The effectiveness of psychosocial interventions on non-physiological symptoms of menopause: A systematic review and meta-analysis

Abstract

Background: Menopause, a crucial transitioning stage for women, can significantly impact mood and wellbeing. We aimed to evaluate the effectiveness of psychosocial interventions on non-physiological symptoms of menopause (depression, anxiety, cognition, and quality of life) through systematic review and meta-analysis. Methods: Five databases were searched from inception to August 2023 for randomized controlled trials. Pre- and post-test means and standard deviations for groups were extracted and used to calculate effect sizes. The effectiveness of Cognitive Behavioral Therapy (CBT) and Mindfulness-Based Interventions (MBI) on depression and anxiety were examined by subgroup analysis. Results: Thirty studies comprising 3501 women were included. From meta-analysis, mood symptoms significantly benefited from CBT (anxiety: d = −0.22, 95 % CI = -0.35, −0.10; depression: d = −0.33, 95 % CI = -0.45, −0.21) and MBI (anxiety: d = −0.56, 95 % CI = -0.74, −0.39; depression: d = −0.27, 95 % CI = -0.45, −0.09). Psychosocial interventions were also found to significantly improve cognition (d = −0.23, 95 % CI = -0.40, −0.06) and quality of life (d = −0.78, 95 % CI = -0.93, −0.63). Mean total therapy hours (‘dose’) was lower for CBT (11.3) than MBI (18.6), indicating reduced costs and burden for women. Limitations: Data regarding menopausal status were not collected, limiting our ability to identify the optimal timing of interventions. Potential longer-term, effects of interventions were not investigated. Conclusion: Our review highlighted the value of psychosocial interventions in improving non-physiological symptoms (particularly depression and anxiety) during menopause, noting the heterogeneity of findings and importance of implementing effective interventions.