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Impact of behaviour on alleviating menopausal symptoms

For the first time, researchers have developed a behavioural measure of strategies used by women to deal with menopausal Hot Flushes (HF) and Night Sweats (NS). The study could help better understand the relationship between cognitions and behaviours in HF/NS experience, potentially leading the way towards developing future psychological interventions for HF/NS.

In recent years, there has been an increased focus in providing non-medical treatments for menopausal HF/NS and there has been some evidence that cognitive behavioural interventions can reduce the impact of HF/NS. However, the Institute of Psychiatry King's College London is one of the main centres developing cognitive behavioural interventions, and focusing on the behavioural component of HF/NS, an area until now relatively under-researched.

The importance of psychosocial and cultural factors in women’s experiences of menopausal symptoms is now well known, and previous studies have revealed discrepancies between the subjective experience and objective physiological measures of HF/NS. Furthermore, previous research published in May 2011, also by a research group at the Institute of Psychiatry, showed that women’s concerns about experiencing HF in a work setting were not supported by the views of their colleagues who generally expressed empathy and support.

HF/NS are common and not problematic for many women but for an estimated 20-25% they cause embarrassment, sleep problems and distress. They are now widely considered a physiological event moderated by a range of cognitive, emotional, and behavioural processes, which include, for example, women’s general beliefs about the menopause and HF/NS as well as their awareness of the stereotypes associated with the menopause in Western cultures.

The study which is due to be published on 30th June, reviews  evidence from 140 women’s reports of HF/NS according to three scales measuring problem rating and frequency of symptoms, individual beliefs about HF/NS as well as behavioural reactions. The research suggests that some behaviours might be helpful and others less helpful in dealing with HF/NS.

Lead author Myra Hunter, Professor of Clinical Health Psychology at the Institute of Psychiatry, King’s College London, said: 'This study suggests that avoidance behaviour, particularly social avoidance, might reinforce the beliefs that HF have negative social consequences, despite recent evidence, that, in reality, this is unlikely to be the case.'

The study found that cooling behaviours, such as the use of fans, wipes and water, were associated with more frequent and problematic symptoms, suggesting that implementing preventative or avoidance behaviours could in fact be counterproductive. The researchers explain that this type of behaviour may focus attention on the symptoms, encourage negative appraisals and reduce the opportunity for the development of alternative, more neutral interpretations, hence maintaining stress and negative beliefs.

Professor Hunter concludes:  'Positive strategies, including carrying on and ignoring HF/NS, using breathing and relaxation, and using humour are associated with more positive beliefs and less problematic HF/NS. These strategies are encouraged in cognitive behavioural interventions.'

The study was funded by the National Institute for Health Research Biomedical Research Centre for Mental Health at King's College London and South London and Maudsley NHS Foundation Trust.

For full paper:

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