Mental health and the menopause

Reviewed by our clinical team

The menopause is something experienced by all women and people who have periods. Menopause means that your periods have stopped for good. This in itself isn't a problem but the time before and after your last period can be! This time is also caused the "change" or the "peri-menopause"- in other words the time around your last period.

Menopause happens because your body "winds down" fertility through shutting down the ovaries. This means that oestrogen levels fall significantly over a few years. This change in hormone levels will eventually cause your periods to stop. This aside, it can also cause a variety of other, unpleasant symptoms, such as  the "classic" hot flushes, night sweats, tiredness, urinary symptoms, vaginal dryness and mood changes.

For some women, the menopause can have a quite a big impact on mental health. When compared to the “famous” symptoms of the change like hot flushes, this aspect can be overlooked. Some women may not realise their psychological symptoms are related to their changing hormones and may not be aware that help is available.

If you’re currently going through the menopause and you think your mental health has been affected, read on for our guide to common symptoms and getting help.

How menopause affects mental health

As your oestrogen levels fall, your mood can be significantly affected.  

Common psychological symptoms include: 

• Anxiety  
• Low mood 
• Feeling sad 
• Feeling stressed 
• Anger and irritability 
• Forgetfulness 
• Poor concentration – this is sometimes known as “brain fog” 
• Loss of self-esteem and confidence

You might also struggle to sleep, which can have the effect of worsening the symptoms listed above. 

Can the menopause cause depression?

Depression is a complex illness that is often caused by a combination of factors, including past trauma, current life circumstances, poor physical health and other psychological conditions. 

We know that the hormonal changes that occur during the menopause can be a trigger for low mood, and that in some women this may progress to clinical depression. This is probably more likely to occur if you’re having bad physical symptoms, or if your relationship or social life has been negatively affected as a result of the menopause.

Depression is also more likely to occur in menopausal women with a past history of depression. 

The good news is, there are effective treatment options available for people with depression. If you think you might be depressed, contact your GP for an appointment.

Looking after your mental health during the menopause

The menopause happens at a time when other big life changes are likely to occur as well: parents might need to be cared for, children might be leaving home, you might need to help look after grandchildren whilst having a full-time job, your general health might be deteriorating, your physical appearance might change (think wrinkles and weight gain), or you might be experiencing career or relationship issues. It's no surprise then that the menopause can be a difficult time for women, and that this can have an impact on your emotional and psychological wellbeing. Symptoms like anxiety, low mood, irritability or memory and concentration issues are not uncommon. Tackling these kinds of symptoms isn’t always easy, but there are some treatment options that can make a difference. 

The first step is to reach out for help if you’re struggling. If you visit your GP, they can talk you through options such as:

• Cognitive behavioural therapy (CBT)  
• Counselling 
• Antidepressants 
• Hormone replacement therapy (HRT)

CBT is a talking therapy used to treat anxiety and depression. It’s designed to help you recognise negative thought cycles, and to break out of them. 

Counselling is another type of talking therapy where you can speak to a therapist about your emotional issues and get support and guidance on coping with them. 

Antidepressants are a good treatment option if you’ve been diagnosed with depression, as they help to lift your mood and help you get back to normal daily activities. Some types can also be used to reduce hot flushes and night sweats. 

HRT involves taking oestrogen (normally combined with progestogen) to artificially replenish your falling hormones. This can help with mood changes, as well as physical symptoms. 

Lifestyle changes 

In addition to the treatments listed above, you can also try making some lifestyle changes to ease your physical and psychological symptoms:

• Regular exercise is known to boost your mood and improve your sleep. It can also improve physical symptoms like hot flushes. 
• Eating well is really important for good general health, especially if you’re overweight.  
• Stress-relieving activities like yoga and meditation can help if you’re experiencing mood swings. 
• Staying cool at night can reduce the impact of night sweats, helping you sleep better. 
• Vaginal oestrogen and moisturisers can help if you’re struggling to enjoy sex and it’s impacting your relationship.

For more guidance on managing your symptoms, speak to your GP. You can also read this article: Menopause treatment options.

References

https://www.nhs.uk/conditions/menopause/
https://www.nhsinform.scot/illnesses-and-conditions/sexual-and-reproductive/the-menopause/overview-of-the-menopause/menopause-and-your-mental-wellbeing
https://www.mind.org.uk/information-support/types-of-mental-health-problems/depression/causes/
https://www.menopause.org/for-women/menopauseflashes/mental-health-at-menopause/depression-menopause
https://www.nhs.uk/mental-health/talking-therapies-medicine-treatments/talking-therapies-and-counselling/cognitive-behavioural-therapy-cbt/overview/
https://www.nhs.uk/mental-health/talking-therapies-medicine-treatments/talking-therapies-and-counselling/counselling/
https://www.nhs.uk/conditions/menopause/treatment/
https://www.nhs.uk/conditions/hormone-replacement-therapy-hrt/
https://www.nhs.uk/conditions/hormone-replacement-therapy-hrt/alternatives/