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You may have heard of cognitive behavioral therapy (CBT). It’s a treatment approach that’s well known for helping people successfully manage mental health conditions like depression and anxiety.

CBT can also be helpful for people experiencing symptoms of menopause. Menopause can cause both anxiety and depression, as well as other psychological and physiological symptoms.

During CBT, people going through menopause learn different techniques to help them cope with daily life stressors. People learn to adopt healthy coping skills and modify harmful or destructive behaviors.

Keep reading to learn more about CBT techniques for menopause, and how you can use them in your life.

The theory behind CBT is that your thoughts, emotions, and actions are all connected, and that your thoughts and emotions can shape your actions.

When you participate in CBT, you learn to identify negative or harmful thoughts so you can see how they affect the choices you make. When you’re able to recognize negative thought patterns when they occur, you can begin to change your behavior.

According to the American Psychological Association, the three core principles of CBT are:

  1. Mental health challenges are partially rooted in unhealthy ways of thinking.
  2. Mental health challenges are partially based on unhealthy behavioral patterns.
  3. If you live with mental illness, you can learn healthier ways to cope with challenges, which may help relieve your symptoms.

Most therapists and psychologists are trained in CBT, but some specialize in it. CBT for menopause is a fairly short-term commitment; four to six sessions is pretty typical. Or, if you prefer, you can take a self-guided approach.

If you’re already dealing with troublesome or disruptive symptoms of menopause, you may want to just cut to the chase and see whether CBT is going to make those symptoms better.

Here’s what the evidence suggests about CBT for menopause:

Hot flashes

Ask anyone who’s gone through menopause, and they’ll be sure to mention hot flashes.

Vasomotor symptoms are quite common in people with menopause. Suddenly, you’re nearly overcome by a sensation of intense warmth. Hot flashes can occur during the day or wake you up at night, a phenomenon also known as night sweats.

According to a 2019 research review, 85% of women experience hot flashes during menopause. Researchers report hot flashes can cause considerable distress.

But CBT may be able to help you cope with that distress.

A 2018 study found that an unguided version of CBT helped people manage problematic hot flashes and night sweats (HFNS). Researchers recruited 124 women who experienced at least 10 episodes of HFNS per week for a randomized controlled trial. They provided one group of participants with a booklet full of information about self-guided CBT techniques.

The booklet contained information about behaviors that could help the women cope with their symptoms at work. These techniques included breathing and relaxation exercises, along with other behavioral strategies.

The women who used the booklet experienced a reduction in their symptoms, resulting in an improved sense of well-being.

Depression and anxiety

The unexpected appearance of menopausal vasomotor symptoms can take a toll on your mood and cause a lot of anxiety. Plus, some people are more prone to depression during the menopausal transition, according to the British Menopause Society.

Research suggests that women who embrace CBT may experience some relief from symptoms of depression and anxiety. This may be due to CBT’s role in breaking negative thought patterns. Negative thought patterns around menopause and aging can sometimes contribute to depressed mood and low self-esteem.

Sleeping difficulties

Having trouble getting quality sleep? You’re not alone.

Sleep disruptions affect many people during perimenopause and menopause. Sometimes, it’s the result of stress, and sometimes it’s the result of other menopausal symptoms that make it harder to sleep well. Depression and anxiety can also affect sleep.

Research shows that CBT helps many women sleep better during the menopausal transition.

There are a number of different types of CBT techniques that you might be interested in trying.

You can start with cognitive techniques, such as:

  • paying attention to your thoughts and your thought patterns
  • identifying negative or unhelpful thoughts when they occur
  • deciding whether your thoughts are accurate or off base
  • replacing your negative thoughts with more realistic ones

As you learn to change your ways of thinking, you can begin to recognize distortions that may be causing problems. You may also gain a better understanding of other people’s motives and behaviors, and gain more confidence in your ability to cope with challenges.

Then you can move on to behavioral techniques. You can work on changing the actions you take when negative thought patterns arise. You can try:

  • practicing alternative coping strategies
  • calming your mind and body when you begin to get upset
  • practicing your response to scenarios that might happen
  • learning to face your fears rather than avoid them

A therapist might suggest that you try journaling or recording your thoughts so you can revisit them later and look for patterns.

You can also practice replacing the negative or self-critical thoughts with more useful, constructive thoughts, and then brainstorming actions that you could take once you’ve changed your way of thinking. Just as with any skill, it may take some practice.

Here’s an example of how you might approach a sudden hot flash:

You feel the heat flooding your face and your neck. Your instinct is to feel embarrassed and worry that everyone is looking at you and wondering what’s going on. But you recognize that unhelpful thought and decide to reframe it with a more positive one.

You reassure yourself that it’s unlikely that anyone is paying that close attention to you. You remind yourself that the hot flash is temporary and will be over soon. You consciously employ some deep breathing techniques to help you feel calmer and less agitated.

You may feel that CBT is worth a try, especially since it’s noninvasive and won’t cause any side effects or potentially harmful interactions with any medications you may be taking.

You can make a number of behavioral changes that can help you cope better with the symptoms of menopause and the impact they have on your life.

But CBT is not the only way to treat menopause symptoms. Other treatments options include:


Some people have turned to the antidepressant paroxetine, a selective serotonin reuptake inhibitor (SSRI), to help them manage their menopausal hot flashes and night sweats. Some people find that SSRIs can help them better manage symptoms of anxiety and depression.

However, some people experience sexual side effects from SSRI therapy. These people may have more success with non-SSRI antidepressants, such as bupropion (Wellbutrin) or duloxetine (Cymbalta).

Hormone replacement therapy

Hormone replacement therapy (HRT) is another option to consider for managing moderate to severe menopause symptoms like hot flashes.

Some people use estrogen alone, while others use a combination of estrogen and progestin. However, HRT is not recommended for everyone. Additionally, HRT should not be used for more than 5 years.

Your doctor can discuss whether HRT is a safe option for you.


Doctors sometimes prescribe an anticonvulsant medication known as gabapentin for hot flashes, especially the nocturnal kind.

Vaginal lubricants and moisturizers

Sexual discomfort is another common occurrence for people going through menopause (and even afterward). Changes in hormone levels can cause vaginal dryness, which can make sex uncomfortable or even painful.

A vaginal lubricant or moisturizer can reduce some dryness and the ensuing discomfort. Many are available over the counter, so you don’t have to get a prescription to give them a try.

Check out our picks for the best vaginal moisturizers here.

Menopause is a normal part of life for many people, although it can cause some unpleasant symptoms sometimes. Sleeplessness, anxiety, hot flashes, night sweats, and other symptoms can be challenging.

But research shows that cognitive behavioral therapy (CBT) can make a real difference for some people, and it might help you during this healthy transition, too.