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What You Need To Know About The Menopause And Mental Health

I decided to ask my Twitter and Facebook followers if there was a mental health topic they felt wasn’t talked about enough, and what I could do to change that. This article is the response to the Facebook request based on the suggestion by Allison Holland to look into the menopause and its effects on mental health.

 

Are there any invisible disabilities, mental or physical, that you feel our overlooked in society and I should write about on my blog?

Posted by Unwanted Life on Thursday, 18 February 2021

 

One of the reasons I was happy to take on this subject as a man was because it wasn’t something I was taught at school. What I know about the menopause has come from the women in my family and the documentaries I’ve watched. Such documentaries and QI gave me random knowledge like, only humans, Short-finned Pilot Whales, and Orcas go through the menopause. Now you know that too.

 

As a result of my lack of education on the subject, I asked Twitter if they’d be taught it at school, and it seems none of them had been either. It seems strange that the menopause isn’t taught as part of sex education when about half the population will go through it and we’ll all know lots of people who’ll experience it.

 

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What Is The Menopause?

 

For those of you who don’t know, the menopause is a significant biological event that will occur in the life of every woman who experiences the menstrual cycle, and that includes women with mental health issues (Sajatovic, Rosenthal, Plax, Meyer, and Bingham, 2003).

 

The menopause is the time in every woman’s life, 12 months after their last period (National Insitute of Aging), with their ovaries losing their reproductive function. Typically, the menopause occurs between the ages of 45-55 (NHS). However, in some rare cases, women may experience premature menopause in their 30s or younger (Women’s Health Concern).

 

Symptoms

 

The following is a list of possible symptoms that you could experience while going through the menopause, which, according to the NHS, should only last a few years. I’m not sure if that’s helpful to hear or not. Anyway, menopause induced depression and menopause induced anxiety, as well as the other symptoms, are a relatively short-term problem. Again, I’m not sure if that’s helpful or not.

 

 

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Menopause And Mental Health

 

Menopausal women undergo significant biological and psychological changes, including a decrease in estrogen levels, which some studies have linked to depressive symptoms (Kim, 2020). As a result, many women might experience detriments to their mental health during their menopausal transition (Elavsky and McAuley, 2007).

 

According to Freeman (2015), changes in menstrual bleeding patterns signal the approach of menopause in mid-life women. With this impending change, many women report hot flashes, sleep disturbance, depression, and other symptoms along with these menstrual changes.

 

A study by Kim (2020) sort to assess the effects of the menopause on feelings of depression. The study was conducted on 644 premenopausal women and 459 women who were menopausal from Korea, aged between 40–60. The study found that women who were experiencing the menopause had far greater depressive symptoms than those who hadn’t started the menopause, at a rate of 2-3 times higher than premenopausal women.

 

This is supported by a study conducted by Freeman, Sammel, Lin, and Nelson (2006), who conducted an eight-year longitudinal study on 436 American women to investigate the risk factors of depression during the menopause who had no previous history of depression. The results of the study found that menopausal women were four times more likely to experience depression than their premenopausal selves.

 

Therefore, if you take Freeman, Sammel, Lin, and Nelson (2006) and Kim (2020) studies together, there is a strong causal link between starting the menopausal transition and the risk of experiencing some form of depressive symptoms.

 

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However, according to Bromberger et al. (2007), controversy exists over if the menopausal transition is a risk factor for depression and that even if it is, women may vary in their vulnerability. The latter part of what they claim makes sense as individual differences are always a factor in mental health, and often health as well.

 

However, again, the longitudinal observational study (evaluated annually from 1995 through 2002) by Bromberger et al. (2007) on 3302 African American, European Americans, Chinese, Japanese, and Hispanic women, aged 42-52 added support to the increased risk of depression. The study found that the start of the menopause came with an increased risk of high depressive symptoms, which would remain elevated through the early stage of the menopause.

 

According to the study by Sajatovic, Rosenthal, Plax, Meyer, and Bingham (2003), 30% of women who have a mental health issue perceived their symptoms to be made worse by the menopause. However, that also means 70% of women with preexisting mental health issues didn’t perceive their mental health to be made worse from being menopausal. It all depends on how you choose to look at it.

