Menopause and mental health

The menopause is something all women will experience, yet the symptoms of the change and how it affects our mental health, is still something not widely spoken about. Find out more about what the menopause is, how it can affect your physical and mental health, and what steps you can take to look after your wellbeing during this period in your life.

What is menopause?

Menopause is a normal part of a woman’s lifecycle where hormone levels decline with age. Periods become less frequent and eventually stop. A person is not considered to have reached menopause until their periods have stopped for 12 months. This most commonly happens between the ages of 45 and 55.

What is perimenopause?

Perimenopause is when you have symptoms before your periods have stopped. It is the time during which your body is making a natural transition towards menopause. Women start perimenopause at different ages. Some women enter perimenopause as early as their mid-30’s.

What are the symptoms?

All women experience menopause differently. Symptoms of both perimenopause and menopause can impact significantly on your daily life. Most experience one or more symptoms of menopause and many will experience early symptoms whilst still having periods.

Symptoms can start years before your periods stop and can carry on for years afterwards. Symptoms can last for months or years and can change over time.  If you go through menopause because of surgical or medical treatments, symptoms of menopause are likely to be less gradual.

It is helpful for women to know the common symptoms of menopause, to help prepare for the impact they might have.

The range of symptoms experienced are:

  • Irregular periods
  • Hot flushes
  • Sleep disturbance
  • Mood changes
  • Anxiety
  • Skin changes (dry and itchy)

  • Body shape changes and weight gain
  • Headaches and migraines
  • Muscle aches and joint pain
  • Hair loss or thinning
  • Problems with memory and concentration (brain fog)

  • Vaginal and bladder issues (discomfort and infections)
  • Decreasing fertility
  • Changes in sexual function
  • Loss of bone density
  • Change in cholesterol levels
  • Palpitations – heartbeats more noticeable

How can menopause impact mental health?

As well as the social and environmental factors of menopause that can cause low mood and anxiety, hormonal changes mean it’s common for women to experience significant changes to their mood, including depression, mood swings, panic attacks, anxiety and low self-esteem. Some women also experience problems with memory, also known as ‘brain fog’ which can cause them to lack confidence and feel low in mood. Menopause can cause an increase risk of depression.

Menopause can affect your mental health not just due to the symptoms experienced, but also because it is a significant life change. Many women liken menopause to a life change as big as having your first child or losing a loved one. Some women may feel a sense of freedom as they no longer experience monthly cycles, whilst others may mourn a sense of loss of their younger selves. Some societies view women who are post-menopause as ageing, less capable and less valued, leaving some women to feel as though they are treated differently after menopause which could cause symptoms of low mood and anxiety.

For women who already may live with a mental health condition, they may find menopause a particularly difficult time for managing their mental health as they might find their current symptoms are amplified due to the hormonal changes menopause brings. Support can include altering the medication you may be taking for an existing mental health problem. Women particularly at risk of experiencing these additional challenges are those diagnosed with a mental illness such as bipolar disorder or schizophrenia.

For trans women, menopause may affect them depending on which medical interventions they have had and whether they take hormone therapy. For some trans women losing their periods can bring back uncomfortable feelings and they may feel a temporary sense of loss of identity.

Menopause can cause a range of physical symptoms which can affect our mental health. Experience of these symptoms can impact our mood and cause some women to feel depressed or anxious. Hormonal changes that cause physical effects, like palpitations and dizziness, can also mirror feelings of anxiety and panic attacks, amplifying symptoms for someone who may already experience an anxiety disorder.

Getting the support you deserve

It is important to reach out to others in order to get the support you need throughout your menopause. The mental and physical symptoms can affect your daily life and wellbeing – so seek help if you're struggling.

Supporting mental health

Experiencing perimenopause or menopause can feel isolating or embarrassing. Talking to your doctor about any significant changes to your mood will help them identify the best form of help and they can refer you to mental health support. Talking to your partner, family and friends might help them to understand what you are going through.

Sharing experiences with other women who may also be going through the menopause can help you to feel less isolated and provides you an opportunity to share supportive suggestions.

Find out what mental health support is available to you, or learn more about what it feels like to experience anxiety and depression.

Self-care

There are plenty of ways you can look after yourself during this life stage such as:

  • Getting plenty of rest and try to keep regular sleeping habits
  • Eating a healthy diet, replenishing vitamins and minerals that might be depleted during this stage such as calcium and vitamin D (bone density)
  • Regular exercise will help to prevent weight gain, improves your sleep, lifts your mood and strengthens bone density
  • Relaxing activities such as yoga, meditation or tai chi
  • Wear light cotton clothing, use fans to cool yourself down
  • Maintaining work life balance

Medical treatment

If your quality of life is being affected contact your GP, who will take the following into consideration: your age, menstrual history, symptoms or physical changes. It can take time to identify as the body changes gradually so a hormone level test might be required to confirm.

For women experiencing severe menopausal symptoms that is causing an impact on their physical or mental health, Hormone Replacement Therapy (HRT) may be recommended by a doctor. This therapy replaces low level hormones. Other treatments may include oestrogen therapy to improve symptoms associated with vaginal pain and urinary issues. There are both benefits and disadvantages of hormonal treatment, which can be found on the NHS website.

Elizabeth's story

Before experiencing extreme anger and mood swings during her menopause, Elizabeth never considered herself to experience changes to her mental health. She shares how her mental health affected both her home life and work, and explains that understanding and realising her symptoms were related to the menopause meant she could begin to take steps to receive treatment and help from her GP. Elizabeth is the founder of #KnowYourMenopause, campaigner for Pausitivity and blogger at 50Sense celebrating women 40 and over.

Read more

Adjustments at work

Workplaces have responsibility to support employees experiencing menopause in the same way they may support and offer reasonable adjustments for staff living with other mental health challenges. Gemma explains some of the ways her workplace supported her during this time:

“Work got me an extra fan and my colleagues moved desks so I could be nearer to a window. I also went outside frequently just to bring some relief. Having an approachable manager was important so that I could feel I ask them for these things. It was also important to me that other colleagues were informed, so nobody questioned why I might be changing behaviours, for example, taking frequent breaks outside! In a nutshell, workplaces can help by being sensitive to what you’re going through. Regular check ins with my manager meant I could keep them up to date with how I was getting on and other amendments also included allowing for reasonable meeting preparation time to compensate for brain fog. I also wore specific clothing that kept me cooler, so if colleagues have to wear a uniform, workplaces could look to see how they could make this more comfortable.”