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Self-help cognitive behavior therapy for working women with problematic hot flushes and night sweats (MENOS@Work)

a multicenter randomized controlled trial

Hardy, Claire PhD1; Griffiths, Amanda PhD2; Norton, Sam PhD1; Hunter, Myra S. PhD1

doi: 10.1097/GME.0000000000001048
Original Articles

Objective: The aim of the study was to examine the efficacy of an unguided, self-help cognitive behavior therapy (SH-CBT) booklet on hot flush and night sweat (HFNS) problem rating, delivered in a work setting.

Methods: Women aged 45 to 60 years, having 10 or more problematic HFNS a week, were recruited to a multicenter randomized controlled trial, via the occupational health/human resources departments of eight organizations. Participants were 1:1 randomized to SH-CBT or no treatment waitlist control (NTWC). The primary outcome was HFNS problem rating; secondary outcomes included HFNS frequency, work and social adjustment, sleep, mood, beliefs and behaviors, and work-related variables (absence, performance, turnover intention, and work impairment due to presenteeism). Intention-to-treat analysis was used, and between-group differences estimated using linear mixed models.

Results: A total of 124 women were randomly allocated to SH-CBT (n = 60) and NTWC (n = 64). 104 (84%) were assessed for primary outcome at 6 weeks and 102 (82%) at 20 weeks. SH-CBT significantly reduced HFNS problem rating at 6 weeks (SH-CBT vs NTWC adjusted mean difference, −1.49; 95% CI, −2.11 to −0.86; P < 0.001) and at 20 weeks (−1.09; 95% CI, −1.87 to −0.31; P < 0.01). SH-CBT also significantly reduced HFNS frequency, improved work and social adjustment; sleep, menopause beliefs, HFNS beliefs/behaviors at 6 and 20 weeks; improved wellbeing and somatic symptoms and reduced work impairment due to menopause-related presenteeism at 20 weeks, compared with the NTWC. There was no difference between groups in other work-related outcomes.

Conclusions: A brief, unguided SH-CBT booklet is a potentially effective management option for working women experiencing problematic HFNS.

1Department of Psychology (at Guy's), Institute of Psychiatry, Psychology and Neuroscience, Kings College London, London, UK

2Division of Psychiatry & Applied Psychology, School of Medicine Institute of Mental Health, University of Nottingham, Nottingham, UK.

Address correspondence to: Myra S. Hunter, PhD, Department of Psychology (at Guy's), Institute of Psychiatry, Psychology and Neuroscience, Kings College London, 5th Floor Bermondsey Wing, Guy's Campus, London SE1 9RT, UK. E-mail:

Received 19 September, 2017

Revised 9 November, 2017

Accepted 9 November, 2017

Funding/support: This study was funded by Wellbeing of Women (RG1701).

Clinical trial registration: Identifier: NCT02623374.

Financial disclosure/conflicts of interest: None reported.

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© 2018 by The North American Menopause Society.