Hot flushes, a hallmark symptom of menopause, are more than just a temporary inconvenience—they're a significant disruption to daily life for many women. Understanding these episodes and finding effective coping strategies is essential to navigating menopause with confidence and ease.
One approach that has shown promise in managing hot flushes is Cognitive Behavioural Therapy (CBT).
Understanding Hot Flushes
Hot flushes, those sudden waves of intense heat that sweep over the body, are a hallmark symptom of menopause. They can manifest with symptoms like flushing, sweating, and a rapid heartbeat, often leaving women feeling uncomfortable and anxious. While the exact cause of hot flushes is complex and multifaceted, they're commonly associated with fluctuations in oestrogen levels during menopause.
On average, they persist for 7 years, but for some women, they can persist for much longer—way into post-menopause.
It's commonly believed that hot flushes coincide with a decline in oestrogen levels, which can occur at various stages of perimenopause, typically intensifying as oestrogen becomes consistently lower, especially in the later stages.
The severity of hot flushes may be exacerbated when oestrogen levels plummet rapidly, as seen in cases of surgical menopause or chemotherapy-induced menopause. Having said that, I've encountered many women with severe hot flushes who don't fall into these categories, highlighting the complexity of this phenomenon.
Oestrogen withdrawal can be compared to adjusting the thermostat on your central heating system; the range of temperatures that trigger hot flushes is significantly narrowed. This narrowed range, known as the thermoneutral zone, renders individuals more sensitive to noradrenaline and possibly cortisol.
In practical terms, this heightened sensitivity means that external triggers like stress, imbalanced blood sugar, coffee, and alcohol can more readily provoke hot flushes.
The Role of CBT
Cognitive Behavioural Therapy (CBT) is a therapeutic approach that explores the intricate connection between our thoughts, emotions, physical sensations, and behaviours. At its core, CBT aims to help individuals identify and challenge negative thought patterns that contribute to distressing symptoms, offering practical strategies to manage them effectively.
This can be effective because there is much more to a hot flush than the physiology. What happens can also depend on our behaviours, feelings, and thoughts.
Thoughts can powerfully influence how we feel and what we do.
The behaviours, thoughts, and feelings include:
I can't cope with this.
Everyone will notice.
People will wonder what's wrong with me.
This will never end.
It's not fair.
I'm over the hill.
If I talk now, I will just mess up and look incompetent!
Everyone can see me sweat and must think there's something wrong with me.
Diagram from BMS Group CBT training for menopausal symptoms
Depending on the environment, this sensation may intensify if one feels unable to openly address the situation or briefly pause to cool down or change clothing.
Consequently, women may start avoiding specific situations where they anticipate experiencing a hot flush, fearing embarrassment. Work environments often pose a particular challenge in this regard.
However, these apprehensions are often unfounded. Still, they may also lead to counterproductive coping mechanisms, such as prematurely exiting meetings.
What We Know Helps
1. Utilising breathing and relaxation techniques as soon as a hot flush begins.
2. Managing overall stress levels effectively.
3. Recognising the influence of thoughts and behavioural reactions.
4. Identifying and adjusting triggers that provoke hot flushes.
This is where CBT comes in.
Addressing Negative Thought Patterns
One of the primary objectives of CBT in managing hot flushes is to address negative thought patterns that exacerbate the experience.
Women often find themselves trapped in a cycle of catastrophising about the frequency or intensity of hot flushes, leading to increased stress and heightened symptom perception and often experience.
This thought process is totally understandable and natural.
Through CBT, individuals learn to reframe these thoughts, adopting different, hopefully more balanced and realistic perspectives that can reduce emotional distress and restore a sense of control.
Reducing the noradrenaline rush that can arise when stressed can help reduce the severity of the hot flushes and stress in general. Since mid-life can be stressful, women often look for ways to reduce stress and improve wellbeing. Cognitive behavioural therapy (CBT) is an approach that many women find very helpful.
Equipping with Coping Strategies
CBT is not just about the thought process involved. CBT equips women with an arsenal of coping strategies to manage the psychological distress associated with hot flushes.
Mindfulness techniques, relaxation exercises, and guided imagery are invaluable tools for cultivating calm and reducing physiological arousal—a key trigger for hot flushes. By incorporating these practices into their daily routine, women create a supportive internal environment that mitigates the impact of hot flushes on their overall wellbeing.
Fostering Resilience and Empowerment
Moreover, CBT empowers women to cultivate resilience and optimism in the face of menopausal challenges. By identifying and building upon their coping skills and resources, women develop a proactive mindset that enables them to confidently navigate menopause.
The Journey with CBT
Embarking on a CBT journey involves identifying unhelpful patterns of thinking and behaviour that contribute to menopausal symptoms. Over a series of sessions, typically spanning a few weeks, women learn to develop strategies to reduce negative thoughts and cultivate positive behaviours.
Diagram from BMS Group CBT training for menopausal symptoms
It can be particularly beneficial for those women who don't want to take HRT or who cannot take HRT for whatever reason.
Conclusion
CBT may not be for everyone; it requires time and commitment. However, the benefits extend beyond managing hot flushes—it equips women with life skills that endure long after the sessions.
I have seen how CBT can help not only management of hot flushes but also really change women's perspective on menopause. Assisting women to reclaim control over their lives. By fostering resilience, challenging negative thought patterns, and equipping with coping skills, CBT empowers women to embrace menopause with confidence, vitality, and a renewed sense of purpose.
I have completed a British Menopause Society training session on CBT for hot flushes, so I have added as an option for my 4 Month Take Control of Menopause package a CBT training session.
Should this appeal, please do message me or book here for a complimentary chat.
Please schedule a complimentary call with me to discuss your experiences. This conversation is an opportunity to explore your symptoms and the possible ways to manage them with absolutely no obligation. Remember, understanding and then addressing your symptoms is vital to finding relief and improving your daily life.
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