Effectiveness of Cognitive Behavioral Therapy in Managing Physical and Psychological Distress in Women during the Perimenopausal Phase

Abstract

Background: Perimenopause encompasses significant physiological, psychological, and emotional changes marked by high distress and deteriorating quality of life (QOL). Although studies have shown that cognitive behavioral therapy (CBT) is an effective treatment during period of transition to menopause, limited psychological based-intervention studies have been conducted in India. The aim of this study was to determine the effectiveness of CBT in managing physical and psychological distress in women during the perimenopausal phase. Materials and Methods: A two-group randomized pre- and posttest design was used. Fifty-three women in the perimenopausal age-group presenting to gynecology outpatient clinic with menstrual problems were assessed for associated symptoms such as hot flashes, night sweats, insomnia, anxiety, depression, and other physical complaints. Baseline assessments included the Depression Anxiety Stress Scale, Menopause Rating Scale (MRS), Hot Flush Rating Scale, and insomnia severity index. The participants were randomly assigned to either the CBT or psychoeducation group. The CBT group received four sessions over 6 weeks, whereas the psychoeducation group received a pamphlet on perimenopausal symptoms and their management. Postintervention assessments were conducted after 6 weeks. Data obtained were analyzed using independent and paired samples t-test after check for normality. Results: Both the CBT and psychoeducation group showed improvements in depression, anxiety, sleep index, and QOL at 6 weeks. However, a significant group difference was found between the two groups on stress, anxiety, MRS’s somatic and psychological symptom scales, as well as sleep index, with CBT showing greater reduction in their mean values (P < 0.05). There were no differences between the groups in depression, hot flush frequency and rating, and urogenital symptoms. Conclusions: Both CBT and psychoeducation was effective in improving the QOL of women in the perimenopausal phase, with results supporting greater effectiveness of CBT as an adjunct treatment for managing menopausal symptoms.