The evidence for using CBT to treat menopause-related symptoms
Recent clinical practice guidelines and systematic reviews
The evidence for cognitive behavioural therapy (CBT) for management of vasomotor symptoms (VMS) of menopause
CBT is an evidence-based intervention for management of vasomotor symptoms (including hot flashes and night sweats) associated with menopause. Below is a selection of a few recent clinical practice guidelines and systematic reviews related to the use of cognitive behavioural therapy for management of menopause symptoms.
Clinical Practice Guidelines and Position Statements
European Society of Endocrinology Clinical Practice Guideline for Evaluation and Management of Menopause and the Perimenopause (2025)
"Cognitive behavioural therapy has high quality evidence from multiple RCTs supporting its use for menopause, so provides an alternative where women are unable to have pharmacological treatment."
NICE Guidelines 23 - Menopause: identification and management (2024)
"Recommendation 1.5.2: Consider menopause-specific cognitive behavioural therapy (CBT) as an option for vasomotor symptoms associated with menopause: in addition to HRT; or for people for whom HRT is contraindicated; or for those who prefer not to take HRT."
"Recommendation 1.5.23: Consider menopause-specific CBT as an option for people who have sleep problems (such as night-time awakening) in association with vasomotor symptoms: in addition to other management options (including HRT); or for people for whom other options are contraindicated; or for people who prefer not to try other options."
NICE Guideline 23, "Menopause: identification and management," updated November 2024
The 2023 non hormone therapy position statement of The North American Menopause Society (NAMS)
"The body of literature as a whole supports that CBT alleviates bothersome VMS for both survivors of breast cancer and menopausal women. Level I; recommended."
The 2023 non hormone therapy position statement of The North American Menopause Society, p. 576
Systematic Reviews
Cognitive behavioural therapy for menopausal symptoms: a systematic review of efficacy in improving quality of life (2025)
"Group-based CBT yielded the most substantial benefits, while self-help modalities showed moderate but meaningful improvements. The findings underscore CBT’s role as a viable non-pharmacological intervention for menopausal symptom management. This is particularly valuable where hormone replacement therapy is contraindicated or declined."
Efficacy of cognitive therapy and behavior therapy for menopausal symptoms: a systematic review and meta-analysis (2022)
"These findings provide support for treatment guidelines recommending cognitive therapy and behavior therapy (CTBT) as a treatment option for menopausal symptoms."