Mental Health and the Menopause

Middle age and menopausal changes provide considerable challenges for many women, on both a physical and emotional level.  It is commonly known as "The Change" but actually there are a myriad of changes happening around this time – not least in terms of family relationships, lifestyle and energy levels.  Menopause really is a period of transition and, like any change, this can be a stressful time.

What happens to our bodies as we approach middle age?

Menopause is a natural part of ageing for women that usually occurs sometime between the ages of 45 and 55, with the average age in the UK being 51. However, 1 in 100 women experience this before the age of 40. The menopause itself refers to the end of a woman’s menstrual cycle and is defined as occurring in the 12 month period after the last menstrual period. The 5 to 10 year period before that, when oestrogen and hormone levels start to drop is known as perimenopause.

During menopause, oestrogen depletion can stimulate various hormonal and biochemical fluctuations which can lead to changes in the brain and nervous system.  These changes can, for example, disrupt your body’s temperature controls and so cause unpleasant hot flushes and night sweats. Other symptoms can include insomnia, a reduced sex drive, headaches and mood changes.

How can hormonal changes affect your mood?

The drop in oestrogen is thought to affect the way that the body manages its levels of serotonin and norepinephrine.  These two substances have been linked directly to depression. Lower levels of oestrogen have also been linked to irritability, stress, forgetfulness, fatigue, anxiety and difficulty concentrating.

However, the cause and effect relationship between depleting hormone levels and certain mental health issues, such as depression and anxiety is not necessarily as simple or direct as it seems. Sleep disruptions, for example, and fatigue can lead to irritability and lack of focus; changes in libido can lead to relationship difficulties, and so on.

Changes in lifestyle

As well as hormonal changes, there are many lifestyle changes that seem to occur at a similar time.  For many women, for whom family life and motherhood has been a defining feature of their lives, for example, menopause often coincides with children leaving home to go to university or to start relationships and families of their own.  ‘Empty Nest Syndrome’ as it’s known, can be a very stressful and traumatic time, where parents (and in particular women) re-evaluate their roles and identities.  It can seem like a cruel twist of fate then that, at the same time, biology is reminding them that their fertile years are now over.  On the other hand, for other women who have wanted children but never conceived, menopause represents the end of hope and opportunity. 

Menopause anxiety is very common and can be one of the most challenging symptoms to deal with. Many women can suddenly find themselves overwhelmed by situations which were never a problem before.  This undermines confidence, creating a vicious circle which can difficult to break out of.  Talking helps of course and many women are surprised to find that these feelings are relatively common-place during this phase of their lives.

How can you deal with menopausal changes?

Here are a few suggestions:  

  • Try looking at the menopause from a different angle.  Instead of focusing on the negatives, explore the positives: freedom from periods and contraception are obvious bonuses!

  • Start to devote some more time to looking after your own needs – start a new hobby or activity, which is just for you.

  • Explore ways to cope with anxiety – mindfulness, yoga, relaxation – whatever works for you.

  • Talk to other women who are going through the same thing and share tips on how to manage changes, both physically and mentally.

  • If you need to, explore therapeutic ways to get you back on track – hypnotherapy is a great way to combat anxiety/confidence issues, for example.

  • Remind yourself that this is a major change – and change is challenging.  Be kind to yourself – you are doing ok.