top of page

Menopause and Mental Health

  • yboukarim9
  • Oct 14
  • 4 min read

By: Bossa Health


ree


What is menopause?


Menopause marks the stage in a person's life when menstrual periods permanently cease, signalling the end of reproductive capability. Often referred to as “the change of life”, this natural transition is typically confirmed after 12 consecutive months without menstruation. While the average age of menopause is around 51, it can occur any time from the late 30s to the mid-50s or beyond. A person's age at menopause often mirrors that of their mother. Besides natural ageing, menopause can also occur if both ovaries are removed during surgery, or if medical treatments such as chemotherapy or radiation damage the ovaries, leading to ovarian insufficiency.


The transition leading up to menopause is known as perimenopause. It can start months or even years before menopause. This phase includes both the years of hormonal fluctuation before the final period and the 12 months that follow it (the early postmenopausal stage). During this time, hormone levels start to fluctuate more noticeably and ovulation becomes less regular.


Common symptoms include:

  • Irregular or missed periods

  • Vaginal dryness

  • Hot flushes and night sweats

  • Sleep disturbances

  • Mood fluctuations

  • Difficulty with memory and concentration, often described as “brain fog”


It is important to view menopause as one stage in a person's life journey. The way someone experiences it can vary widely, depending on their health, reproductive history, and lifestyle.


The impact of menopause on mental health


The hormonal changes that occur during menopause can have a profound effect on emotional wellbeing. Fluctuating levels of oestrogen and progesterone are closely linked to mood changes, low mood, and anxiety, and for some people, these are among the first signs that menopause is approaching. Because these hormones influence many systems in the body – including the brain – their decline can make some people more vulnerable to mood disorders such as depression and anxiety.


Oestrogen helps to regulate key brain chemicals like serotonin and dopamine, which play an important role in maintaining mood and emotional balance. Progesterone, too, has a naturally calming effect on the body. When levels of these hormones begin to fall during perimenopause, it can affect how the brain manages stress and emotions. As a result, some people may experience new or more intense feelings of anxiety, irritability, or sadness. Research indicates that individuals going through perimenopause face a 40% increased risk of developing depressive symptoms compared to those who are premenopausal.


Depression during perimenopause may not always look like “typical” depression. Instead of persistent sadness and a sense of hopelessness, symptoms can include fatigue, irritability, or feelings of detachment – often mistaken for normal midlife stress. External pressures such as work demands, caring responsibilities, or relationship changes can compound these feelings. Additionally, physical health issues more common in midlife, such as obesity, cardiovascular disease, or chronic pain, are known to increase the likelihood of depression and anxiety.


Anxiety can emerge or worsen during menopause. Some people experience panic attacks, restlessness, or heightened awareness of physical sensations such as palpitations and breathlessness. These symptoms may be linked to hormonal fluctuations, as the decline in oestrogen can make the body’s stress system more reactive, leading to elevated levels of cortisol, the stress hormone.


Sleep problems are another major contributor to mental health difficulties at this stage, affecting up to 60% of peri- and postmenopausal people. Hot flushes, night sweats, or general insomnia can leave people feeling exhausted, which in turn worsens mood and increases stress. Because poor sleep and mental health challenges often reinforce one another, addressing sleep quality is a key part of maintaining emotional wellbeing during menopause.


Support and management


Effectively managing vasomotor symptoms (such as hot flushes and night sweats) and improving sleep can reduce the risk of depressive symptoms and enhance overall quality of life. Both pharmacological and non-pharmacological treatments are available and should be tailored to individual needs.


While some people are prescribed antidepressants, these are not always the most appropriate option unless depression has been formally diagnosed. Alternative or complementary treatments include:


  • Hormone Replacement Therapy (HRT): Restores declining hormone levels and is highly effective in alleviating menopausal symptoms.

  • Cognitive Behavioural Therapy (CBT): Helps manage mood changes, anxiety, and sleep problems.

  • Counselling: Offers emotional support and coping strategies during this transition.

  • Mindfulness and relaxation techniques: Can reduce stress and improve emotional regulation.


In addition, adopting a healthy lifestyle plays a crucial role in supporting both physical and mental wellbeing. A balanced diet, regular physical activity, and practices such as walking or meditation can improve mood, reduce anxiety, and enhance sleep quality. Free resources are widely available to help people stay active and feel empowered during this life stage.


Menopause provides a valuable opportunity to re-evaluate your health, priorities, and personal goals. Speak to your GP if you need support during this time. Bossa Health is also here for those who would like to explore psychological support, such as CBT.



References



Mental Health UK. (n.d.). Menopause and mental health. Retrieved from https://mentalhealth-uk.org/menopause-and-mental-health/ Mental Health UK


Badawy, Y., Spector, A., Li, Z., & Desai, R. (2024). The risk of depression in the menopausal stages: A systematic review and meta-analysis. Journal of Affective Disorders, 357, 126–133. https://doi.org/10.1016/j.jad.2024.04.041


Garg, R., & Munshi, A. (2025). Menopause and mental health. Journal of Mid-Life Health, 16(2), 119–123. https://doi.org/10.4103/jmh.jmh_61_25


Johns Hopkins Medicine. (n.d.). Introduction to menopause. Retrieved from https://www.hopkinsmedicine.org/health/conditions-and-diseases/introduction-to-menopause

 
 
bottom of page