Coping with menopause and mental health
You might be familiar with hot flushes, night sweats, and sleep problems as common physical changes during menopause. But have you considered its impact on your mental wellbeing? Join us as we explore the connection between menopause and mental health and discuss ways to help you prepare for this life stage.
If you're already feeling like you're riding an emotional rollercoaster in the time leading up to menopause (also known as perimenopause), you’re not alone. The hormonal changes that come around this life stage can make us feel like we’re in a never-ending state of premenstrual syndrome (PMS).
One day you might experience anxiety, while the next day, you could be feeling irritable. Perhaps you're noticing that focusing on tasks has become more challenging like your brain is navigating some sort of frustrating fog. Surreal as it may all seem, experiencing any of this is completely normal.
But what exactly is up with these changes? And how can you cope with them? We’ve got you covered with everything you need to know about menopause and mental health so that you’re well-prepared for whatever comes your way during this phase.
Can menopause affect mental health?
During perimenopause, our body produces less and less hormones, like oestrogen and progesterone. As a result, our ovulation stops, and we no longer release eggs from our ovaries. This eventually leads to no more periods and that’s when we officially reach menopause.
Apart from being a major player in the menstrual cycle, oestrogen also plays a key part in our psychological wellbeing. It helps with the production of serotonin, a hormone that helps to stabilise our moods and is linked to empathy, trust and relationship-building, memory, concentration, eating, and sleeping – essentially all parts of our life! 
So, when we experience hormonal shifts during the time around menopause, they not only trigger physical changes in our bodies but also impact us mentally and emotionally. This is so common that 7 in every 10 women experience some level of mental health impact during this phase , so it’ll be completely normal when you find yourself going through a rollercoaster of emotions like anger, worry, or even sadness.
Anxiety and depression are also common conditions that you may encounter when you reach menopause. So, let’s take a closer look at how they can affect you so that you’re not caught off guard when the time comes.
Menopause and anxiety
Feeling a bit more on edge or worried is related to anxiety, which is common during menopause.
Usually, a bit of anxiety is a normal and often healthy response to stressful situations. But keep in mind that it can be an issue when it becomes uncontrollable and impacts your day-to-day life.
What causes menopause-related anxiety?
Basically, during perimenopause, the levels of oestrogen (aka the feel-good hormone) start to decline, which leads to a hormonal shift that messes up the delicate balance of chemicals in your brain. This affects how you regulate your mood and can make you feel more anxious.  On top of that, physical symptoms such as, hot flushes, shortness of breath, night sweats, and sleep problems, can pile up and make your anxiety even more intense.
Our roles and responsibilities in life also tend to change around the time of menopause. Whether you’ll have a new job, start taking care of elderly relatives, or your kids (if you chose to have any) start lives of their own, these changes can also trigger anxiety.
Recognising that your body and your life are different will be key to adjusting. Remember that change is a normal part of life, and each phase brings new adventures. It’s natural to be afraid of the unexpected, so it’s okay to reach out to others for help if needed.
This might be getting professional support through a psychologist or psychiatrist, joining a menopause support group, or even just talking to friends and relatives going through a similar phase. Sometimes, just getting any worries off your chest is enough to put feelings of anxiety to rest.
Signs and symptoms of menopause-related anxiety
When it comes to menopause-related anxiety, there are several signs and symptoms to watch out for. These can include:
- Fast heart rate and heart palpitations, making your heart beat faster than usual.
- Feeling of sickness or nausea that makes your stomach churn.
- Shaking or tremors, those quivering sensations that you might feel running throughout your body.
- Sweating without any particular physical effort. Headaches that make you lie down for hours at random times of the day.
- Chest pain, which can be uncomfortable and scary at the same time.
- Rapid breathing, like you’ve just ran a marathon.
- Panic attacks, which can be intense and can happen for no apparent reason.
Everyone's experience is unique, so if you feel anxiety when you reach menopause, you might not have all of these symptoms, or you might have some that aren't on the list. You know your own mind best, so if you're concerned about your health, it's a good idea to talk to a doctor who can give you reassurance and support. It can be intimidating to talk to (pretty much) a stranger about how you feel, but try to keep in mind that your mental wellbeing impacts your physical one, and you deserve to feel good and at peace, don’t you?
