Institute of Psychiatry, Psychology and Neuroscience, King's College London, Guy's Campus, London, UK.
Climacteric. 2021 Feb;24(1):51-56. doi: 10.1080/13697137.2020.1777965. Epub 2020 Jul 6.
This article describes cognitive behavioral therapy (CBT) for women with problematic menopausal symptoms, and provides the evidence from clinical trials of women going through the menopause, women with breast cancer treatment-induced symptoms and women with problematic symptoms in a work context. The CBT focus is primarily on vasomotor symptoms (VMS) but it also targets stress, low mood and sleep problems. CBT is a brief therapy (four to six sessions) that is theory- and evidence-based; it is acceptable to women and effectively reduces the impact of VMS, improves sleep and has benefits to quality of life. VMS frequency is also reduced significantly in some trials but not others. CBT has been found to be consistently effective when delivered in groups, self-help book and on-line formats (with or without additional support). The MENOS 1 and MENOS 2 CBT protocols are recommended for the treatment of VMS by the North American Menopause Society (2015); CBT has been recommended for the treatment of anxiety and depression for women during the menopause transition and post menopause (NICE, 2015); and telephone CBT has been shown to be an effective treatment for insomnia.
本文描述了针对有问题的更年期症状的女性的认知行为疗法（CBT），并提供了针对处于更年期的女性、乳腺癌治疗引起症状的女性和工作环境中有问题症状的女性的临床试验证据。CBT 的重点主要是血管舒缩症状（VMS），但也针对压力、情绪低落和睡眠问题。CBT 是一种简短的疗法（四到六次疗程），基于理论和证据；它被女性接受，有效地减轻 VMS 的影响，改善睡眠，提高生活质量。在一些试验中，VMS 的频率也显著降低，但在其他试验中则没有。当以小组、自助书籍和在线格式（有或没有额外支持）提供时，CBT 被发现一直是有效的。北美更年期学会（2015 年）推荐 MENOS 1 和 MENOS 2 CBT 方案治疗 VMS；NICE（2015 年）建议 CBT 治疗更年期过渡和绝经后女性的焦虑和抑郁；电话 CBT 已被证明是治疗失眠的有效方法。
