Menopause is a natural phase in a woman’s life, marking the end of the menstrual cycle and changes to fertility. Driven by hormonal changes, the perimenopause and menopause can significantly impact on mental health. Understanding the relationship between hormonal shifts and mental wellbeing during menopause is crucial for managing symptoms and maintaining a balanced life.
It’s estimated that around 70% of women over the age of 45 experience neurological and psychiatric symptoms during the perimenopause. Research also suggests that perimenopausal women are at a higher risk of developing mental health conditions, whilst women who already have a diagnosis will experience worsening symptoms.
Understanding hormonal changes during menopause
Menopause is characterised by a decline in oestrogen and progesterone, the hormones responsible for regulating the menstrual cycle. These hormonal changes occur in stages:
- Perimenopause: this transitional period can begin several years before menopause. Hormone levels fluctuate, leading to irregular periods and the onset of menopausal symptoms.
- Menopause: defined as the point when a woman has not had a menstrual period for 12 consecutive months. Hormone production from the ovaries significantly decreases.
- Postmenopause: the stage following menopause, where hormone levels stabilise at a lower level. Symptoms may persist but typically lessen over time.
How hormonal changes affect mental health
During menopause, the relationship between hormones and mental health is tightly interconnected. The hormonal changes that happen, especially the decline in oestrogen and progesterone, directly affect brain function, mood regulation and emotional wellbeing.
Oestrogen and serotonin
Oestrogen plays a crucial role in regulating neurotransmitters, especially serotonin, which is often called the “feel-good” chemical. Serotonin helps maintain a stable mood and emotional balance. When oestrogen levels drop during menopause, serotonin production is also affected, which can lead to mood swings, irritability and increased feelings of sadness or anxiety.
Progesterone and anxiety
Progesterone is another hormone that declines during menopause. It has calming effects on the brain, acting like a natural sedative. As progesterone levels fall, women can become more prone to feelings of anxiety, restlessness and even panic attacks. The loss of progesterone’s effect can also make it harder to deal with everyday stress too.
Stress responses
The hormonal changes of menopause can alter the body’s stress response. Cortisol, the stress hormone, can become more pronounced as the buffering effects of oestrogen and progesterone decline. This heightened stress response can heighten feelings of anxiety, irritability and overwhelm, making it more difficult to cope with normal stressors.
Mood swings and emotional sensitivity
Hormonal fluctuations can cause sudden and intense mood swings. For some women, these mood changes can be similar to those experienced during PMS, but they may be more severe and prolonged. The unpredictability of these emotional swings can feel overwhelming and contribute to a sense of emotional instability.
Increased risk of depression
The declining levels of oestrogen and progesterone during menopause increase the risk of developing depression, especially in women who have experienced it earlier in life. Oestrogen’s role in regulating mood-related chemicals like serotonin and dopamine means that its loss can lead to feelings of hopelessness, fatigue, and disinterest in daily activities—hallmarks of depression.
Brain fog and memory issues
Many women experience cognitive changes during menopause, such as difficulty concentrating, forgetfulness or a sense of “brain fog.” These issues are linked to the drop in oestrogen, which supports cognitive functions like memory and learning. While these symptoms can cause distress, they are often temporary and may improve after menopause.
Dr Clare Dolman from King’s College London said: “Almost 900,000 women have left their jobs because of menopausal symptoms.” This could be to do with brain fog, overwhelm and concentration issues.
Impact on sleep and mental health
Hormonal changes during menopause often cause sleep disturbances, such as insomnia, night sweats or waking up frequently during the night. Poor sleep can contribute to mood disorders, including anxiety and depression, as it affects cognitive function and emotional regulation. This can make it harder to manage mood changes and mental health challenges.
Self-esteem and body image
The physical changes that occur during menopause, such as weight gain or changes in skin and hair, can also affect self-esteem. Declining oestrogen levels can lead to shifts in body composition and metabolism, sometimes resulting in a negative body image. This can affect mental health by contributing to feelings of insecurity or inadequacy.
Collagen can support skin health and appearance by reducing the visibility of wrinkles, increasing elasticity and promoting hydration. It can also help to reduce inflammation. This can help with confidence and self-esteem. Learn more about the menopause and your skin.
Coping strategies for managing mental health during menopause
Managing mental health during menopause can be challenging due to the hormonal fluctuations that affect mood, sleep and your emotional wellbeing. There are some options to take if you feel that you need extra support during menopause
Seek professional help
Professional support can help if you’re struggling with your mental health during menopause. Whether you are looking into talking therapy, cognitive-behavioural therapy (CBT) or medication, it can help you to cope with your hormonal changes and feelings.
Hormone Replacement Therapy (HRT) can also help with mental health symptoms by stabilising hormone levels – this is an important conversation to have with your doctor.
Stress management
Techniques such as meditation, deep breathing and yoga can help manage stress and promote mental clarity. Engaging in activities you enjoy can provide a sense of purpose and reduce stress levels too.
Maintaining strong social connections can provide emotional support and reduce feelings of isolation. Join support groups or online communities to share experiences, or speak to your friends and family.
Lifestyle changes
A diet rich in fruits, vegetables, whole grains, lean proteins, and healthy fats can support overall wellbeing. Avoid excessive caffeine and sugar, which can make anxiety and mood swings worse. Physical activity releases endorphins, which can improve mood and reduce anxiety.
Establish a regular sleep routine and create a restful environment to improve sleep quality. Avoid screens and heavy meals before bedtime. Collagen can also help to support a healthy sleep routine as it contains the amino acid glycine, which has been shown to improve sleep quality.
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