Does menopause have a negative impact on your mental health?

hormones and mental health

The menopausal transition, also known as perimenopause, usually begins around age 47 and involves stages of irregular menstrual cycles that culminate in the last menstrual period.

This is caused by fundamental hormonal changes as the ovaries age, and is accompanied by a variety of physical symptoms. The most well-known is probably hot flashes.

Many argue that these hormonal changes and their symptoms (or a combination of these factors) can contribute to poor mental health.

Our team considered evidence from prospective studies (this type of study looks at outcomes such as the development of disease during the study period)) This study tracked changes in women’s mental health symptoms during the menopausal transition.

Specifically, we considered studies that investigated symptoms of depression and risk for disorders, anxiety, bipolar disorder, psychosis, and suicide risk.

Overall, we found no consistent evidence that menopause is associated with a universal or uniform increase in risk for any of these diseases.

However, we also found a relative lack of prospective studies investigating menopause and mental health.

Although this research is limited, we know the most about the relationship between menopause and depressive symptoms and disorders, so this was our area of ​​focus.

Not all women are at risk

Our study found that only two prospective studies investigated the risk of developing major depressive disorder (MDD) as assessed uniformly by clinicians.

Although neither study found that menopause increased the risk of developing new-onset MDD, a more robust study found that women with a personal history of MDD have an increased risk of developing MDD during menopause. found.

Twelve studies investigated the risk of developing clinical depressive symptoms (lower threshold than MDD) over the menopause, but the results of these studies were mixed.

Previous influential papers have found that menopause can double or even quadruple the risk of developing depressive symptoms, but the new study paints a more nuanced picture. is showing.

We did not find consistent evidence for a universal or uniform increase in depressive symptoms during the menopausal transition, but instead found subgroups of women who may be at increased risk.

Difference between results and symptoms

Although more longitudinal studies are needed to understand exactly who is at risk for mental health symptoms and disorders during the menopausal transition, our findings suggest that menopause-specific risks for depression This suggests that a combination of factors and common depression risk factors are at play.

Women may be particularly vulnerable when menopause-related risk factors and other triggers (e.g., stressful life events, financial hardship, lack of social support) occur together.

We found that severe hot flashes, sleep disturbances, surgical menopause (caused by the removal of both ovaries), and a prolonged transition period can increase the risk of depressive symptoms.

In addition to this, some women may be more mood sensitive to the hormonal changes of menopause than others, which may explain why subgroups of women are at greater risk. may also be helpful.

To me, it’s no surprise that severe hot flashes, especially if they interfere with sleep, can contribute to mood disorders.

All kinds of disruptive physical symptoms can affect our mood.

For example, if you have a bad cold, you may feel irritable or grumpy (especially if your sleep is disrupted), but this irritability may not be the cause. symptoms Rather, it’s the result of catching a cold.

diverse experience

A recent survey of more than 7,000 Australians and Europeans found that around 60 per cent self-reported psychological symptoms associated with menopause. The psychiatric symptoms are defined by the study authors as mood changes, depression, or difficulty concentrating or remembering.

So, how does this high number of reported psychiatric symptoms match the results of prospective studies on mental health?

First, mood symptoms are different from clinical measures of depressive symptoms. Mood symptoms used in menopausal scales and checklists are typically assessed with a single yes/no answer.

In contrast, symptoms of depression are assessed using validated scales designed to measure the mental health status of depression.

It is also important to consider the role of history and culture in shaping the views we hold about menopause.

The idea that menopause is associated with poor mental health has been around for many years. The first modern menopausal symptom assessment scale was developed by him in the 1950s, setting the precedent that psychological symptoms were a core part of the menopausal experience.

Midlife is a stressful time in life, with relatively low levels of mental health, regardless of gender. Therefore, other life stage factors and menopausal-specific factors such as hot flashes and sleep deprivation may have a combined effect.

We will also challenge the idea of ​​the ‘bad menopausal woman’ by better training doctors and health professionals to help women cope with menopause, while acknowledging the diversity of symptoms and experiences. Have to.

Currently, both here in Australia and around the world, many GPs are not confident in treating the physical symptoms of menopause and refer patients to ‘specialists’, which can delay treatment.

I have witnessed this problem many times in my clinical work as a psychologist.

Unfortunately, GP confusion about menopause and lack of confidence in treating its symptoms can create an additional mental health burden for some women, leaving serious symptoms untreated. We endure it completely unnecessarily.

Just as no two women are exactly the same, so too is the experience of the menopausal transition. It’s important to recognize that, rather than assuming that menopause itself can affect all women’s mental health in the same way.

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