Emotional & Mental support
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Women going through the menopausal transition are at a higher risk of mood changes and symptoms of depression and anxiety.
Common physical, emotional and cognitive issues related to menopause can complicate and overlap with mental health symptoms.
Stress related to life circumstances can also complicate understanding whether changes in mood and mental health are related to menopause.
Having an open discussion about your symptoms, life circumstances and mental health history can assist your doctor in offering suitable treatment options and lifestyle changes.
Therapies proven for the broader population are also suitable for mental health symptoms related to menopause – medication, psychological therapy and lifestyle changes.
While not a problem for everyone transitioning through menopause, the risk of mood changes and symptoms of depression and anxiety are higher during perimenopause, even in women without a history of major depression.
While the risk is higher for women in the age-related and natural menopausal transition, women might also have a higher risk of mood changes after menopause caused by surgery such as hysterectomy or if the ovaries have been removed. Depression also occurs at a higher rate in women with a lack of oestrogen caused by primary ovarian insufficiency.
Mental health symptoms related to menopause
Mental health symptoms related to menopause can include feeling:
irritable, sad, anxious, hopeless
stuggling to focus, concentrate, forgetful,
tired, unmotivated
Some women might experience these symptoms in a mild form which others unfortunately may suffer more severe symptoms of depression (including thoughts of suicide) lasting for at least two weeks. This is known as a major depressive episode and is more likely in women who have a history of major depression during their pre-menopausal years.
While many women do not have mental health issues during the menopausal transition, unstable oestrogen levels can have an impact on the brain, predisposing some women to feelings of depression and anxiety.
Some of the common physical, memory and thinking symptoms related to menopause (hot flushes, night sweats, sleep and sexual disturbances, weight changes and “brain fog”) can complicate and overlap with mental health symptoms.
Another complicating factor is stress related to life circumstances. Feeling stress is common during middle age as personal and environmental changes take place. This can have a strong effect on mood in some women. Life circumstances that can impact mental health include caring for children, teen issues, carers for elderly family members, career changes, body changes, illnesses, pre-existing ADHD, relatonships, pain levels, medication.
The menopause transition is an ideal time to look at your health and consider lifestyle and other changes so that you can live the healthiest possible lifestyle.
Untangling physical and mental health symptoms related to menopause
For some women, mental health issues and other changes can begin to affect how they live their lives. Your doctor can take a holistic approach to your health to help you untangle the web of symptoms around physical and mental health changes.
Understanding mental health during perimenopausal and postmenopausal changes can include:
identifying your stage of perimenopause / menopause and any physical and cognitive symptoms
discussing your history of mental health symptoms
discussing your current mental health symptoms
understanding any lifestyle factors that could affect your mood – for example, lack of sleep and exercise understanding other stressful life circumstances contributing to your symptoms – for example, caring for children and parents, career and relationship changes, body changes and illness.
When you see your GP/specialist it is important to explain the realm of menopausal symptoms you are experiencing as well as your life circumstances and clinical history so that they can help them to recommend the best treatment options and lifestyle and behavioural changes for your situation.
Treatment options for mental health symptoms
Lifestyle changes to assist with managing mental health are similar to those recommended for menopause-related physical changes. Changes that can help with mental health symptoms include:
ensuring healthy levels of physical activity
improving sleep
considering changes to decrease stress associated with life circumstances
limit alcohol intake
Psychological therapies and social supports can be beneficial to women with mental health symptoms.
Women should have an individualised assessment with their doctor in order to discuss the most appropriate treatment pathway. Options may include lifestyle changes, psychological therapies and medications such as menopausal hormone therapy (MHT) or antidepressants.
While some international guidelines do not recommend MHT as firstline therapy, many doctors have seen a positive effect on mood with the use of MHT in the first instance.
There is evidence that oestrogen has antidepressant effects, particularly in perimenopausal women. We emphasise an individualised approach with treatment tailored to the individual patient.
Oestrogen is not recommended for women with a history of breast cancer.
At this stage, there is no evidence to recommend alternative or complementary therapies for treatment of perimenopausal depression.
Where can you find more information?
If your mental health or other symptoms are bothering you, your doctor can help. Your doctor can help you understand physical and mental health changes and offer options for managing your sympt
Help for depression and mood changes?
If you have severe mental health symptoms or symptoms of depression and have thoughts of suicide, help is available.
Lifeline – Phone 13 11 14
beyondblue – Phone 1300 22 4636
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How I lost my mojo thanks to Perimenopause
How I lost my Mojo at home and work thanks to Perimenopause!
I was 45 years old and suddenly felt like I had been hit be a tidal wave.
I felt burnt out, sleep deprived, self-conscious and unable to perform as well as I used to at work.
I had surges of hot flushes which periodically drenched me, was a lot more irritable and impatient with fellow staff and clients, had a frozen shoulder and aching knee, had some brain fog, especially with peoples names, and general exhaustion. There were days when I just wanted to walk out of the office and never return. I could barely cope at home with the kids and my husband, let alone deal with co-workers.
I can recall being performance managed for my comments in a workplace meeting which in hindsight were too outspoken, but I just seemed to lose the ability to hold back my opinions which I had once reserved.
Ironically, despite knowing quite a lot at the time about menopause, I still considered myself too young, I only had a 7 year old child, still had consistently heavy periods and there was nothing that made me initially think it was perimenopause. I actually thought I had a very, very long winded case of the flu.
As incredible as it seems, with 50% of the population going through it, most women still don’t know the basic facts about perimenopause and menopause, making it difficult to identify hormonal changes as a potential cause for not feeling well. In turn they are often not seeking the support and treatment options which could really provide them with significant symptomatic relief.
Our mothers were often also uneducated on the topic and/or quiet about it, there was no education at school and most of the medical fraternity have been poorly educated themselves about how to identify, treat and support. My own doctor wrote it off as anxiety caused by life challenges at the time, and prescribed me anti-depressants and melatonin for sleep.
Like me, many of my menopausal workmates, have felt neglected, overlooked, embarrassed and frustrated and opted to simply leave work, retire early, reduce their work hours, not apply for promotional opportunities, merely because they were feeling overwhelmed and insecure as a result of their physical and psychological menopausal symptoms.
As recently highlighted by the Senate inquiry into Menopause, workplaces need to better accommodate women who experience symptoms of menopause and perimenopause.
“All employers have a responsibility to address stigma around menopause in their workplaces. Implementing organisation wide menopause policies, promoting internal awareness for employees and managers about these issues and sharing menopause-specific workplace resources can all help to address menopause stigma.”
We are often in the prime of our careers when perimenopause symptoms strike, with an enormous amount to still offer an organisation. It is an inevitable time in our lives but it can be challenging and we need workplace support to help us get access to information about the symptoms, treatment options and lifestyle changes we may need to continue to be as productive, confident and empowered.
Better psychosocial risk assessments which include support for menopausal employees, menopause awareness training at work, workplace policies and procedures, flexible working arrangements are all steps in the right direction but it is still uncommon to find this level of support in many organisations.
At Corporate Wellness Solutions we look deeper at what amounts to a psychosocial hazard rather than just what the Code guides us on. That is why I decided to add menopause to our psychosocial wellness solutions programs.
We can provide you with all the perimenopause and menopause information and education from the experts, policy templates, conversation guides and prompts to initiate menopause conversations with managers and employees (from both perspectives), symptom trackers, checklist for businesses to compare how menopause friendly their workplace is and a wellness support program tailored to your employee needs.
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