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[CLKD]

The updated draft guideline also includes new recommendations on the management of genitourinary symptoms such as dryness, painful sex and vaginal discomfort or irritation. A choice of vaginal oestrogen such as cream, gel, tablet, pessary or ring should be offered to women, trans men and non-binary people registered female at birth, including those on systemic HRT, and treatment should be continued for as long as it’s needed to relieve symptoms.

The draft updated menopause guideline is live for public consultation from 17 November 2023 to 5 January 2024.

Do we write a joint letter explaining ...............

[Dierdre]

Good news regarding update for genitourinary symtoms.
I've had CBT for anxiety and although it helped with general anxiety the techniques couldn't control my health anxiety.  It's something I'm either going to have to come to terms with and accept I'll always worry about my health, real or hypothetical. The alternative is citalopram.
I doubt CBT and talking to my vagina would help my GSM 

[Kathleen]

Hello again ladies.

I just wanted to add that I have had CBT therapy as well and unfortunately it didn't really work for me. 

I think therapy can help during the menopause because some of the symptoms are psychological and not just physical. Anything that helps us to manage this time in our lives is worth trying!

Wishing you all well ladies and take care.

K.

[suzysunday]

It was the Five Live phone-in topic yesterday morning. It was interesting to hear different reactions. Louise Newson was one of the contributors. I don't think you can Listen Again on 5 which is a shame.

Taz x

The phone -in is available on Nicky Campbell's podcast for 5 live.

[suzysunday]

Didn't quite get that right with the quote!  It is available on Nicky Campbell's 5 Live podcast

[Taz2]

Thanks suzysunday. I forgot about the podcast. It's worth a listen.

Taz x

[Julia Dizzy]

And was the draft of the new guidelines written by a man??? Tell me how CBT can help when you wake in the night drenched in sweat??? Oh just a minute, I will do my CBT practice and it will go away?? What rubbish. Only Oestrogen can stop them.

I have had CBT for anxiety a few times and it has never worked for me.

And don't get me started on how long you would have to wait to see someone on the NHS for it

[CLKD]

Absolutely correct Julia Dizzy ..........

[Katymac]

I've had cbt for dealing with longterm health issues and it does play some part in not feeling desperation at times. Coming to terms with "this is the future" & "it might well not get better than this"

But it isn't a magic pill, it takes a fair amount of mental discipline (while you have brain fog & sweats, not to mention anxiety??)

But for menopause? Mine was surgical and came on suddenly; I was ILL; unable to function, eat, sleep, stand at some points

[Dierdre]

Menopause is caused by the decrease in estrogen, we become deficient in estrogen. The treatment is HRT for those who need it, not everyone does.
Diabetes is insulin deficiency, will this also be treated with CBT?? No.
Anemia is iron deficiency, will this be also treated with CBT?? No.
Underactive thyroid? No.
The problem is Menopause is still not classed as an illness and a lot of women don't suffer at all. I didn't. I do now with GSM.
CBT will help with the mental health problems but not the physical ones so as long as it's used alongside HRT then great but it can't ever replace HRT.

[dangermouse]

With the pendulum swung in the direction of Louise Newson’s high dose strategies, there will naturally be a backlash and new guidelines. The recent media reporting of CBT for menopause was predictably taken out of context. The benefits of HRT as a cure all are often exaggerated by celebs and it, often, does not help with anxiety. In fact, oestrogen, being a stimulant, can make it much worse.

The BMS were just trying to point out that other strategies, like CBT, could also be considered by GPs for some patients, to rationalise the management of their symptoms. As awful as some symptoms are, and I’ve had some intense ones, accepting them rather than concentrating all your focus on them can reduce their overall impact and, in some cases, calm the autonomic nervous system enough for the physical symptoms to reduce. In reverse, it’s very easy to bring on a panic attack whilst in the throws of scary neurological symptoms from the brain reacting to plummeting hormones.

NHS CBT is very restrictive though, due to  needing a rigid, systematic approach. REBT is much more helpful and life changing.

[Penguin]

With the pendulum swung in the direction of Louise Newson’s high dose strategies, there will naturally be a backlash and new guidelines. The recent media reporting of CBT for menopause was predictably taken out of context. The benefits of HRT as a cure all are often exaggerated by celebs and it, often, does not help with anxiety. In fact, oestrogen, being a stimulant, can make it much worse.

The BMS were just trying to point out that other strategies, like CBT, could also be considered by GPs for some patients, to rationalise the management of their symptoms. As awful as some symptoms are, and I’ve had some intense ones, accepting them rather than concentrating all your focus on them can reduce their overall impact and, in some cases, calm the autonomic nervous system enough for the physical symptoms to reduce. In reverse, it’s very easy to bring on a panic attack whilst in the throws of scary neurological symptoms from the brain reacting to plummeting hormones.

NHS CBT is very restrictive though, due to  needing a rigid, systematic approach. REBT is much more helpful and life changing.

What's REBT? I'm open to trying anything for the anxiety as hrt only goes so far and I've already done two rounds of CBT.

[dangermouse]

Hi,

It’s Rational Emotive Behavioural Therapy which focuses on the beliefs behind our self talk, which we tend to exaggerate as no-one else can hear us! It’s about being realistic, rather than expecting to feel happy all the time, by changing our habits, for example, to feel calm concern when in difficult situations rather than out of control anxiety. It’s truly life changing and puts you back in charge of your emotions and how you interact with the world.

You can get some great workbooks on it to do yourself (from Windy Dryden) or you can see a therapist. It’s my main choice of therapy for my clients.

[CLKD]

I understood that the idea was to offer CBT in the first instance for what is basically a hormonal upheaval.

[Penguin]

Hi,

It’s Rational Emotive Behavioural Therapy which focuses on the beliefs behind our self talk, which we tend to exaggerate as no-one else can hear us! It’s about being realistic, rather than expecting to feel happy all the time, by changing our habits, for example, to feel calm concern when in difficult situations rather than out of control anxiety. It’s truly life changing and puts you back in charge of your emotions and how you interact with the world.

You can get some great workbooks on it to do yourself (from Windy Dryden) or you can see a therapist. It’s my main choice of therapy for my clients.

Thanks, I'll look into it, starting with a workbook I think! I found cbt only goes so far as a lot of my fears (health anxiety) seem too deep rooted to be rationalised with. Anxiety you're right, a lot of it is around my beliefs / self talk which are very extreme in some areas. I've never heard of it before, so thank you.