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Menopause, a natural biological process marking the end of a woman's fertility, typically occurs between the fifth and sixth decade of life. This phase is characterized by the exhaustion of the ovarian follicle pool, leading to less responsive ovaries despite the high levels of Follicle Stimulating Hormone (FSH) and Luteinizing Hormone (LH). The consequential decrease in estrogen production results in symptoms like hot flashes, heavy sweating, headaches, hair loss, muscle pains, vaginal...
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The female reproductive system can be affected by several disorders, including Premenstrual Syndrome (PMS), Premenstrual Dysphoric Disorder (PMDD), endometriosis, and various forms of cancer. PMS and PMDD are cyclical conditions that cause physical and emotional distress, with symptoms that include edema, mood swings, and food cravings. PMDD is a more severe form of PMS characterized by increased symptom severity that peaks during the luteal phase and tends to improve or resolve shortly after...
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Menopause and Mental Health.

Clair Crockett1, Georgie Lichtveld2, Rebecca Macdonald3

  • 1Newson Health, Winton House, Church Street, Stratford-Upon-Avon, UK. clair.crockett@newsonhealth.co.uk.

Advances in Therapy
|November 21, 2025
PubMed
Summary

Menopause significantly impacts women's mental health due to hormonal changes, affecting mood, sleep, and cognition. Effective management, including hormone replacement therapy (HRT) and biopsychosocial support, is crucial for well-being.

Keywords:
DepressionHormone replacement therapyHormonesMenopauseMental healthOestrogenPerimenopauseProgesteroneSuicideTestosterone

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Area of Science:

  • Reproductive Endocrinology
  • Neuroscience
  • Public Health

Background:

  • Menopause involves profound hormonal shifts (estradiol, progesterone, testosterone) impacting neurotransmitter systems (serotonin, allopregnanolone, GABA).
  • These hormonal changes can lead to severe mood disturbances, cognitive decline, anxiety, and depression, peaking during perimenopause.
  • Midlife women experience the highest suicide rates, linked to hormonally-related mental health challenges.

Purpose of the Study:

  • To highlight the significant mental health impact of menopause and perimenopause.
  • To advocate for improved menopause management strategies.
  • To emphasize the need for enhanced clinician training and patient support.

Main Methods:

  • Review of hormonal influences on neurotransmitter systems.
  • Analysis of mental health outcomes during perimenopause and post-menopause.
  • Examination of current clinical guidelines and treatment gaps.

Main Results:

  • Hormonal fluctuations during menopause significantly affect mood, sleep, and cognitive function.
  • Despite NICE guidelines recommending hormone replacement therapy (HRT), clinical knowledge gaps hinder its effective use.
  • Perimenopause presents acute mental health challenges, with nearly 40% of women's lives spent post-menopause.

Conclusions:

  • Individualized menopause management integrating biopsychosocial approaches is essential.
  • Improved clinician training and confidence in prescribing HRT are critical.
  • Effective menopause management is an urgent public health priority for women's long-term health and well-being.