Menopause and depression
While experiencing temporary shifts in your mood during menopause is quite normal, depression is a whole different thing.
Depression is a serious condition where the low mood and feelings of sadness or numbness stick around for weeks or even months, affecting your daily life. It's like a heavy dark cloud that follows you around for long stretches of time.
About 53% of women  experience depression during menopause, so if it happens, know that you won’t be alone. There are many ways to get help and there’s absolutely no shame in seeking support to feel better.
Why does depression happen during menopause?
It all goes back to those pesky hormone fluctuations, particularly oestrogen and progesterone, which play a significant role in regulating our mood. Shifts in their levels disrupt the balance of chemicals in our brains, such as serotonin, norepinephrine, and dopamine, which are responsible for feelings of happiness.  This is why some people feel as if someone turned the “happy” button off in their brain when they reach menopause.
But there's more to it than just science. Our minds and bodies will undergo significant changes during menopause, which can also be influenced by life events like separation from a partner, economic struggle, or the loss of a loved one. In other words, our experiences can greatly influence our mental wellbeing. Surprisingly, depression doesn't always require a major event to show up. It can sneak in little by little and pile up nearly unnoticed. This means that it manifests differently for each person, as we all have our own unique experiences and ways of reacting to them.
Although it might feel like the world is crashing down, there is a way through depression. You've got what it takes to navigate that kind of journey with a little bit of support and guidance from medical professionals, your family, and friends.
Signs and symptoms of depression during menopause
- Feeling persistently down or sad, like there's a dark cloud hanging over you.
- Losing interest or pleasure in activities that used to bring you joy, making everything feel dull.
- Noticing changes in your appetite that lead to weight gain or loss, affecting your relationship with food.
- Struggling with sleep, whether it’s difficulty falling asleep or sleeping too much, leaving you tired and restless no matter what.
- Feeling tired and lacking energy, as if your internal battery needs a recharge to get through the day.
- Finding it hard to concentrate or make decisions, with your thoughts feeling foggy and unclear.
- Experiencing restlessness or slowed-down movements, making it challenging to find a sense of balance.
- Dealing with feelings of worthlessness or overwhelming guilt that weigh heavily on your heart and mind.
- Facing thoughts of death or contemplating suicide, which can be incredibly upsetting.
How to help my mental health during menopause?
The way forward towards healing and feeling better might look different for everyone. Remember, learning to live with menopause is a journey – it’s not a destination you reach and call it a day.
So, what can you do? Self-care can be a great starting point to safeguard your mental well-being when you reach menopause — and even before it too!
Know what will happen in your mind and body
It is possible that menopause will feel like a wild ride with all those changes happening. It might not be all smooth sailing, but it’s very natural! And knowing how it can affect you is the first step in getting prepared.
It’s worth taking the time to learn more about the physical, emotional, and psychological changes that come with menopause. Understanding what to expect can give you reassurance and help you ride the ups and downs with more confidence. The earlier you understand the challenges of menopause, the more prepared you'll feel, and the smoother the journey can be.
Consider talking to friends and relatives who have gone through menopause or joining supportive online communities — there’s much to learn from each other!
And while you're in this discovery process, why not subscribe to our newsletter? It's packed with information about all things related to intimate care and your changing body. From big changes to small details, we've got you covered!
Get the sleep you need
Give yourself the gift of quality sleep by prioritising it. You could create a relaxing bedtime routine that works for you, whether it's reading a book, listening to calming music, or taking a warm shower. Make sure your bedroom is comfortable, with cosy bedding and a peaceful environment. You could also practise good sleep hygiene by avoiding stimulating activities close to bedtime, like exercise or scrolling down your social media feed. Trying to always go to sleep at the same time also helps your body consistently rest better.
If you're struggling with night sweats, try keeping a bedside fan to help you cool down — or at least keeping a window open. You could also wear light, breathable sleepwear (or nothing at all, if you’re comfortable) to help you stay cool during the night. Remember, the more rested you are, the more ready you’ll feel to tackle the challenges of menopause.
