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Every person’s experience of menopause is unique, and the symptoms they may encounter can differ. Physical symptoms, such as hot flushes and night sweats in menopause, are prevalent for many and are well-known as being a part of this life stage.
What is spoken about less, however, is the impact that menopause can have on your mental health, despite around 70% of perimenopausal women developing neurological and psychiatric symptoms and more than half of people going through menopause experiencing neuropsychiatric symptoms such as insomnia and depression.
If you are struggling with your mental health during perimenopause and menopause, know that you aren’t alone and that there are a variety of treatment options that can help you feel more like yourself.
How menopause affects mental health
During menopause, your body is navigating a sharp decline in the hormones oestrogen and progesterone. Produced by the ovaries to help regulate the menstrual cycle, the levels begin to fluctuate and fall in perimenopause and reach a permanently depleted state once you reach menopause.
Oestrogen also plays a major role in regulating your mood. It can increase serotonin levels, a neurotransmitter that contributes to feelings of happiness and well-being and help with the effectiveness of ‘feel-good’ endorphins. So, when you have less oestrogen in your body, this can lead to less serotonin and endorphins, lowering your mood.
Aside from what’s happening inside your body impacting your emotions, you may also find that dealing with the other menopause symptoms can take a toll on your mental health. Over 60% of women describe going through menopause as ‘difficult’ or ‘extremely difficult’, with some expressing their experiences as 'awful' and a 'nightmare'.
Mental and emotional symptoms of menopause
Menopause can bring about significant mental and emotional changes that may go beyond you feeling a little flat and leave you overwhelmed at times. Psychological and neurological symptoms of menopause can include:
- Depression
- Anxiety
- Low mood
- Low energy
- Lack of confidence
- Loss of self-esteem
- Crying spells
- Rage and irritability
- Forgetfulness
- Brain fog/ difficulty concentrating
- Panic attacks
- Poor motivation
- Insomnia
- Poor sleep
- Suicidal thoughts
Menopause symptoms can all have a knock-on effect on other parts of your life, and this can further impact your mental and emotional well-being. For example, one study explored the issues faced by menopausal women. It found that the following percentages of women reported menopause affecting the following aspects of their lives:
- Sex drive – 46%
- Relationship with their partner – 27%
- Relationship with members of their family - 12%
- Relationship with their children - 8%
- Relationship with friends - 8%
- Social life – 20%
- Time spent on hobbies/leisure activities -15%
Things that can help
So many women experience mental health issues during perimenopause and menopause yet nearly half of women don’t go to their GP for support and 80% don’t even speak to their partner about what they’re going through.
However, there’s no need to navigate this period of your life alone. There are a variety of treatment options that can help you manage the mental and emotional symptoms of menopause.
Hormone replacement therapy (HRT)
HRT is an effective treatment for menopause symptoms. It works by replenishing oestrogen and other hormones that decrease during menopause, which can significantly affect mood and mental well-being.
Low hormone levels are linked to anxiety, depression, and mood swings, so restoring balance can alleviate these emotional symptoms. Further, by stabilising hormone levels, HRT may help improve sleep quality and reduce feelings of irritability or sadness, promoting better mental health during menopause.
Cognitive behavioural therapy (CBT)
CBT is a structured form of therapy designed to help individuals manage their emotional responses by identifying and altering negative thought patterns.
During menopause, cognitive distortions such as self-blame, catastrophizing, overlooking the positives or ruminating on symptoms can worsen your mental health.
CBT for menopause equips you with practical tools to reframe these thoughts and manage emotional fluctuations more effectively. CBT can improve overall mental well-being during menopause, with one study finding that CBT resulted in:
- A 73% reduction in insomnia
- A 50-63% reduction in depression
- An 18-71% reduction in anxiety
- An 18% reduction in nervousness
- A 41% reduction in melancholy
Antidepressants
Although not a first-line treatment, antidepressants, chiefly selective serotonin reuptake inhibitors (SSRIs), are sometimes prescribed to manage the emotional symptoms of menopause and can be particularly beneficial for some women when used alongside HRT.
