MENOPAUSAL women will be offered counselling on the NHS as well as hormone replacement therapy drugs.Cognitive behavioural therapy, which helps people manage problems by changing the way they think and behave, will supplement HRT drugs.New guidance said HRT is the recommended first-line method for managing menopause symptoms such as hot flushes, insomnia and low mood.Prof Jonathan Benger added: "We have revised the guideline to be really clear CBT is an adjunct, it's an add-on therapy, and it can help people manage the symptoms." CBT should be only offered in tandem or if women are unable to take HRT. Draft guidance suggested CBT could be offered instead of hormone therapy but this sparked anger among some campaign groups.At a briefing in Central London, Prof Benger agreed there is a challenge with getting CBT on the NHS. The chief medical officer of the National Institute for Health and Care Excellence said HRT does not shorten women's lifespan on average despite a slightly higher risk of breast cancer.The greater risk is balanced by better bone health through and a lower risk of fractures in old age. Prof Benger said there is good evidence menopausal women are not getting "highquality care" on the NHS.NHS data shows women are three times more likely to be offered HRT in richer areas than in poorer parts.

HRT AND CBT

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