Menopause and Mental Health
Menopause is a transitional time in life with multiple physical and mental health changes that can be challenging. Despite being something roughly half of the population will experience, there is not always a lot of accurate information out there. A study from the Mayo Clinic even found that less than 7% of newly trained doctors felt they had received competent education in treating a woman experiencing menopause.
Oftentimes, menopause is treated as the punchline to a joke, a gag in a sitcom, or maybe just something no one talks about. I recently attended a conference where many of the female attendees stated they had never had family or friends discuss menopause growing up, or if they had, it was all horror stories about what to expect. This training focused on supporting women dealing with menopause and perimenopause, noting that these negative messages are very detrimental to many women. They can leave people feeling isolated, alone, and confused. But it does not have to be that way.
So, what is menopause, what does it mean for our mental health, and what can we do about it?
Defining Menopause
Menopause.org defines menopause as “the final menstrual period, which can be confirmed after 12 consecutive months without a period. This time marks the permanent end of menstruation and fertility. It is a normal, natural event associated with reduced functioning of the ovaries, resulting in lower levels of ovarian hormones (primarily estrogen).”
Perimenopause is a term that is used to reference the time period leading up to and one year after this mark, which may last for years at a time. During this timeframe, women may experience dramatic changes in hormones and other biological processes that can produce a host of symptoms, some of which can have a major impact on mental health. Perimenopause often starts in a woman’s 40s, though the timeframe can vary from person to person.
Common menopause symptoms include irregular periods, anxiety, insomnia, hot flashes, irritability, joint pain, depression, changes in sexual functioning, concentration and focus difficulties, and other symptoms that may vary from person to person. Such changes also typically occur during a period of life where there can be multiple social stressors, such as children leaving the home, caregiving responsibilities for aging loved ones, career transitions, and other major life events. Taken together, this can result in a time period that is challenging for anyone to navigate alone.
Menopause and Mental Health
There are key changes that women need to be aware of when it comes to mental health changes alongside menopause onset. One thing no one will let anyone forget about menopause is that it can bring about hot flashes. These are often described as a significant source of frustration and distress for women during this time, and it can bring along with it self-consciousness, embarrassment, interpersonal isolation, poor sleep, and generally feeling bad. What’s actually happening when a hot flash sets in? Estrogen is a hormone that helps inhibit certain temperature control responses in the body. When levels drop during menopause, it can allow this system to go haywire at times, creating that sudden hot, sweaty, unpleasant feeling.
And when hot flashes occur during the sleep period, we refer to them as night sweats. This also has the added frustration of potentially disrupting a good night’s sleep, which can create a host of additional concerns. In an attempt to solve this problem, some women may find themselves trying things to help with sleep that can actually be a problem for long-term sleep quality. Hormone changes can also disrupt sleep outside of night sweats, leading to more irregular sleep patterns, more frequent awakenings, or difficulties with insomnia.
Not only this, but some women may experience increasing depression, anxiety, or irritability during this time frame. Hormonal changes can cause fluctuations in mood that can be hard to predict and manage, even for someone who has spent their whole life navigating the hormone cycles of the female reproductive system. Add in a few bad nights’ sleep and feelings of physical discomfort, and it can be a lot to manage. For people who have previously had problems with mental health diagnoses like major depression, generalized anxiety disorder, OCD, or bipolar disorder, the hormone changes associated with menopause may cause a resurgence or change in the symptoms that need to be addressed.
Another common symptom that may show up for some women during this period is brain fog. This is due to a host of factors, including those noted above. Brain fog becomes yet another hurdle to overcome, making certain routines and daily tasks more difficult. It can be easy to think you are losing your mind, but it’s just a number of physical, psychological, and hormonal changes that are occurring and impacting the way the brain processes information.
What do we do about it?
So is it all doom and gloom? Everyone is fated to suffer through these symptoms, practicing the old mantra of “grin and bear it”? Certainly not! There are multiple ways to address concerns. Globally, menopause “treatments” are a $17 billion industry and growing, but it is hard to know what works and what is hype. For medical changes, make sure to bring concerns to your medical team for trusted, reliable, and evidence-based treatment options. For mental health changes, there are also great resources available.
Therapy has also been shown to benefit women coping with the changes and symptoms of menopause. Cognitive Behavioral Therapy (CBT) is an evidence-based treatment approach that can help with many of the symptoms noted above. Cognitive behavioral therapy works by helping people understand the interconnections between events in their lives, thoughts about those events, emotional reactions, and behavioral responses. As we go through life, we all learn certain patterns of responding. Sometimes, those patterns are not serving us well in our current environment, and it can be important to make a change. CBT helps individuals identify these areas and support adaptive changes in daily living.
When applied to menopause, this may look like changing nighttime behaviors to support healthy sleep, examining personal thoughts and perceptions about hot flashes, or working to build healthy skills to manage anxious responses in the moment, among other approaches. Specific therapies exist to help address anxiety, depression, OCD, insomnia, hot flashes, and more.
Upward Behavioral Health is committed to providing evidence-based care for the treatment of the symptoms that are concerning to you. If you have been wrestling with menopause or other mental health symptoms, please contact us to set up a free 15-minute consultation call and see how we can work together.