Understanding the Impact of Menopause on Mental Health

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Menopause, as well as the years leading up to it, can cause intense physical symptoms, including hot flashes, irregular menstrual cycles, and sleep disturbances. But what many don’t realize is the impact that menopause can have on mental health. Up to 23% of menopausal people will experience mood changes, and some will experience mental health conditions such as depression or anxiety.

This article discusses the connection between menopause and mental health, including factors that increase your risk of mental health issues during menopause—and most importantly, what treatments and coping options may help so that you can feel more like yourself again.

The Connection Between Menopause and Mental Health

Menopause is defined as the point in time when menstruating people naturally stop having periods. For most people, this happens at around age 50. But the transition to menopause (called perimenopause) can start in your 40s, as your body’s hormone levels begin to change.

During the menopause transition, the ovaries gradually start producing less estrogen, which is what leads to the cessation of menstruation and fertility.

Everyone experiences menopause a little differently, but for most, the menopause transition is marked by physiological symptoms that can be uncomfortable.

Menopause Symptoms

Some of the most prominent symptoms of menopause include:

  • Hot flashes, which are characterized by sudden moments of extreme heat in the body, often causing you to feel flushed and sweaty; some people have these only occasionally, but some people have them several times a day
  • Trouble sleeping—either falling asleep or staying asleep
  • Vaginal dryness and increased risk of urinary tract conditions and infections

Mood Swings

In addition to these physiological experiences, you may be more prone to intense mood swings. In particular, people may experience an increase in depression symptoms, likely driven by hormonal changes. Some menopausal people seem to be more prone to anxiety and panic attacks during this time—again, likely because of hormonal shifts.

Some of the mental health symptoms people experience during menopause might have more than one cause. In other words, these symptoms aren’t always simply caused by hormone shifts. For example, there are major life stressors that happen during a person’s 40s and 50s (all of which can contribute to depression symptoms:

  • Raising children
  • Caring for aging parents
  • Work stress

Moreover, some of the physical signs of menopause in and of themselves may impact mental health. Hot flashes, lack of sleep, decreased energy, and weight gain are all menopause complaints that can also affect the quality of life.

Additionally, some of the physical signs of menopause, such as hot flashes, may resemble anxiety symptoms and panic attacks.

Risk Factors

Some people may be more vulnerable to the mental health effects of menopause than others. Perhaps the biggest risk factor is having had a mental health challenge in the past. For example, according to the North American Menopause Society, the strongest risk factor for developing depression during menopause is having a history of mental health challenges or depressive moods in your younger years.

Other risk factors for increased mental health issues during menopause include:

  • Lack of social and emotional support
  • Experiencing major life changes or challenges during the menopause transition
  • Experiencing intense discomfort from physical side effects of menopause, especially hot flashes
  • Lack of positive health behaviors, such as healthy eating or regular engagement in exercise
  • Experiencing consistent lack of sleep
  • Other health issues emerging during this time, especially thyroid issues, which may lead to further hormonal imbalances

Diagnosis of Menopause Impacting Mental Health

Menopause itself is defined by not having a menstrual period for 12 months in a row. But people may be in perimenopause for many years. According to the North American Menopause Society, testing your hormones levels to determine if you are in perimenopause isn’t helpful because your hormones are constantly in flux due to normal changes in the menstrual cycle.

If you are in your 40s or 50s and think that you are in menopause or perimenopause, it’s best to meet with a gynecologist to discuss what is going on with you. They can help you determine where you are in your transition, and what—if any—medical interventions might be helpful for you.

Additionally, your gynecologist can help you determine if any mental health challenges you are experiencing may be related to menopause, and if so, what your next steps may be.

If your gynecologist believes you may be experiencing a mental health disorder, such as major depression or anxiety, they will likely refer you to a psychiatrist for a diagnosis.

Mental health disorders are diagnosed using the DSM-5, which is a standard way that mental health providers classify mental health conditions. Your mental health provider will use these criteria to determine what condition you may be experiencing so that you can get proper treatment and care.

To find a local menopause provider specializing in menopause and related conditions, please visit the North American Menopause Society directory.

Treatment of Mental Health Issues Related to Menopause

Treatment of mental health conditions during menopause may involve therapy, medication, and hormone replacement treatments. Your gynecologist may work alongside your psychiatrist or therapist to help determine the right treatment plan for you.

Here are some options that may be considered include:

Cognitive-Behavioral Therapy (CBT)

Cognitive-Behavioral Therapy (CBT) is the main type of therapy recommended for mental health conditions experienced at menopause, according to the North American Menopause Society.

CBT helps you become more mindful of your thoughts so that you can learn how they affect your emotions, behavior, and impulses.


The North American Menopause Society recommends SSRIs (selective serotonin reuptake inhibitors) to treat depression and anxiety caused by or exacerbated by menopause.

However, as they point out, sometimes SSRIs can cause sexual side effects, such as decreased desire and decreased ability to orgasm. If this is the case, they recommend you try SSRIs that have fewer sexual side effects, such as duloxetine (Cymbalta) or bupropion (Wellbutrin). Talk to your healthcare provider about the best antidepressant for you.

Hormone Replacement Therapy (HRT)

Taking synthetic hormones, known as hormone replacement therapy (HRT), may help with some of the mental health challenges that arise during menopause. The North American Menopause Society says that estrogen in particular may help elevate your mood and guard against depression. HRT may be used alone or in conjunction with antidepressants.

Coping With the Impact of Menopause on Mental Health

For many people, coping with the mental health impacts of menopause involves multiple approaches. In addition to medical interventions and therapy, people in menopause may need to take a look at their life stressors and how these may be impacting their mental health.

Prioritize Self-Care

Midlife is a busy time for many of us, as we usher our child off into the world, deal with an empty nest, and care for aging parents—all while usually still working and tending to our household responsibilities. Taking time to care for yourself can be difficult, but making this a priority can have positive impacts on your mental health.

Make Some Lifestyle Changes

Certain lifestyle changes can also help with the physical and psychological impacts of menopause. These may include eating a healthy, balanced diet, getting your body moving on a daily basis, and prioritizing sleeping (and catching up on it when it’s hard to come by).


The transition of menopause is influenced by shifted hormones that can cause uncomfortable physical symptoms such as hot flashes and sleep disturbances. Many people also experience intense mood swings, as well as increased symptoms of depression or anxiety. Thankfully, help is out there if you are experiencing the mental health impacts of menopause. Your gynecologist or a trained mental health professional can find you the help you need to feel better.

A Word From Verywell

If you are experiencing the mental health impacts of the menopause transition, you can take heart in knowing that you are not alone. Menopause isn’t something that people talk about nearly enough, yet so many of us are in the throes of it, dealing with all of its challenging symptoms. Connecting with other people going through the menopause transition can be invaluable and make it easier to cope.

11 Sources
Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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By Wendy Wisner
Wendy Wisner is a health and parenting writer, lactation consultant (IBCLC), and mom to two awesome sons.