Menopausal Women To Be Offered Therapy

[Sparklingsunshine]

Hi

Thought I'd share this on the forum. Hope its ok. theguardian.com/society/202...

[TiggerMe Ambassador]

Talking about it this morning 10 am on Radio 5 Live with Nicky Campbell and Louise Newsom

[RedApple Administrator]

I think the sub heading is important here:

'Evidence review by Nice found that cognitive behavioural therapy should be considered ‘alongside or as an alternative to HRT’

[Sparklingsunshine in reply to RedApple]

I hope this isn't another attempt to cut the NHS prescription bill by offering CBT, which the powers that be seem to think is the panacea to all our problems. I'm also wary of the very long waiting lists for mental health support.

We cant support people with really serious mental illness as it is due to crumbling NHS infrastructure, let alone start offering millions of women help with the menopause. In an ideal world maybe, but we dont live in an ideal world sadly. I'm wondering where all these extra therapists are going to come from?

[RedApple Administrator in reply to Sparklingsunshine]

It's not dissimilar to the ignornace surrounding thyroid disorders. Before diagnosis of hypO, I was offered anti-Ds, referred for counselling, psychotherapy etc. It was years before a caring GP thought to do blood tests for possible other causes, including thyroid (which revealed very high TSH and very high antibodies).

The medical profession simply do not understand how all hormone imbalances can have a major effect both physical and mental health.

[HealthStarDust in reply to Sparklingsunshine]

Trainees. Lots of them. Many would prefer to be a Psychology Assistant but competition is even more tougher so end up in talking therapies.

As you can tell, I have little good things to say about therapy for very real physical problems.

We need occupational therapy back if anything. Doing, such as excercise, going out, gardening etc, is much more powerful than talking.

[Sparklingsunshine in reply to HealthStarDust]

I had a 6 week course of CBT earlier this year as I was struggling with the anxiety due being chronically dizzy 24/7 as I have vestibular migraines. Don't get me wrong I think Western medicine has for too long treated physical and mental health as almost two separate entities, independent of each other.

We all know they work in synergy and have a huge impact on each other. That said being told to think differently made diddly squat difference to my dizziness, the only thing that has helped is the right medication and time.

[HealthStarDust in reply to Sparklingsunshine]

I’m not sure they do work in synergy. I believe mental health symptoms are organic in nature and it’s a bit of a cop out to not actually find the root cause.

[Sparklingsunshine in reply to HealthStarDust]

I guess what I meant was depression and anxiety often makes physical symptoms worse and pain, fatigue, lack of sleep in turn can often cause anxiety and depression. It all feeds into each other.

[HealthStarDust in reply to Sparklingsunshine]

Yes, I do believe they have a knock effect but I am doubting it’s a synergy as we are taught to believe.

[HealthStarDust in reply to Sparklingsunshine]

P.S. yes, time too. Healing should never be rushed.

[Bearo in reply to HealthStarDust]

The B in CBT is behaviour, I.e doing things as you suggest.

CBT combines Cognitive therapy (changing your thoughts) and Behavioural therapy (changing behaviour).

But it is, basically, a talking therapy.

[HealthStarDust in reply to Bearo]

The behaviour part goes like this… change your thoughts to change your behaviour. Occupational therapy on the other hand is specifically a more hands on approach directed at supporting someone change behavour. That’s my meaning when it comes to doing. More doing rather than talking is much better for one’s health.

For some talking works, but it takes far too long and has yet to be proven to be a long term fix. Which makes me suspect that behaviour change is through the rewards from the therapist themselves.

I don’t think any thing can change my mind about the lack of benefit from talking therapies.

[Bearo in reply to HealthStarDust]

I wasn’t praising talking therapies, just outlining the behavioural part of CBT, for anyone who doesn’t know what it means.

[FancyPants54 in reply to RedApple]

CBT!? For menopause. How typical! Telling the silly little woman that it's all in her head and all she needs to do is think pretty thoughts and she will be fine!

I'd like to see them sending men who can't get an erection for CBT! But no need, because they can simply buy their little blue pills over the counter whilst some of us have to work at GPs for years, crying, begging, and eventually going private to get what we need.

[sparkly in reply to FancyPants54]

Well said 😂A bit like sending thyroid patients for cbt instead of taking replacement hormone treatment too. If you need your hormones replacing no amount of talking is going to do that

Might be helpful with dealing with anxiety and low mood that peri/menopause creates but talking about your hot flushes, night sweats and insomnia certainly won't get rid of them

[FancyPants54 in reply to sparkly]

Neither will CBT stop you driving your car head-on into a lorry coming the other way if you needed oestrogen to stop your brain being so depressed. More women commit suicide between the ages of 50-52 than at any other time. (Or that was an accurate statistic around 2 years ago.)

