What’s the Relationship Between Menopause, Anxiety and Depression?

Menopause’s physical symptoms are widely known: hot flushes, night sweats, fluctuating hormones and more. Its mental impact, however, is often less understood.

If navigating major physical changes weren’t enough, women frequently experience significant changes to their mental and emotional health at the same time. Anxiety and depression are common issues that women navigating menopause may face. For those who may already have anxiety or depression as a pre-existing condition, these challenges can be exacerbated as perimenopause and menopause approach. 

Whether you’re at the beginning of your menopause journey or deep in the heart of it, building a greater understanding of the correlation between menopause, anxiety and depression can be of substantial benefit. The more we understand about how this natural biological process impacts our health on a holistic level, the more equipped we are to find the tools and support we need for what’s ahead.

What’s the relationship between menopause, anxiety and depression?

Studies continue to identify the links between menopause and mental health issues such as anxiety or depression. A 2020 study in Brazil found that 58% of women aged 45-55 who were in the midst of perimenopause had anxiety symptoms, with 62% of women in the same study demonstrating symptoms of depression. 

Given the hormonal changes that take place during menopause, the findings of this study aren’t surprising. Changes in oestrogen levels have been associated with shifts in the incidence of anxiety in women. With oestrogen linked to serotonin in the brain (often referred to as the ‘happy hormone’) and a drop in oestrogen linked to a rise in cortisol levels (the stress hormone), there’s a substantial, growing body of evidence that points to correlations between menopause’s stages and fluctuating anxiety levels in women. 

As with any other side effect or symptom of menopause, this experience can be different for everyone. Some brains are more susceptible to the impact of fluctuating hormone changes, with some women more likely to experience mood changes than others. 

Alongside the impact of hormonal changes on anxiety and depression markers, menopause’s symptoms itself can lead to the development of these mental health challenges. Common menopause symptoms include:

• Hot flushes and night sweats: these are marked by sudden, intense heat spreading through the body, leading to sweating, flushing or chills. These are caused by a decrease in oestrogen and are often one of the early signs of perimenopause.
• Irregular periods: menstrual periods become irregular as menopause approaches due to fluctuating hormones. This can result in longer or shorter gaps between periods, as well as changes in the intensity of the period itself.
• Mood changes: alongside anxiety and depression, irritability and mood swings are common indicators of each menopausal change. 
• Vaginal dryness and discomfort: as a result of menopause’s changes, vaginal tissues can become thinner and less lubricated, resulting in discomfort during sex.
• Issues with sleeping: many women find themselves struggling with insomnia or with staying asleep as they navigate each menopausal change.
• Fatigue: a lack of energy is common throughout menopause, often the result of sleep disturbances or hormonal changes.
• Joint pain and stiffness: it’s common for women to experience issues with memory or with concentration as they move through menopause. While this can be tied to changes in hormones, this can also be the result of menopause-related stress. 

While anxiety and depression may be direct results of hormonal changes, the symptoms above can also reduce an individual’s sense of connectedness to self. As a result, anxiety and depression may occur, creating a cycle of mental and physical health challenges that need to be navigated throughout these different menopausal stages.

Pre-existing anxiety and depression considerations

While the impact on mental health can be challenging for any woman navigating menopause, this can be of particular concern for women who have pre-existing anxiety or depression. Women with a history of mental health challenges can find the support necessary for the process ahead by taking additional care in their preparation for menopause.

For women who fall into this category, it’s essential to build a rich and robust support network. Mental health professionals, support groups and personal communities can all play a pivotal role in providing necessary emotional support through this time of transition. 

Alongside this network, developing a range of techniques to help manage mental health issues as they arise can be a powerful and proactive step forward. These techniques can include:

• Relaxation techniques – including deep breathing exercises, meditation and mindfulness
• Regular exercise – this can be useful in releasing endorphins, which provide a natural boost to our physical, mental and emotional wellbeing
• Maintaining a healthy diet – fruits, vegetables, whole grains and lean protein can all help to stabilise blood sugar levels, improving overall health outcomes and assisting in reducing anxiety or depression symptoms

Many women also find that cognitive-behavioural therapy (CBT) is a useful tool during menopause. This can provide significant support in managing anxiety and depression challenges, with a focus on addressing negative thought patterns and behaviours.

Hormone therapy and anxiety and depression

Hormone therapy can be a remarkably effective treatment for menopausal women who are experiencing the impact of anxiety and depression. As hormone replacement therapy can alleviate a number of the symptoms associated with menopause, this can help women to lessen the factors contributing to their mental health challenges. 

Hormone replacement therapy (HRT) is a form of medical treatment that supplements the body with hormones that are either in decline or entirely lacking. Treatment will often involve taking either solely oestrogen or a combination of oestrogen and progesterone, with individual medical approaches dependent on personal circumstances, experiences and practitioner guidance.

Our programs are designed to strategically relieve your symptoms, with regular follow-up and monitoring by our patient care team that ensures you’re receiving the highest quality of individualised care. Our years of combined medical experience bring tangible change to the lives of Australian women every day, providing them with the treatment they need to overcome many of menopause’s symptoms and live each day to the full. 

Find support for your mental and physical health throughout menopausal challenges at the Australian Menopause Centre.