Evaluating the Feasibility of a CBT Group Therapy Programme (MENOS Protocol ) for NHS Staff With Problematic Menopause Symptoms.

Challenging menopause symptoms can affect healthcare workers' well-being and work life, potentially contributing to career changes and thus impacting workforce retention and health service delivery. Increasing numbers of UK National Health Service (NHS) workers are working through menopause transition and reporting problematic menopausal symptoms in the workplace. Although psychosocial interventions have been developed for menopause, the evaluation of their effectiveness within the healthcare workforce remains scarce . This study assesses the feasibility and acceptability of a Cognitive Behavioural Therapy (CBT) group intervention for UK NHS workers experiencing problematic hot flushes/night sweats (HF/NS).

A mixed-methods design employing a randomised two-arm parallel design with intervention and control conditions was used to assess feasibility and acceptability. Measures of menopause symptoms, beliefs and behaviour, midlife female health, memory and of the menopause-related impact on work were collected through online surveys from both study arms at baseline (6 days before the start of the intervention), post-intervention (to be sent within 1 week of the last intervention session) and three months post-intervention. Focus groups were conducted around 4 months after completion of the intervention with participants in the intervention group to gather their perspectives on the acceptability of the study and intervention. The extension of the CONSORT 2010 checklist for feasibility trials was used for reporting this study.

Participants and Recruitment Procedure. Participants were recruited from NHS workers in a single Health Service Trust in Northern Ireland (UK) between March and June 2025. The project was advertised through a direct email to a Trust-wide staff mailing list, Trust social media, the Trust-based menopause café and posters in the workplace. Recruitment material directed staff to register interest with a designated member of the research team based in the Trust via telephone or email. Trust Occupational Health also provided staff who were referred to their service with menopausal complaints with recruitment information on the study. An eligibility screening tool was developed and completed with all participants by phone or via email. Those deemed eligible were sent a participant information sheet and an informed consent form. Once, the participants consented by completing a consent form, they were randomly allocated to either the intervention or control arm until a sufficient sample size was generated. Further Information on inclusion and exclusion criteria is included later in the application.

Measure Collection and Anonymity. Once consent was given and participants were allocated to either the intervention or control arm, they were sent an email by a designated member of the research team with a link to online questionnaires. Participants were issued with a computer-generated code to complete the first survey. This code was known only to them. They were asked to make note of this code and re-use it for completing further questionnaires at Time Point 2 (Post-Intervention) & Time Point 3 (3-month-follow up). Therefore, there was no link between the participants' identifiable information and the coded data that they provided throughout the study.

Intervention The intervention arm received the CBT group programme for menopausal symptoms - Hot Flushes/Night Sweats (using the MENOS protocol) for 6 weeks in weekly two-hour sessions. The intervention includes psychoeducation about menopause, the hot flushes cognitive behavioural model, plus the identification of triggers, stress management, sleep hygiene, cognitive techniques and paced breathing techniques. The CBT intervention was held during working hours in a healthcare setting and was delivered by two facilitators, a trainee clinical psychologist/CBT therapist and a senior nurse. The control arm continued to receive usual care. At the end of the study, participants in the control arm were offered a self-help book of the CBT programme for hot flushes and night sweats.