 

The problem with the menopause and its link to depression are that it’s hard to untangle if the hormonal change is the cause or if it’s a result of the other physical symptoms of the menopause that cause it, such as hot flushes and insomnia (Freeman, 2015). The point made by Freeman (2015) on the cause of the depressive symptoms is a good point to make because if you’re experiencing the discomfort of hot flushes, sleep disturbance, and all the other physical symptoms women have to live with while going through the menopause, then it’s likely to have an effect on their mental health. This effect would be relevant for knowing how to treat the mental health of women going through the menopause.

 

Although depressive symptoms seem to be fairly common with the onset of the menopause, I struggled to find studies into anxiety being caused by the menopause. Therefore, we have to make do with what The North American Menopause Society (NAMS) says on their website for now. According to NAMS, few scientific studies support the idea that menopause contributes to anxiety, even though some women report such symptoms. However, I guess feeling like that is likely with such a change in life as it’s also an indicator of mortality.

 

Thus, could it be possible that the anxiety some menopausal women feel is related to their death anxiety and not as a direct consequence of the menopause itself?

 

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How To Mitigate The Mental Health Effects Of The Menopause

 

Hormone replacement therapy (HRT)

This option pretty much does what it says on the tin, it’s a treatment that pumps up the hormones in your body as the menopause causes those levels to decline. However, there are risks with HRT, with some types being linked to breast cancer, according to the NHS.

 

Fitness

A study by Elavsky and McAuley (2007) looked to see if exercise could be used to help manage the mental health side-effects of going through menopause. The study was a four-month randomized controlled exercise trial on 164 previously low-active middle-aged women participants aged between 42–58 and who were experiencing menopause. The results indicated that physical activity enhanced the participants’ moods and improved menopause-related quality of life. However, it should also be noted that the other mental health benefits may be as a result of a reduction in menopausal symptoms, rather than as a direct result of exercising.

 

Hot flush tips

According to the NHS, women can start to experience hot flushes before they have their last period, with most women only having the occasional hot flush that doesn’t really bother them. However, for some women they can be disruptive, uncomfortable, and embarrassing.

 

  • Reduce or cut out coffee and tea.
  • Quit smoking.
  • Keep your rooms room cool and use a fan (electric or handheld) if necessary.
  • Spray water on your face (I had to do this to help avoid heatstroke during a heatwave, it can be quite effective).
  • Use a cold gel pack (available from pharmacies).
  • Wear loose layers of light cotton or silk clothes.
  • Instead of a duvet, have layers of sheets on the bed as this will allow you to remove them as needed.
  • Drink less alcohol.
  • Sip a cold drink.
  • Avoid hot showers/baths.

 

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Seek support

Go talk to your doctor, that’s what they’re there for. You could even seek out support groups or talk to women around your age and older, because as I’ve stated in this article, pretty much every woman will have experience of this once they’ve reached a certain age.

 

As always, leave your feedback in the comments section below. Also, feel free to share your experiences of going through the menopause and any advice you have on dealing with it in the comments section below as well. If you want to stay up-to-date with my blog, then sign up for my newsletter below. Alternatively, get push notifications of new articles by clicking the red bell icon in the bottom right corner.

 

Lastly, if you’d like to support my blog, then you can make a donation of any size below as well. Until next time, Unwanted Life readers.

 

 

 

References

 

Avis, N. E., Crawford, S. L., & Green, R. (2018). Vasomotor Symptoms Across the Menopause Transition: Differences Among Women. Obstetrics and Gynecology Clinics of North America45(4), 629–640. Retrieved from https://doi.org/10.1016/j.ogc.2018.07.005 and https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6226273.

Bromberger, J. T., Matthews, K. A., Schott, L. L., Brockwell, S., Avis, N. E., Kravitz, H. M., Everson-Rose, S. A., Gold, E. B., Sowers, M., & Randolph, J. F., Jr (2007). Depressive symptoms during the menopausal transition: the Study of Women’s Health Across the Nation (SWAN). Journal of Affective Disorders, 103(1-3), 267–272. Retrieved from https://doi.org/10.1016/j.jad.2007.01.034 and https://pubmed.ncbi.nlm.nih.gov/17331589.

Dennerstein, L., Dudley, E. C., Hopper, J. L., Guthrie, J. R., & Burger, H. G. (2000). A prospective population-based study of menopausal symptoms. Obstetrics and Gynecology96(3), 351–358. Retrieved from https://doi.org/10.1016/s0029-7844(00)00930-3.