[deejames in reply to FancyPants54]

That's not what is being said. Nobody is saying the symptoms are imagined but the therapy is to help cope with those symptoms as there are no effective physical treatments apart from HRT which only helps to an extent and not with all women

[FancyPants54 in reply to deejames]

You would be surprised perhaps at the number of women who have and continue to be fobbed off by their doctors with antidepressants and CBT when what they are asking for and need is hormones. It's rife out there and if any talk of CBT gets into the NICE clinical guidelines that's the bit the GPs will read and remember and fob women off with. It doesn't matter how it's worded. The retain the bits they agree with and many GPs are clueless over menopause. Sadly a lot of female GPs are worse than the men!

HRT if administered correctly, by someone who knows what they are doing and who will work with the patient to find the method of administration that's best for that patient and the exact dose and timing needed for that patient can relieve all the symptoms. You don't need talking therapies with the correct HRT because you feel absolutely normal.

Some women do struggle with it of course. Often with inadequate help. And others are advised not to use it. Sometimes correctly and sometimes not based on outdated data. Some choose not to because they feel it's somehow weak and cheating. But more and more women are asking for HRT and we need to make sure they can get it. We need GPs to be trained in it's correct use and we need them to stop scaring women with out of date ideas. Therefore we need the abbreviation CBT to be nowhere near the NICE guidelines.

Sorry, that's a rant. But it really gets my goat. My GP has been very helpful after admitting he knew nothing much about it. He will prescribe whatever my HRT private specialist asks him too prescribe. So we have been able to try out lots of things to find what works for me. But he's unusual sadly. It should not be a postcode lottery.

[Sparklingsunshine in reply to FancyPants54]

My concern is there have been significant HRT shortages, not sure what the reason is, meaning restrictions, rationing and less choice. The HRT Tsar that the government hired to tackle the shortfall has now left and no one has replaced her.

I hope this isnt another attempt to provide healthcare on the cheap, rather than providing the medication we need. The NHS does seem to be under the impression that CBT is the answer to a question no one asked lol.

[HealthStarDust in reply to Sparklingsunshine]

I think this is all of our concern. The most disturbing part is the words as an alternative to HRT.

No amount of talking about the symptoms will help one cope with them. Replacing the hormone on the other hand, and sorting out the issues around accessing them would!

This is just another way for men to hold all the power by keeping women sick.

[deejames in reply to FancyPants54]

HRT worked for some of my symptoms to some extent. It was and still is not a cure all. CBT helped with the anxiety and depression both with menopause and other issues. There is a place for both types of therapy. The mind body connection is being found to be highly relevant in many diseases and conditions. We learn more every day.

[RedApple Administrator in reply to deejames]

deejames ' no effective physical treatments apart from HRT which only helps to an extent and not with all women'

For the benefit of anyone reading here, can you please expand on what you've said here? Why does HRT only help to an extent, and why only some women?

[deejames in reply to RedApple]

I can only talk from personal experience and those of my acquaintance. Many had some of their symptoms relieved. Some continued to suffer. Two women I know are finding it marvellous for physical symptoms but not for the emotional side.I am sure this is a pattern repeated throughout the world.

I am very grateful for the HRT I took but it certainly did not relieve all my menopausal difficulties

[Sparklingsunshine in reply to deejames]

Well taking HRT for several years now has eliminated many of the unpleasant menopause symptoms like hot flushes and feeling bleurgh that I experienced.

HRT might not be medically suitable for everyone, and some prefer a natural route, plus finding the right one can be challenging, but most women I've spoken to have seen very significant improvements.

The menopause is cause by hormonal changes, just as thyroid conditions are. Not sure that CBT is going to be particularly useful.

[HealthStarDust]

This makes me so mad! I wish CBT wasn’t touted as some kind of cure all. In fact, it’s thanks to the psych industry in part that so many diseases go unnoticed.

Talking is not the answer for everything. I can’t imagine being offered CBT for erectile dysfunction! 😡

[RedApple Administrator in reply to HealthStarDust]

'it’s thanks to the psych industry in part that so many diseases go unnoticed.'

Whilst seeing a counsellor, my research led me to the very old paper about Myxoedematous Madness by Dr Richard Asher. (More info here helvella.blogspot.com/p/dr-... )

I was elated to have found a cause for my so called psych problems. Printed it out, took it to my next psych session and handed it to my counsellor. She pushed it away, saying it wasn't relevant. I politely but firmly asked her to read it before dismissing it. She again refused, point blank.

[HealthStarDust in reply to RedApple]

You did more than I would. If they refused to be taught they don’t deserve my time or knowledge. I have very little time for psych professionals these days. It’s not even health care! It’s a way to funnel women away from mainstream services for their very physical health problems.

[RedApple Administrator in reply to HealthStarDust]

I was naive at the time. It was before this HU platform ever existed. If I'd known then what I know now, I'd have listened to my own intuition and not even agreed to go for the first psych assessment!

[HealthStarDust in reply to RedApple]

Yes, I remember being that naive with it all too.

Hopefully, there are a little less of these arrogant psych professionals around than before. Not enough, but it’s a start.

