CBT and Hot Flushes: A Mind-Body Approach to Menopause Symptoms

By Dr. Holly Vaughan, Menopause CBT Trained Specialist

Hot flushes and night sweats – collectively known as vasomotor symptoms – are some of the most common and disruptive symptoms of menopause. Affecting up to 80% of women, they can interfere with sleep, daily life, work, and confidence. While hormone replacement therapy (HRT) remains the most effective treatment for these symptoms, it's not the only option – nor is it suitable for everyone.

This is where Cognitive Behavioural Therapy (CBT) comes in.

CBT is a well-established psychological therapy that helps people understand and change unhelpful thought patterns and behaviours. According to guidance from the British Menopause Society (BMS), CBT has been shown to be a safe and effective approach for managing menopause-related symptoms, particularly hot flushes, night sweats, low mood, anxiety, and sleep disturbances.

As a menopause CBT-trained menopause specialist, I’ve seen firsthand how empowering this approach can be for women navigating midlife change.

How Does CBT Help With Hot Flushes?

CBT doesn’t stop hot flushes entirely – but it changes the way we respond to them.

Flushes can feel overwhelming, especially when accompanied by embarrassment or anxiety. Thoughts like “Everyone’s staring at me” or “This is so out of control” can escalate the experience, making it more distressing than it needs to be. CBT helps identify and reframe these thoughts, reducing the emotional intensity and improving your sense of control.

Through structured techniques, CBT helps you:

* Recognise and challenge unhelpful thoughts

* Develop calming strategies such as paced breathing

* Improve sleep habits

* Build confidence in managing symptoms, especially in public or at work

CBT also supports the mind-body connection, acknowledging that stress, anxiety, and low mood can all make vasomotor symptoms worse. Addressing these areas has a knock-on effect, helping to reduce the impact and severity of hot flushes.

What the Evidence Says

According to BMS guidance, CBT for menopausal symptoms is backed by solid evidence. Studies have shown:

* A significant reduction in the distress and interference caused by hot flushes

* Improved sleep and mood

* Better quality of life

The National Institute for Health and Care Excellence (NICE) also recommends CBT as a treatment option for women experiencing low mood and anxiety related to menopause.

Is CBT Right For You?

CBT is particularly helpful for women who:

* Can’t or choose not to take HRT

* Want to feel more in control of their symptoms

* Are looking for a non-medical, empowering approach

* Are experiencing menopause-related anxiety, low mood or sleep issues

As part of the More Than Menopause team, I offer CBT-informed support tailored to your needs – combining psychological insight with medical expertise to give you a truly holistic approach.

The Takeaway

Menopause is more than just a physical transition – it's a mental and emotional journey too. CBT offers practical, evidence-based tools to help you navigate this stage with more confidence, less distress, and greater resilience.

If you’d like to explore how CBT could help you with hot flushes and other menopause symptoms, you’re not alone – and support is here.