Menopause & Mental Health: Causes, Impacts & Realities

Written by: Natalie Grigson

Hormonal harmony plays a big role in how you feel.

Menopause & Mental Health: Causes, Impacts & Realities

We’ve come a long way when it comes to the conversation around menopause. Think about it: Just 20 years ago, menopause still felt like a very taboo subject. Women were expected to suffer in silence—and because people weren’t talking about it, there was a serious lack of real information out there.

Today, many people aren’t sure what menopause even is, when it starts, or what the symptoms are.

So, let’s clear this up right now: Menopause is when you are finished having periods, for good. When you’re in menopause, you haven’t had a period in at least 12 consecutive months.¹ Perimenopause, on the other hand, are the years leading up to menopause when female sex hormone levels are declining. This transitional period can last anywhere from four to 10 plus years, and can start as early as your mid-thirties. These are the typical “symptom” years—years that movies would have us believe are just constant sweating, crying, panic attacks, and fits of rage.²

While symptoms during perimenopause and menopause vary widely from person to person, we do know that it’s pretty common for these stages to affect mental health.

In this article, let’s go over some of the most common mental health symptoms during menopause and what you can do to cope with them. Let’s talk about it openly and honestly—and continue to destigmatize the conversation surrounding menopause and the years leading up to it.

How Menopause Impacts Mental Health

According to the American College of Obstetricians and Gynecologists (ACOG), as many as four in 10 people going through perimenopause experience mood changes like irritability, sadness, anxiety, low energy, or difficulty concentrating.³ If these symptoms sound familiar, it’s because menopause symptoms can be a lot like PMS symptoms. But, unlike PMS, these symptoms may occur at times unrelated to your period.

There are several things going on simultaneously that can lead to this cocktail of emotions:

Your hormones are fluctuating wildly. Most people know that leading up to menopause, estrogen is decreasing. But as it is decreasing, it’s also rising and falling unevenly, which can result in irregular periods, and of course, unexpected mood swings.⁴
You may have feelings about menopause itself. While some people may be thrilled to say goodbye to their period and everything that comes with it each month, others may mourn the loss of their fertile years. Menopause may also represent getting older to some women—which, let’s be honest—we don’t exactly have the best relationship with in our culture.
Serotonin may be low. As estrogen levels fall, so too do serotonin levels. This is one reason depression can come about or worsen during perimenopause. This also seems to be what causes hot flashes or night sweats.⁵
Sleep can be more difficult during this time. Between 40 and 60 percent of people experience difficulty sleeping in the years leading up to menopause.⁶ Just like hormonal fluctuations during your period can impact sleep, perimenopause can too (and not getting enough sleep can wreak havoc on mental health).
Life may really be life-ing. Perimenopause tends to occur at an age when life’s stresses may be adding up. If you have children, they might be growing up or starting to leave the nest; your parents may be aging or facing health issues. You may also be navigating changes in your career, whether it's thriving or facing difficulties. All of these things can greatly impact mental health.

If you’re going through perimenopause or have now officially entered the Menopause Club and you’re struggling with mental health, you are absolutely not alone. Let’s look at the numbers, shall we?

Menopause and Mental Health Statistics:

Again, the ACOG estimates that four in 10 people going through perimenopause experience mood changes.
This number may actually be quite conservative; Cardiff University puts it closer to 70 percent.⁷
Almost 900,000 females have left their jobs because of menopausal symptoms.⁷
Perimenopausal females are 40 percent more likely to experience depression.⁸
Anywhere from 15 to 50 percent* of peri–or postmenopausal people experience anxiety.⁹

* Why is this range so wide, you ask? Because there are still very limited studies on the connection between menopause and anxiety. Yes, we’re finally coming out of the dark ages of “That woman is being hysterical!” but science still has a long way to go in terms of fully understanding female bodies.

Can Menopause Worsen Existing Mental Health Issues?

If you already have a mental health issue like anxiety, depression, schizophrenia, bipolar disorder, or insomnia, menopause may worsen your symptoms.¹⁰

This also seems to be true of PMDD.

Is There a Menopause Version of PMDD?

If you have Premenstrual Dysphoric Disorder, or PMDD, you’re probably well accustomed to severe mood swings and uncomfortable physical symptoms like cramps, bloating, nausea, and possibly headaches. PMDD is basically PMS on steroids, and unfortunately, people with PMDD are more likely to experience intense symptoms during perimenopause.¹¹

The good news is, once you’ve actually made it through to the other side and stopped having periods, the hormonal fluctuations that cause PMDD each month will be over.

In the meanwhile, there are things you can do to help manage symptoms.

How to Address Menopause Depression

If you’re experiencing depression, anxiety, insomnia, or any other mental health issues in the years leading up to or after menopause, there are things you can do to help curb symptoms.

Keep a healthy diet: This one may seem obvious, but we’re still going to mention it. A diet filled with vegetables, leafy greens, healthy, lean proteins, healthy fats, and fiber-filled non-processed carbohydrates can do wonders when it comes to menopausal mental health. A lot of people make the mistake of cutting out carbs during this time to ward off menopausal weight gain. However, this may actually do more harm than good when it comes to mental health—and even physical health—for menopausal women. Health carbs are especially important for those who are active.

Exercise daily: Exercise is vital to mental health, and most of us have been told this since we were young. But exercise is so important for mental health, it can even prevent and treat certain mental health disorders, all on its own.¹²

Develop a sleep routine: A sleep routine is an activity or series of activities you do every night before bed. It helps you wind down from the day, and it lets your body know it’s time to get sleepy. This might look like dimming the lights and meditating, journaling, taking a bath, or reading a book. Part of your sleep routine should involve going to bed and waking up at the same time every day, putting away cell phones and screens at least an hour before bed, and avoiding any big late night meals.

Try natural supplements: Thousands of women seeking alleviated symptoms have found success with MENO Menopause Relief, which is hormone-free, prescription-free, and designed to target hot flashes, mood swings, and night sweats. It’s OBGYN-formulated, too.

Discuss options with your doctor: Let’s say you’re eating well, you’re staying active, and you’re doing everything you can to get enough sleep. Consider having an open conversation with your doctor, who may recommend or discuss the possibility of medications like hormone replacement therapy (HRT) and antidepressants.¹³

For non-prescription, non-hormonal support, you can try MENO Menopause Relief for mood and hot flash relief, and MENO Vaginal Moisture to help with vaginal dryness.

A note on sex and gender: Sex and gender exists on spectrums, and this article uses terms like “male” or “female” to refer to sex assigned at birth. Learn more.