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Understanding the Mental Health Impact of Menopause

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Menopause is often associated with well-known physical symptoms like hot flashes and night sweats. Some of the other not as "well-known" physical symptoms include; irregular periods, vaginal dryness, sleep problems, weight gain, thinning hair, dry skin, breast tenderness, bloating, and joint pain. Being that is in May which is Mental Health Awareness Month, I thought it would be a good time to address the significant impact menopause can have on mental health. This lack of awareness can lead to confusion, frustration, and even a sense of isolation. In this article, we’ll explore the mental health challenges women may face during perimenopause and menopause and offer strategies to help manage these symptoms.




My Story: A Journey Through Perimenopause


My experience is a powerful illustration of the mental health struggles many women face during perimenopause. In my mid-late forties, I began experiencing uncontrollable crying spells and mood swings. Initially, I dismissed these symptoms, believing I had no reason to feel this way- I have a wonderful supportive husband, 3 awesome kids, and great friends. However, the situation escalated, and my mental health deteriorated to the point where I found myself not participating in activities that once brought me joy, pulled back from social things, and drinking some wine became a nightly routine.


After immersing myself in research and podcasts around perimenopause I started to understand why I was feeling this way. I was fortunate enough to get support by being enrolled in a Women's Health Certification program where I had a health coach and was surrounded by Women in the field of Women's Health. In knowing that the root cause of my symptoms where related to perimenopause- I took action in learning all things perimenopause.


The Hormonal Connection


Perimenopause, the transitional phase leading up to menopause, involves significant hormonal fluctuations that can begin up to eight years before a woman’s last period. These hormonal changes, particularly in estrogen and progesterone, can profoundly affect the brain.


Estrogen, for instance, is closely linked to serotonin, a neurotransmitter that plays a crucial role in mood regulation. Fluctuations in estrogen levels can disrupt serotonin balance, leading to mood swings, depression, and anxiety. Additionally, progesterone breaks down into a compound that affects the brain's calming receptors, and its erratic levels during perimenopause can contribute to feelings of irritability and impulsivity.


Recognizing the Symptoms


While many women are familiar with the physical symptoms of menopause, there is often a gap in knowledge regarding its mental health impacts. Symptoms can include:


  • Mood Swings: Sudden and intense changes in mood.

  • Depression: Persistent feelings of sadness or hopelessness.

  • Anxiety: Excessive worry or nervousness.

  • Irritability: Increased tendency to become annoyed or angry.

  • Crying Spells: Uncontrollable bouts of crying.

  • Low Confidence: Decreased self-esteem or self-worth.

  • Difficulty Concentrating: Problems with focus, memory, and cognitive function.


I experienced all of these symptoms, and I know that many women have more severe anxiety and depression that can be crippling and often need to be prescribed an anti-depressant. Women who have experienced depression or anxiety earlier in life or have had it during or after pregnancy are at a higher risk of developing these conditions during perimenopause and menopause. Here are some key statistics and insights on this topic:


  • Women with a history of depression are 2 to 5 times more likely to experience depressive symptoms during perimenopause and menopause compared to those without a prior history.

  • Those who have experienced postpartum depression are at a higher risk of developing depression during perimenopause and menopause.

  • Around 20-30% of women meet the clinical criteria for a diagnosis of major depression during perimenopause, which is double the rate compared to other life stages.

  • Symptoms of depression can appear up to 8 years before menopause, during the perimenopausal transition.

  • Anxiety symptoms are also common during perimenopause. Women with a history of anxiety disorders are at an increased risk of experiencing heightened anxiety during this time.

  • Approximately 51% of women report increased anxiety during the perimenopausal transition.

  • 50-60% of women experience symptoms of depression during menopause .

  • A 2020 study found that 23-28% of perimenopausal women experienced clinically significant levels of depressive symptoms.



Breaking the Stigma


It’s essential to understand that these mental health symptoms are not “all in your head.” Hormonal changes during perimenopause and menopause can lead to real and significant emotional challenges. Unfortunately, many women feel isolated and blame themselves for these changes.


Janet Ko, President and Co-founder of the Menopause Foundation of Canada, emphasizes the need for awareness and education. “It’s a myth that it’s just about hot flashes,” she says. “It is a profound hormonal change that will impact your entire body, and when you don’t understand that mental health can be part of that, you may be experiencing these challenges and not connecting the dots on the why.”


Seeking Help


If you are experiencing mental health challenges during perimenopause or menopause, it’s crucial to seek help. Here are some steps you can take:


Talk to a Healthcare Provider: Discuss your symptoms with a healthcare provider who understands menopause. Hormone therapy, counseling, or antidepressants may be recommended. After consulting with my doctor, she felt that I was doing a good job in dealing with my moods by getting outdoors and exercising and having a good social network where I share my feelings. She did not feel that I need to go on anti-depressants but did suggest HRT which has been a game changer!


Lifestyle Changes: Regular exercise, a healthy diet, and prioritizing sleep can help manage symptoms. For those who follow me on social media, you know that this is where I am the strongest advocate. How I personally dealt with the mental affects of perimenopause was by spending more time outdoors hiking in forests, adjusted my diet to be more protein and whole food based, limiting alcohol and sticking to a bedtime routine. Being on HRT has allowed me to start enjoying the things that I stopped doing before like biking.


Support Networks: Connect with support groups or talk to friends and family about what you’re experiencing. I feel like the topic of perimenopause and menopause is everywhere now on social media which is wonderful.


Dr. Alison Shea, a menopause expert at McMaster University, stresses the importance of recognizing and addressing these symptoms. “Your brain is not functioning the way it was before, so it really is a roller coaster,” she explains. Understanding that these feelings are valid and seeking appropriate treatment can make a significant difference.


Perimenopause and menopause are times of profound change that can impact both physical and mental health. By raising awareness and breaking the stigma, we can ensure that women receive the support and treatment they need during this transition. Remember, you’re not alone, and help is available. Your mental health is just as important as your physical health, and you deserve to navigate this journey with understanding and support.


If you found this article helpful, please share it to help others who may be experiencing similar challenges. Let’s work together to raise awareness and support women’s mental health during menopause.

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