<img src="https://api-s.withalva.com/image.gif" alt="">
LibraryStories

Mental health

It's common for menopause to change your mental health and wellbeing. We know that sometimes it can be hard to recognise when your feeling a bit off. For most people life is busy and stressful - and there's little time to recognise your own feelings. We summarise how menopause can impact your mental health, and how to recognise you might not be feeling ok.

What happens to the mind with menopause?

Some women pass through menopause with no noticeable changes to their brain function or mood. Others, unfortunately, won't be so lucky. Mental health symptoms such as anxiety, feeling low and memory changes are common amongst menopausal and perimenopausal women. Of the 34 symptoms of menopause, the mental health ones include:

  • Low mood
  • Unexplained anxiety
  • Depression (persistent low mood, which won't go away) (1)
  • Mood swings
  • Brain fog, or difficulties with memory
  • Problems with concentration
  • Feelings of low self-esteem
  • Having reduced motivation
  • Low energy.

These can happen at any moment - and have a lot of contributing factors. Menopause and hormonal changes may not be the root cause of changes to your mental health - life events, relationships, work, diet and lifestyle will all have an impact. But, the hormonal changes of menopause can wreak havoc on the brain. The women we've spoken to at Alva say it's the mental symptoms that often have most impact on your life. It can be hard to work when your memory is flagging, or you suddenly find yourself getting much more anxious.

How does menopause affect your brain?

The simple answer is that we don't quite know - yet! So many aspects of life affect your mental health it can be difficult for academic studies to isolate single causes.

Broadly, there's agreement that the risk of some mental health problems increases during perimenopause. One large study (4) identified that the perimenopause is linked to a higher risk of depression and depressive symptoms.

Our hormones interact with some of the important chemicals that control our mood (e.g. serotonin and norepinephrine). When hormone levels change at menopause - important chemicals can become imbalanced and increase the risk of depression (2, 3). The risk decreases after menopause, when hormones are more stable (5,6).

There's now acedemics working to develop new types of experiment, which could link changes in hormone levels directly to mood swings (7). We'll be watching this space carefully and keeping you up to date.

Why menopause can be a difficult time

It's no secret that by the time menopause comes along women's lives are hectic! We take on responsibilities for a home, in marriages and partnerships, will often have professional lifes and aging parents... and that's before we've even mentioned children. Any number of these is a huge amount to juggle and can lead to a lot of stress.

Frankly, just thinking about the amount women have going on during menopause makes me anxious. With so much on women's plates taking a break can be hard. Often women are not thinking about themselves at all - putting everyone else's needs about their own. As a result, there's an increased risk of burnout, and mental health problems.

The physical symptoms some women experience at menopause can add to the burden. Juggling life is enough - without hot flushes, night sweats or sleep problems.

Recognise how much you're taking on - and try to give yourself some space to look after your mental health! Exercise, good nutrition, mindfulness and hobbies you enjoy can all help. Along with other more structured ways of getting support such as talking therapy, CBT or group therapy.

Ways to understand your mental health, and identify problems early

So much time spent thinking about other people makes it tough to recognise when you aren't feeling good. Some signs that your mood might have dropped include:

  • Feeling exhausted all the time
  • Crying more often than usual
  • Other people, such as partners or colleagues, asking if you're feeling ok
  • Changes to appetite (both wanting more or less food)
  • Feeling worried about things that haven't bothered you in the past
  • Low motivation
  • Enjoying life less.

Don't ignore these changes, or think they are just 'part of life'. They build up, and can lead to more serious problems if they're ignored.

Tracking your symptoms can be a helpful way to understand your mood. If you're trying to understand more about your mood, some of the following resources might help:

  1. NHS app store for mental health.

This is a library of apps which have been reviewed and approved by the NHS. They cover everything from stress to sleep.

  1. NHS every mind matters website. You can get a personal plan to help you take care of your mental health. It gives you a few simple, evidence based things to try to improve your mental health and wellbeing.

  2. The MIND website.

Mind is an amazing charity that provides a whole range of information and support for your mental health

  1. The Samaritans website and hotline.

If you're ever feeling low and don't feel there's a place to turn the Samaritans provide an amazing, confidential service. Don't go through a crisis alone.

References:

  1. Royal College of Obstetricians and Gynaecologists. n.d. Mood Changes And Depression. [online]
    Available at: https://www.rcog.org.uk/en/patients/menopause/mood-changes-and-depression/](https://www.rcog.org.uk/en/patients/menopause/mood-changes-and-depression/ [Accessed 21 October 2019].

  2. Golden, R. and Gilmore, J., 1990. Serotonin And Mood Disorders. 20th ed. Psychiatric Annals, pp.580-586

  3. Janowsky, H., Halbreich, U. and Rausch, J., 1996. Association Among Ovarian Hormones, Other Hormones, Emotional Disorders, And Neurotransmitters.. American Psychiatric Press, pp.85-106.

  4. Bromberger, J. and Kravitz, H., 2011. Mood and Menopause: Findings from the Study of Women's Health Across the Nation (SWAN) over 10 Years. Obstetrics and Gynecology Clinics of North America, [online] 38(3), pp.609-625.
    Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3197240/.

  5. Cohen, L., Soares, C., Vitonis, A., Otto, M. and Harlow, B., 2006. Risk for New Onset of Depression During the Menopausal Transition. Archives of General Psychiatry, [online] 63(4), pp.385-390.
    Available at: https://jamanetwork.com/journals/jamapsychiatry/fullarticle/209471.

  6. Freeman, E., Sammel, M., Liu, L., Gracia, C., Nelson, D. and Hollander, L., 2004. Hormones and Menopausal Status as Predictors of Depression in Womenin Transition to Menopause. Archives of General Psychiatry, [online] 61(1), pp.62-70.
    Available at: https://jamanetwork.com/journals/jamapsychiatry/fullarticle/481940.

  7. Gordon, J., Peltier, A., Grummisch, J. and Sykes Tottenham, L., 2019. Estradiol Fluctuation, Sensitivity to Stress, and Depressive Symptoms in the Menopause Transition: A Pilot Study. Frontiers in Psychology, [online] 10.
    Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6581734/.