• A new position statement from the Royal College of Psychiatrists discusses the link between menopause and the onset of new mental health conditions.
• The statement notes that only 21% of females knew that menopause was associated with mental health conditions like depression and bipolar disorder.
• It further notes that research is needed to increase awareness of how hormonal changes during menopause can impact mental health.

There are various symptoms that people can experience before, during, and after menopause.

One of the lesser-known symptoms is the effect that menopause can have on mental health.

“I believe this is a much-needed conversation that I have been seeing in my clinical practice for years” said Menijie Boduryan-Turner, PsyD, licensed psychologist and founder of Embracing You Therapy in Woodland Hills, CA.

“There has been a significant increase in insomnia, depression, anxiety, changes in concentration, memory impairment, and body image issues correlated with menopause. As suggested, most women are unaware of this link because for decades we have treated menopause as a medical condition, given the obvious reasons, and have been ignorant of the impact it has on women’s mental health,” Boduryan-Turner told Healthline.

This is a major contrast to the number of females who are aware of other associated issues, such as hot flashes and reduced sex drive.

“Menopause can have a significant yet often overlooked impact on women’s mental health and well-being. Women account for 51% of the population, and all will experience menopause at some point,” Lade Smith, president of the RC Psych, told The Guardian.

“This is a societal issue for everyone. Simply put, we must do better,” Smith said.

According to the RC Psych, only 21% of females were aware that menopause can be associated with mental health issues.

This is in contrast to 81% who were aware of hot flashes due to menopause, and 64% aware of a reduced sex drive.

RC Psych published its position statement with certain key aims in mind, such as:

• More training and education for the psychiatric workforce.
• Promoting a wider understanding and awareness of the association between menopause and mental health.
• Enhancing equity in the identification of, and access to support and appropriate treatment for, females with menopausal symptoms and pre-existing mental health needs.
• Advocating for comprehensive, interdisciplinary approaches to menopause support and treatment across health systems.
• Considering how a female’s experience of menopause and mental health can impact their relationships with children and family.
• Setting out key evidence to illuminate existing knowledge and treatment gaps about menopause regarding its interplay with mental health.

“I think it’s important to know that mental health challenges that occur or are exacerbated by menopause are common,” said Amy Roskin, MD, JD, board certified OB-GYN and Chief Medical Officer at Seven Starling, a women’s health platform.

“It’s essential to be aware of this and have support from your healthcare providers in order to best diagnose and manage these issues,” Roskin told Healthline.

The position statement points out the mental health effects that perimenopause can have. Anxiety and low mood are fairly common side effects of hormonal changes associated with menopause. However, for some females, menopause can significantly increase the risk of developing a serious mental health condition.

The physical and hormonal changes during menopause can also lead to relapse or trigger eating disorders. The report also notes that suicide rates are higher among those of menopausal age.

“With greater public awareness, there is more conversation and dialogue. There is more compassion and willingness to seek help. When mental health experiences are normalized, we are more likely to seek support and not suffer alone,” said Boduryan-Turner.

“I have worked with clients who struggled with severe depression with suicidal ideation; therefore, it is extremely necessary for us to have more education, information, and awareness on this topic.”

The statement notes that for females with a history of mental illness who are entering menopause, hormone therapy can be a key treatment to address both their physical health risks, as well as their mental health symptoms.

Some experts may recommend a combination of hormone therapy and cognitive behavioral therapy (CBT) rather than antidepressants for perimenopause-associated anxiety and low mood symptoms.

There is some older evidence to show that females experiencing depressive episodes during menopause may not respond as well to selective serotonin reuptake inhibitors (SSRIs), a common type of antidepressant. It also shows that there may be significant discontinuation rates associated with adverse effects.

“A healthy diet, exercise, work/life balance, psychotherapy, psychiatric medications, and HRT can all be important parts of strong emotional health for women in midlife,” said Nissa Keyashian, MD, board certified psychiatrist and author of “Practicing Stillness.”

“I recommend finding a psychiatrist with expertise in women’s health who has expertise in HRT and menopause,” Keyashian told Healthline.

“There are many different formulations of HRT that can minimize risks and side effects and maximize benefits to your emotional health and well-being.”