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Severe mental illness and the perimenopause
Sophie Behrman1, Clair Crockett2
1Oxford Health NHS Foundation Trust, UK.
Bjpsych Bulletin
|November 13, 2023
Summary
Perimenopause hormonal shifts can worsen mental health symptoms, especially for those with existing conditions. Collaborative care and treatments like hormone therapy can improve overall well-being during this transition.
Area of Science:
- Reproductive Endocrinology
- Psychiatry
- Women's Health
Background:
- Perimenopausal hormonal fluctuations trigger diverse physical and psychological symptoms.
- Individuals with pre-existing mental disorders may face symptom exacerbation and altered treatment responses during perimenopause and postmenopause.
- Psychotropic medications can suppress estradiol, potentially complicating the menopausal transition.
Purpose of the Study:
- To highlight the impact of perimenopausal hormonal changes on mental health.
- To emphasize the risks for individuals with pre-existing mental disorders.
- To advocate for integrated care models for perimenopausal women with mental health conditions.
Main Methods:
- Literature review on hormonal changes during perimenopause and their psychological effects.
- Analysis of the impact of psychotropic medications on the hypothalamopituitary-gonadal axis.
- Exploration of collaborative care models between primary and mental health services.
Main Results:
- Hormonal fluctuations during perimenopause significantly impact mental and physical health.
- Pre-existing mental disorders can be adversely affected, with potential for poorer long-term physical health outcomes.
- Estradiol suppression by psychotropics may exacerbate menopausal transition challenges.
Conclusions:
- Integrated care approaches are crucial for proactive management of perimenopausal symptoms in women with mental health conditions.
- Lifestyle modifications and hormone replacement therapy (HRT) can improve well-being and mental/physical health.
- Early intervention and tailored support can mitigate negative health outcomes during the menopausal transition.
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