kingdom and the United States.
A review of research found that alternative therapies were effective in relieving symptoms related to mood, memory, and concentration problems in women going through menopause. While hormone replacement therapy (HRT) remains the gold standard, doctors should consider suggesting it along with pills and patches. They could also be offered as an alternative for women who refuse to take the drug, they suggest.
They found that mindfulness and cognitive behavioral therapy (CBT) can offer some relief, with a small to medium effect on symptoms.
Ten of the studies explored the impact of CBT on menopausal symptoms, while nine looked at mindfulness, a type of meditation in which people focus on being intensely aware of what they are feeling at the moment.
Other studies looked at a variety of interventions, including those based on acceptance, group counseling, and marriage support.
The women’s symptoms were measured using internationally recognized questionnaires and included lack of interest in doing things, problems sleeping, low mood and anxiety.
The findings found that women’s low mood “benefited significantly” from CBT and mindfulness.
Data from 11 studies showed a small to medium effect in terms of improving anxiety, the researchers said, which equates to some relief of symptoms, although they would not disappear completely.
Individually, CBT had a small effect on anxiety, while mindfulness had a medium effect, according to findings published in the Journal of Affective Disorders.
When it came to depression, CBT had a small to medium effect, while mindfulness had a small effect.
Overall, both interventions offered a medium to large effect on improving quality of life.
A small improvement was found in memory and concentration, although the researchers acknowledged that the data in this area was weak, although it was also unclear how long the effects might last in women.
Lead author Professor Aimee Spector said there was some evidence that mindfulness could be offered alongside HRT to women, adding that some NHS trusts already offer it for depression.
She said: ‘The message we want to make really clear is that with this we are in no way suggesting this as an alternative or recommending this instead of HRT.
‘My personal experience with HRT has been extremely positive.
“I think what we know is that HRT doesn’t reach everyone and not everyone wants it, and not everyone is eligible to receive it, so we need to consider other things.”
Using the therapies could be beneficial for groups of women for whom HRT is not recommended, such as breast cancer survivors, she said.
Certain ethnic groups, such as Southeast Asian and Afro-Caribbean populations, have lower acceptance, while those who are socially disadvantaged often do not have access to HRT.
He added: ‘So I think our message is that having holistic interventions can provide options for people who may not be eligible, don’t want HRT, possibly as an adjunct to HRT, and can support the psychosocial aspects as well as the biological aspects.’
About three in ten women going through menopause have a first depressive episode, anxiety is “highly prevalent” and half of women report tension, nervousness or irritability, they found.
It comes after draft guidance from the National Institute for Health and Care Excellence (Nice) recommended the use of talk therapy for menopause, while women should be given a better understanding of the risks and benefits of HRT.
HRT replaces the hormones estrogen, progestin, or both, and can be administered via gels, creams, pessaries, tablets, or sprays.
The risk of developing serious side effects with HRT is very low according to the NHS website, although it may cause a small increase in the risk of breast cancer.
Dr Louise Newson, GP and menopause specialist, said it was not surprising that the new study had found some improvements after mindfulness and CBT, but that “it is important to remember that menopause is due to a deficiency hormone that affects the entire body.
He said this deficiency leads many women to experience physical and psychological symptoms, while long-term health risks associated with low hormone levels include an increased risk of heart disease, dementia, diabetes, clinical depression, schizophrenia, osteoporosis and early death.
She said: “The first-line treatment of perimenopause and menopause for most women is to replace missing hormones by prescribing the correct dose and type of HRT.”