[1tuppence in reply to RedApple]

Did you sack her?

[RedApple Administrator in reply to 1tuppence]

🤣 We didn't use that term in those days, but yes I suppose I did. I told her there and then that I would not be attending any more sessions. She basically accused me of 'abandoning our relationship', which convinced me that I had very definitely made the right decision!

[1tuppence in reply to RedApple]

Good for you. I had a similar experience when training..... and I too did what you did. Like your experience, although I was polite, I was also definite, and the therapist was not pleased.

[humanbean]

I suffered with severe depression and anxiety for years, both before and after menopause, and treatment offered always ended up being anti-depressants or nothing.

I was sent for CBT once (long after menopause) which was utterly useless, and the solutions suggested to improve my mood by the CBT therapist were really quite insulting.

All anti-Ds ever did was destroy my libido and flatten my emotions. They turned me into a zombie.

I was never able to tolerate HRT, which didn't help matters.

Once a woman is menopausal doctors assume her iron/ferritin must be absolutely fine because she no longer has periods. This isn't true for all women, particularly if they enter menopause with very low iron.

So doctors were basically stumped at how to do anything worthwhile for me, and blamed me for all my problems because I refused to take HRT, got no improvement from CBT, and started refusing anti-Ds. I was therefore considered to be a non-compliant patient, and [sarcasm on] everyone knows that they are the scum of the earth.[sarcasm off]

In order to get rid of the worst of my anxiety and depression and help myself I had to find out the following :

1) Found out I could get an iron panel done privately with just a finger-prick blood sample.

2) Found out I could buy iron supplements from pharmacies without prescription.

3) Found out about the BNF (British National Formulary) and could get the info I needed on dosing.

4) Found out suggested optimal levels for iron, ferritin and other iron-related levels.

Until I'd found out all the above I would never have had the confidence to start treating my own very low iron. I didn't know before I started that optimising my iron and ferritin was going to get rid of my anxiety and depression - I just knew it needed to be a lot better than it was for my own good health. Then eventually I realised that improving iron/ferritin was improving my mental health as well as my physical health.

At some point during me raising my iron my anxiety disappeared and then a bit later my depression 95% disappeared.

I'm 100% sure that taking thyroid hormones helped too, but the iron was what started the process of improvement. And until I got my iron/ferritin better I really struggled with tolerating thyroid hormones in any form.

According to the Guardian article :

Women experiencing hot flushes, night sweats, depression and sleep problems could be offered therapy to help reduce their menopause symptoms, under new guidelines.

I don't believe CBT will help at all. The NHS and the medical profession are just trying to fix a problem (lack of HRT) with the cheapest alternative they can think of which makes it look like the NHS is actually doing something about it. The fact that hormone levels are unlikely to be altered by CBT suggests they are just hoping for a massive placebo effect.

What will they do if the placebo effect is small, and wears off quickly? Blame the women.

[Bertwills]

This week I visited a GP. I’d read that they could now prescribe a sleeping tablet. Article in Pulse Magazine with all info. I’ve had severe insomnia for decades & use Nytol to get any sleep at all.

Disaster of course, she hadn’t heard of new drug, flatly denied they could prescribe, insisted only the Sleep Clinic could. Wouldn’t check her computer to see if I was right. Her advice, do online CBT & get up in the night to do a jigsaw. Apparently this will completely solve my chronic problem.

Why did I bother?! Idiotic system staffed by incompetent people.

I will email her the article & maybe try again. I get nothing from the NHS. I have had to go privately for my 3 prescriptions and pay for my dentist too. Feel so cheated.

[Sparklingsunshine in reply to Bertwills]

I feel for you, I coped with chronic insomnia due to Fibro for years, my sleep is better but I stil, wake multiple times a night and I'm a very light sleeper 😪 which doesnt help. Over the years I've tried every sleep aid going from herbal tea to heavy duty sleeping tablets.

I've been on a sleep course with breathing exercises and relaxation techniques thrown in. I cant help feeling these are more aimed at those coping with stress and phone addictions, rather than a physical condition that I had. I even tried melatonin tablets but found no relief.

Having exhausted most of what was on offer my GP prescribes me an antihistmine which is sedating, Promethazine, known as Phenergan. I take it sparingly now but its very effective and non habit forming. Montmorency cherries or sour cherry juice also has promising data for those looking for natural remedies.

[Bertwills in reply to Sparklingsunshine]

Fibro here too. I’ve tried everything too. I once took Phenergan which was prescribed for my sleepless toddler. Couldn’t believe how dopey I felt! Never gave it to him again.

I’ll carry on with my Nytol & now I’ve calmed down I will educate the GP. Again!

[FancyPants54 in reply to Bertwills]

You sound like me. My GP is good in that he will follow advice but I have to buy that advice from private specialists (HRT, Endo, Thyroid prescriptions and yes, dentist too). I also feel cheated.

[serenfach]

Oh dear, you have chopped your leg off. Would you like to talk about it?