Elavsky, S., & McAuley, E. (2007). Physical activity and mental health outcomes during menopause: A randomized controlled trial. Annals of Behavioral Medicine, 33(2), 132–142. Retrieved from https://doi.org/10.1007/BF02879894 and https://www.researchgate.net/publication/6380732_Physical_activity_and_metal_health_outcomes_during_menopause_A_randomized_controlled_trial.

Freeman, E. W., Sammel, M.D., Lin, H., & Nelson, D. B. (2006). Associations of Hormones and Menopausal Status With Depressed Mood in Women With No History of Depression. Archives Of General Psychiatry, 63(4), 375–382. Retrieved from https://jamanetwork.com/journals/jamapsychiatry/fullarticle/209523.

Freeman, E.W. (2015). Depression in the menopause transition: risks in the changing hormone milieu as observed in the general population. Women’s Midlife Health, 1(2). Retrieved from https://doi.org/10.1186/s40695-015-0002-y.

Kim, K. (2020). Identifying the Factors That Affect Depressive Symptoms in Middle-Aged Menopausal Women: A Nationwide Study in Korea. International Journal of Environmental Research and Public Health, 17(22), 8505. Retrieved from https://doi.org/10.3390/ijerph17228505 and https://www.mdpi.com/1660-4601/17/22/8505/pdf (this link will download the study as a PDF).

Sajatovic, M., Rosenthal, M. B., Plax, M. S., Meyer, M. L., & Bingham, C. R. (2003). Mental illness and menopause: a patient and family perspective. The Journal of Gender-specific Medicine6(2), 31–34. Retrieved from http://citeseerx.ist.psu.edu/viewdoc/download?doi=10.1.1.627.8944&rep=rep1&type=pdf.

 

Support

 

The North American Menopause Society

Menopause Support

55 thoughts on “What You Need To Know About The Menopause And Mental Health

  1. I know that my mum had some dark days when she was going through the change. She didn’t speak to anyone about it but it got to the point where we knew something wasn’t right. Now that she’s open about it and has support and right kind of medication from her doctors, she is much happier. As a younger woman, I had no clue the strain and mental toll the menopause has. Hopefully everyone reading this post will understand a little better!

    Rosie

    • This is such an excellent post that is not talked about enough, especially in the country I was born. When my was going through the changes it was a difficult time for her and even the family because we (includinf herself) didn’t know what was going on and truly thought something was wrong and that she was sick. It was not until she went to the doctor after some time of experiencing the symptoms that she knew what it was. It was truly an emotional time for her.

      Up here in the US it is talked about but among the older ladies who are about to experience it or are currently experiencing. There should be something provided about this topic to the younger generation as well, so we can all be well informed abiut how it affects the body mentally. Emotionally, and physically.

      Thanks for sharing.

      • Thanks for sharing your experience. I can certain see why someone would think they were sick if no one had talked to them about the menopause, I imagine it happens more than you’d think

    • I started reading this and immediately questioned myself on whether or not this was taught in school. In doing so, I too questioned my friends on the same and we all said no.

      It’s so intriguing re women sharing this transition in life with orcas etc. Trivia for the next quiz night!

      But honestly, thank you for taking the time to research, document and share such an under spoken subject.

  2. This was such an interesting read and thank you so much for sharing all these case studies! I think as you said, almost no one ever during school had heard mentions of menopause during sex education, so it’s great that people speak about it! I didn’t know about humans, orcas and short finned pilot whales to be the only one to go through menopause. Thank you for sharing 🙂

    • Thank you. My eyes were opened while researching this article, I thought I had some understanding of it, but I was way off. Like, I had no idea HRT had links to cancer

  3. Thank you for sharing. You blog about some of the most interesting topics. I am a little curious if menopause affects mental health differently if it occurred naturally or as a result of surgery. I know a few people who entered menopause early after cancer scares.

  4. I’m going through the menopause and what helps me the most is running. I notice that if I don’t go for a week, my mood drops.
    Also, sugar, caffeine and alcohol makes my hot flushes worse.
    Well-researched article.

  5. I currently have a few family members going through menopause. It hard to see the hot flashes and mood swings. I wish more people knew about the affect it can have on mental health. Just being a young lady and how a monthly cycle affects a women’s mental health. This such good information and glad you are bring light to this subject.

  6. I hadn’t realized that there were so many mental and emotional health-related side effects of menopause, I’ve only ever heard of the physical symptoms. Very informative, thanks for sharing.