Live a healthy lifestyle
Choosing to incorporate a balanced diet and regular exercises to your daily routine can be a simple and natural way to manage menopausal symptoms and enhance both your mental and physical health.
To make symptoms of menopause more manageable, you could:
- Reduce caffeine and alcohol intake and consider quitting smoking, if you’ve picked up those habits.
- Keep a food diary to identify triggers for hot flushes, so you can remove them from your diet.
- Ensure your diet includes enough calcium and vitamin D and incorporates fibre and wholegrain foods.
- Avoid hot drinks before bedtime, as they can trigger hot flushes.
When it comes to physical activity, go for whatever brings you joy and suits your preferences. It could be a brisk walk in nature, dancing to your favourite tunes in the living room, swimming, or trying out a fitness class. Find what resonates with you and make it a regular part of your routine.
Exercise keeps your body in good condition but also releases endorphins, those feel-good chemicals in your brain, which helps to uplift your mood and increase your chances of mental wellbeing.
Try to give your busy mind a break
It’s easy to get stuck in the rustle and hustle of daily life, so try to consciously make some time for peace and tranquility. Whether it’s doing light yoga stretches, meditating, or taking some deep breaths to release tension – these activities can have a big impact on your mental health. Embrace the stillness and allow yourself to let go of stress, even if only for a few minutes each day.
And if yoga and meditation aren't your thing, fret not! You can always carve out some time for your favourite hobbies. From curling up with a good book to spending some quality time in nature, what really matters is that you have some “me time” doing activities that bring you joy and relaxation.
Treatments to support your mental health during menopause
If you find that self-care strategies and lifestyle changes aren't bringing the relief you seek, don’t worry. There are plenty of treatment options, both medical and non-medical, that you can explore.
Can hormone replacement therapy (HRT) help during menopause?
Hormone replacement therapy (HRT) is medication that can work wonders during menopause. Basically, it contains the female hormone (oestrogen) that our bodies naturally produce less of at this life stage. 
HRT is commonly prescribed to address annoying symptoms such as hot flushes, brain fog, joint pains, mood swings, and vaginal dryness. By replenishing the hormones your body needs, it helps restore balance and give you much needed relief.
Keep in mind that just like with any medication, there are risks involved with using HRT. You may experience side effects such as, breast tenderness, irregular bleeding and feeling bloated. However, most of the time, these are just mild symptoms that tend to go away within a few months of using the medication.
So, if you're considering taking HRT, or are unsure about treatment options, don't hesitate to talk to your doctor. They will be able to support you and address any concerns you may have so that you can make an informed decision about whether HRT is the right option for you.
Meeting up with an endocrinologist or psychiatrist may be a good idea too, as they look at the body and brain from specialised perspectives that can complement HRT with other medication prescriptions if needed. It’s up to your healthcare providers, together with you to decide what can work.
What about psychological therapy?
Psychological therapy can be a great non-medical complement to support your wellbeing during menopause.
Although in some cultures going to the psychologist may be frowned upon, they’re actually a great help when it comes with coping with mental health during menopause (and at any point in life, really!).
Going to therapy doesn’t automatically mean there’s something wrong with you, it’s just another tool to get to know yourself better and find ways to deal with your thoughts and emotions. A good therapist can help you navigate the challenges you're facing and find new ways to support your mental wellbeing.
Whichever route you take, remember that your mental health matters and it's totally okay to reach out for help when you need it. Dealing with mental health challenges is something we all experience at some point, so there's no need to feel awkward or ashamed about it. We all have our own unique paths, and every step you take towards a healthier you is something to be proud of!
Go at your own pace and consider leaning on loved ones or a close friend who may be going through a similar phase. Your doctor is also there to lend an ear, provide guidance, and explore treatment options if necessary. They've likely encountered many cases like yours and can share helpful tips and tricks.
Remember, there's a solution for anything life throws at us. The journey might be challenging, but finding peace with your mind and body will be absolutely worth it in the end!
If you'd like to learn more about the effects of menopause, why not explore everything you need to know on hormonal changes that occur during menopause or the relationship between menopause and intimacy?
The medical information in this article is provided as an information resource only, and is not to be used or relied on for any diagnostic or treatment purposes. Please consult your doctor for guidance about a specific medical condition.