The Menopause Charity
Everybody experiences menopause differently, and for some people, it can affect their mental wellbeing. You might experience anxiety, low mood, problems with memory and concentration, low energy and motivation, panic attacks, mood swings, low self-esteem or new fears and phobias.
Contents of this page
The changes to your hormones during perimenopause and menopause can impact your mental health. You may experience feelings of overwhelm, stress, anxiety or even depression. Menopausal symptoms may include:
- Low mood, feeling unhappy or depressed
- Feeling tense or nervous
- Memory problems
- Panic attacks or anxiety
- Loss of confidence
- Anger and irritability
- Poor concentration (brain fog)
You might be feeling this way because of the hormonal changes that are happening in your body. But you might also find that living with other symptoms of menopause is affecting your mental health.
Many women also experience difficulty sleeping. Lack of sleep and tiredness can also make these symptoms worse. Exploring different options to help improve your sleep may help you improve your mental health and wellbeing during menopause.
Some of the physical changes that occur during menopause can also affect the way you feel about yourself, your confidence and self-esteem.
The mental symptoms of menopause are as real as the physical ones, and it is important to seek help if you are struggling. Speak to your GP about all of the symptoms you are experiencing so they can provide you with the right support and help.
Further information about tracking your symptoms and speaking you your GP are available here.
Significant shifts in your hormone levels, particularly estrogen, can cause marked changes to how you feel. Research suggests that more than half of all perimenopausal women report an increase in depressive symptoms. However, the mood changes experienced as a result of menopause should not be confused with depression.
Menopause guidelines are clear that antidepressants should not be used as first-line treatment for the low mood associated with perimenopause and menopause as there is no evidence that they actually help psychological symptoms.
Menopause can cause an increased risk of depression. Antidepressants are beneficial for people with clinical depression and can be safely given with HRT. If you think you or someone close to you might be suffering from depression, you should speak to your GP.
What Can Help Me?
There are lots of treatment options you can consider to help the psychological and emotional changes you may experience during perimenopause and menopause. These can include:
* Talking therapies
* Hormone Replacement Treatment (HRT)
* Non-hormonal medication
* Alternative remedies
* Complementary therapies
Cognitive behavioural therapy (CBT) is an effective treatment to help your psychological and emotional changes during perimenopause and menopause, helping bring a sense of balance to your thoughts and feelings.
* CBT aims to help you make sense of overwhelming problems by breaking them down into smaller parts, providing you with strategies to help you cope with unwanted thoughts, feelings, and associated physical reactions.
* CBT provides you with a pragmatic approach to stopping negative thought cycles, providing helpful ways to react to situations.
Psychotherapy and counselling are other beneficial therapies that may help you accept and adapt to the challenges at this time of life.
For more information read our latest post from Cognitive Behavioural Therapist Louise Phillips
Hormone Replacement Therapy
The psychological and emotional changes experienced at this time of life are often due to fluctuations in your hormonal levels.
Hormone Replacement Therapy (HRT) is recognised as the most effective treatment for many women by helping to relieve symptoms by replacing oestrogen levels that naturally fall in menopause.
Whilst physical symptoms often improve quickly, the psychological symptoms can sometimes take a little longer, however most women usually feel a return to their ‘old self’ within 3 – 6 months of starting HRT. Remember to be patient whilst you find the right type and dose of HRT for you.
As you start to feel the benefits of treatment in often debilitating physical symptoms and sleep, you often feel a lift in your mood, a greater sense of calm and increased energy and drive.
For more information on HRT visit our knowledge hub
If HRT is not suitable for you or you choose not to take it, there are non-hormonal medications that you may wish to try to help your physical and psychological symptoms.
Menopause guidelines are clear that antidepressants should not be used as first line treatment for low mood during menopause if you haven’t been diagnosed with depression but they can be used second line. Examples of such antidepressants are venlaflaxine, fluoxetine and sertraline.
Other drugs used for hot flushes are gabapentin or pregabalin. Some drugs are prescribed off license.
For more information on treatment options visit our knowledge hub
Herbal medicines, like St John’s wort, black cohosh and isoflavones like red clover, are available to buy over the counter in chemists and health food shops, with many claiming to ease menopausal symptoms. *
Although ‘natural’, these products are not necessarily risk-free. There is mixed evidence on how effective these treatments are, and it is important to understand the ingredients of products may vary. These products can also interfere with other drugs, including those used to treat breast cancer (for example, tamoxifen).
If you’re considering herbal remedies, ensure any product you use has the Traditional Herbal Registration (THR) mark of certification and speak with your GP or pharmacist as they can explain their quality and ingredients.
Another type of treatment is called bioidentical or compounded hormones, but these are unregulated and it is not known whether they are safe or effective.
* The only treatment therapies that The Menopause Charity recommend are limited to those recognised as being effective by NICE. These treatments are fully regulated treatments administered in accordance with all guidelines and protocols.
Read the NICE guidelines for the diagnosis and management of menopause.
Some women find that complementary therapies such as acupuncture and aromatherapy can help improve stress, anxiety and low mood.
Acupuncture involves super-fine needles being inserted into the skin across specific parts of the body. Some women find that treatments help relieve their physical perimenopause or menopause symptoms with reductions in hot flushes, excess sweating and sleep disturbance. Others find it relaxing and beneficial for their overall mental wellbeing. There is some evidence to support the general use of acupuncture.
Aromatherapy uses oils extracted from plants, and some contain phytoestrogens. While aromatherapy lacks an evidence base to support its use some believe that the oils such as Lavender, Juniper, Clary Sage and Geranium, may help relieve symptoms such as mood changes. These oils can be diluted in a carrier oil that can be absorbed through the skin via a massage, or they can be inhaled, or added to a warm bath where some find it contributes to their well-being, enjoying the benefits of a sensory experience that can be calming, relaxing and uplifting.
Whilst acupuncture and aromatherapy lack robust large trial evidence to support their use for perimenopause and menopause, many find they contribute to their well-being alongside treatment such as HRT and other lifestyle changes.
For more information on treatment options visit our knowledge hub
Juggling menopause, relationships at home and in work, and facing the challenges of modern-day living can all be demanding on your time. However, finding time for you is invaluable to boosting our physical and mental health.
Regular sleep, movement, eating a healthy, balanced diet, keeping hydrated and finding ‘you’ time, can help to improve some menopausal symptoms.
Follow our social channels or sign up to our newsletter for regular advice and self-care tips to help you thrive through your menopause journey.
If you have found this article helpful, please consider making a donation so that we can help more people understand the impact menopause can have on mental health.
This week every £1 donated will be matched by The Big Give meaning One Gift = Twice the Impact