  7. Very good information on your blog. There needs to be a better understanding of all that affects women’s health. No one is to be put in a box as if all our bodies are identical. Just sharing. 😊

  8. Thank you for sharing this important post, I think it is often forgotten about that women experience great changes during menopause- and their hormones can cause mental health issues (like at any time in someone’s life). Thank you for sharing this insight

  9. Menopause is just a natural way of reducing the physiological burden on women, yet most of the women in the developing world and certain communities in the developed world relate their status with having kids and keep having them; naturally, they will feel trapped. The RDA for a woman of Iron is 2mg as compared to men that is 1mg. Proper education, information is needed so they can have a fulfilled lives while enjoying their womanhood.

  10. I have seen my mom going through change and I know it is very hard. But menopause is natural and nothing to be afraid of. You can have your darkest moments and shine bright the very next second which is not easy. I am even more inspired to read this post written by you. It makes me happy to read about this subject from you 🙂

  11. It’s so true that no one really talks about it and we aren’t taught about it in school. I know my aunt has severe depression now that she has gone through menopause. She did not have issues before and now it’s like she’s a completely different person. Unfortunately, she is someone who will not see a doctor or therapist about it. 🙁 Thanks for getting this information out there!

  12. Informative article! Menopause scares me for some reason… The symptoms can be really annoying too. I remembered my mom and aunts whine about having to undergo menopause. The hot flushes, irritable skin, mood swings. Thanks for sharing! Learned a lot from your article. Really important to know this as a woman.

    http://www.lifebeginsattwenty.com

  13. I’m pre-menopausal and really not looking forward to it. My mum was on HRT and hated it – she said it made her ‘feel artificial’. She still got hot flushes and, though fewer, they were worse. But menopause also brings weight gains, general apathy and moodiness/quick to anger, as all your energy is concentrated on controlling your own body…

    A nice article – well done!

  14. One of my aunts was talking about menopause recently, so it was great to come across this! Because menopause occurs over a longer period of time and not always at the same age, sometimes it is hard for women to know immediately that it is menopause and not a random reaction, mood-swing, or anxiety in relation to something else.
    Love that you are talking about this! I find sex education in general as taught by the schools to be incredibly lacking in general, and not all of us are as driven to fully round out their knowledge . . .

  15. I would like to thank you for writing this piece because there is a serious lack of education on menopause. Throughout her life a woman get educated on sex as you said, then on reproductive health and it stops there. I entered premenopause last year and I didn’t even know it. A friend of mine who is older and who has been in menopause for years is the one who made me realize it. I noticed that all my girlfriends who are my age were experiencing some of the symptoms and didn’t realize neither that they were entering premenapause. I am the one who made them aware of it. My symptoms for now are breast tenderness, insomnia, lack of concentration and memory problem. I feel dysfunctional and diminished in my abilities, and it’s just the beginning. I don’t even want to think about what’s coming next. Anyway, thanks again.

  16. This is great information. I don’t know why, but the topic of menopause seems to be avoided for the most part. However, it’s a completely natural phase of life that nearly every woman will experience (I know there are some exceptions). While I am all too familiar with the physical impact of menopause, I’ll be honest and admit that I’ve never stopped to consider the way it could impact my mental health. Thank you for this!

    • The only reason I can think of for making the menopause a taboo subject is because of we live in a male dominated world, even though it makes no sense to not talk about it

  17. Really enjoyed this post. As a woman, I believe it’s important to share as much information as possible about this topic as I know many are still not aware of it. I wish it wasn’t so much of a taboo subject because it’s not something we should hide. It’s a natural progress in women’s life. Thanks for sharing!

    Olivia

  18. This post has so much valuable information a lot of which I’ve not come across before. I’ve not heard of exercise being used for hormone balance during the menopause it’s so interesting

  19. I am not going to lie, I was skeptical to read a menopause article written by a man. BUT I was thrilled to find it so informative and well-written. Nice job! It does seem like there are a multitude of mitigating factors to cause the entire menopausal process to be a source of stress and anxiousness (among other things). In general, if I do not have enough real restful sleep, my mental and physical facilities are weakened and I can range from a total jerk to a basketcase. Add that on to hormonal misbalances and hot flashes and I see some turbulent waters ahead. However, Most of the ladies I’ve known, say it’s rough by also freeing and worth it. 🤷‍♀️ One day, I’ll find out. Thanks for sharing!

    • It probably wouldn’t have been a subject I would have decided to write about until someone suggested it to me, but I’m glad I did. Writing this post helped me to learn a few things that ideally we should have all been taught in school

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