Why menopause is high risk for mental ill health

Hot flushes and mood swings are often associated with menopause, but mental ill health can be another common symptom women should be aware of during this time.

The combination of natural biological changes a woman experiences during menopause, along with personal and environmental stressors can create a perfect storm for mental ill health, according to Professor Jayashri Kulkarni, director of HER Centre Australia – a Melbourne-based organisation dedicated to women’s mental health.

“When people talk about menopause, they talk about hot flushes, but depression related to menopause is really unrecognised,” Prof Kulkarni says.

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What is menopause, and how does it affect mental health?

Menopause occurs when it has been 12 months since a woman’s last period.

However, the time leading up to menopause – known as perimenopause – when symptoms most commonly associated with menopause, such as hot flushes and insomnia, can start.

It is also when menstrual cycles change, including the gaps between periods and their flow.

These symptoms occur because of changing levels of estrogen and progesterone in the body.

The period of perimenopause can last anywhere between four to 12 years and usually happens between the ages of 45 and 55.

It is the fluctuations in these hormone levels, in combination with other factors, which can make a woman experiencing perimenopause at risk of depression.

“Menopause is a 10 to 12-year process and it starts in the brain,” Prof Kulkarni says.

“There are mood changes, increased irritability, hostility and panic attacks one week and then the next week they are feeling fine.”

However, biology is not the only factor which may increase a woman’s vulnerability to perimenopause-related depression – life circumstance can play a role too.

“These women are often the ones who are caring for adolescent children, elderly relatives and they were often the ones taking on the pandemic-related roles at home.”

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How to know menopause may be affecting your mental health

Prof Kulkarni says it’s important women in their 40s and 50s are aware the process of menopause begins in the brain and that may lead to an increased vulnerability to mental health issues.

“From the age of 45 years you might start to notice changes,” Prof Kulkarni says.

“You might feel grumpy but then feel fine – this might be an indication that your biology is beginning to change.”

It is when you begin to notice these changes that Prof Kulkarni says it becomes particularly important to consider your mental health.

“If you are picking up on these changes, look for ways to improve the quality of your life to deal with the stressors.”

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Ways to look after your mental health during menopause

Keeping a healthy lifestyle, including good nutrition and safe exercise, are all ways to help manage the changes and stressors associated with menopause.

Prof Kulkarni also cautions against using alcohol as a stress reliever.

Instead, she recommends taking a daily 30-minute walk.

“Rain, hail or shine, go for a walk,” she says.

“It is great for both the body and mind.”

Lastly, Prof Kulkarni urges women who feel that they may be experiencing perimenopause depression to reach out and seek help from a healthcare professional.

“It’s going to be a 10 to 12-year journey, but you will come out on the other side of it fine,” she says.

More information

• HER Centre Australia at +61 3 9076 8156 or [email protected]
• Beyond Blue at (03) 9810 6100.

Written by Jemina Nuredini.