While antidepressants don’t address the hormonal causes of mood changes, they can help balance brain chemicals that regulate mood.
Counselling
Counselling provides a supportive space for women to explore and process the emotional impact of menopause. Talking to a trained professional can help you understand your feelings and develop strategies for managing stress, anxiety, or low mood.
Counselling can also assist in addressing relationship or self-esteem issues that may arise during menopause. Regular sessions encourage emotional release and offer you the tools to cope with the often unpredictable mood changes that menopause can trigger, promoting better emotional resilience.
Mindfulness
Mindfulness involves practices that centre your attention on the present moment, helping you to manage stress, anxiety, and emotional turbulence.
For women experiencing emotional symptoms during menopause, mindfulness can be a powerful tool that allows you to be aware of and accept your thoughts and feelings without judgement.
Techniques like mindful breathing or meditation can help reduce feelings of overwhelm, improve focus, and stabilise mood swings. By promoting relaxation and reducing stress, mindfulness practices enhance overall emotional balance and well-being during menopause.
Crisis support
During menopause, some women may experience intense emotional distress, including panic attacks, severe anxiety, or thoughts of self-harm. Crisis support services offer immediate help in these situations and include:
- 999 or A&E if you or someone else is in danger
- 111 or 111 online
- Samaritans - call 116 123 at any time from any phone for free
- Shout – text 85258, available 24/7
- National Suicide Prevention Helpline UK - 0800 689 5652, open 6 pm to 3:30 am every day
- CALM - call 0800 585858, open 5 pm-midnight every day
Other things you can do to help
Alongside professional support, there are also a variety of self-care steps and lifestyle changes that can help your mental health during menopause:
Exercise
Aerobic exercise, such as walking, swimming, jogging, dancing, cycling and even gardening has been proven to reduce depression and anxiety. However, there are so many physical activities that can help boost your mood.
For example, yoga for menopause is beneficial for both the physical and emotional symptoms of menopause. Cold water swimming during menopause is also a great option. When we conducted an online survey about this activity, the majority of respondents said that they did water swimming for their mental health.
Sleep
Sleep and mental health are interconnected with poor mental health affecting your sleep and vice versa. Improving your sleep quality can have benefits to your overall mental health and is shown to have a significant positive impact on stress. Steps to improve your sleep quality include:
- Sticking to a regular sleeping pattern
- Avoiding electronics at least an hour before bed
- Creating a dark, quiet and cool sleep environment
- Maintaining a healthy diet
- Undertaking regular exercise
Holistic treatments
Holistic treatments aim to improve well-being with an approach that encompasses the mind, body, spirit and emotions.
Reflexology for menopause, for instance, involves massaging pressure points on the feet. It is considered a very relaxing therapy that can help improve mood, reduce tension and improve sleep.
Herbal remedies for menopause may also have some benefits. St John’s wort, for example, is commonly used as a remedy for mild to moderate depression.
Other holistic treatments that you may find helpful include:
- Massage
- Acupuncture
- Aromatherapy
- Meditation
- Hypnotherapy
Other lifestyle changes
During menopause, other factors and situations in your life can affect your mental well-being, which can be particularly difficult when you are already managing a significant transition. However, making small changes to your day-to-day life can make a big difference to how you feel:
- Make time for rest
- Adopt a nutrient-rich menopause diet
- Reduce your alcohol intake
- Connect with others
- Learn new skills
- Spend time in nature
- Reduce screen time
- Start a journal
If you’re struggling with your mental health and menopause symptoms in general, reach out for support. Our Menopause Care doctors understand what you are going through and can provide you with tailored guidance and treatment based on your personal experiences and symptoms.
We provide support in many ways, you can book a consultation with one of our menopause doctors, or with Rebecca Smithson, who specialises in CBT. We also offer support through our menopause mentor, Jane James, who can provide advice on your next best step through understanding your situation, giving guidance and offering a listening ear.
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