Mental health consultations during the perimenopausal age range: a qualitative study of GP and patient experiences

There is an increased risk of mood changes in perimenopause, and evidence that patients and GPs may overlook this association. Evidence also shows that GPs have a lack of confidence in managing perimenopausal symptoms.

To examine clinical consultations for patients in the perimenopausal age range who were presenting with mental health symptoms, and the experiences of GPs providing care to such patients.

A qualitative study was undertaken in one integrated care system in south-west England. It involved 18 women aged 45-55 years, who had consulted with their GP about a mental health symptom in the previous 6 months, and 11 GPs.

Participants were recruited between February 2023 and August 2023. Data were collected through semi-structured interviews, and thematic analysis was used to identify recurring patterns and key insights regarding consultation practices, patient-GP communication, and gaps in education and training.

Women either did not recognise perimenopause or were uncertain whether it contributed to their mental health symptoms, and felt inhibited or embarrassed about raising the issue. GPs reported using variable approaches to asking about perimenopausal symptoms and acknowledged that there were gaps in their training. Time constraints and the stigma surrounding menopause further hindered consultations.

Addressing mental health symptoms during perimenopause requires a proactive and informed approach in primary care. Improved GP training on menopause, coupled with patient education to increase awareness and confidence, could improve consultations and the management of mental health symptoms experienced during perimenopause.