Menopause and Mental Health: Understanding the Connection
Understanding what you're experiencing is the first step towards feeling supported
Menopause and perimenopause are natural stages of life, but the changes that come with them can affect much more than your menstrual cycle. Changes in hormones can influence your mood, sleep, energy, concentration and emotional wellbeing, sometimes leaving you feeling unlike yourself. Understanding the connection between menopause and mental health can help you make sense of these changes and recognise when additional support may be helpful.
What are menopause and perimenopause?
Perimenopause is the stage leading up to menopause, before your menstrual cycle stops. During this time, changes in hormone levels can cause both physical and emotional symptoms. Some common symptoms include hot flushes, difficulty falling or staying asleep, night sweats, mood changes, anxiety and brain fog.
These symptoms can have an impact on your mental health and wellbeing, particularly when they affect your sleep, energy levels and ability to manage day-to-day life.
Perimenopause usually occurs around the mid to late 40s, but everyone's experience is different.
Menopause is when your menstrual cycle has stopped for 12 consecutive months. Many of the symptoms experienced during perimenopause can continue into menopause, including hot flushes, sleep difficulties, mood changes, anxiety and brain fog.
For some women, these changes can lead to a sense of feeling disconnected from themselves or a lack of sense of self. The physical and emotional changes can feel unfamiliar and may take time to adjust to.
Menopause usually occurs in the early to mid-50s, although this can vary from person to person.
But what causes menopause and perimenopause?
Perimenopause begins when the ovaries start producing lower and more fluctuating levels of oestrogen and progesterone. These hormonal changes can contribute to many of the symptoms associated with perimenopause and menopause.
Changes in oestrogen can contribute to symptoms such as hot flushes, night sweats and changes in weight, while changes in progesterone can affect menstrual regularity and contribute to symptoms such as irritability, anxiety and sleep difficulties.
However, not everyone experiences menopause in the same way. Some women may experience relatively mild symptoms, while others may find the physical and emotional changes much more difficult to manage.
How can menopause and perimenopause affect mental health and wellbeing?
Menopause and perimenopause can affect mental health and wellbeing in a number of different ways. For some women, these changes may be subtle, while for others they can have a significant impact on everyday life.
Mood changes
You may notice changes in your emotions or find that things affect you differently than they used to. This can include:
Irritability
Feeling more emotional
Mood swings
Feeling overwhelmed
Anxiety
Changes in hormones, sleep and emotional wellbeing can contribute to increased anxiety. You may experience:
Increased worry
Racing thoughts
Feeling restless or on edge
New or increased anxiety
Low mood
Some women may also experience changes in their mood, motivation and enjoyment of everyday activities, including:
Feeling down
Reduced motivation
Loss of enjoyment
Feeling unlike yourself
Cognitive changes
Another common experience is a feeling of "brain fog". This can make it harder to concentrate or remember things and may include:
Brain fog
Difficulty concentrating
Forgetfulness
Feeling mentally slower
The connection between hormones, sleep and mental health
The effects of hormonal changes, poor sleep and mental health can often overlap and influence one another.
For example:
Hormonal changes → Sleep difficulties → Fatigue → Reduced emotional resilience → Increased anxiety or low mood
Sleep can play a big role in the emotional toll that menopause and perimenopause can have on mental health. When we don't get enough quality sleep, it can become harder to regulate our emotions, manage stress and cope with everyday challenges.
Physical symptoms such as night sweats and hot flushes can make it difficult to fall asleep or stay asleep throughout the night. This can leave you feeling exhausted during the day and more easily irritated or overwhelmed.
When poor sleep continues, it can also contribute to increased stress and anxiety, and for some people, ongoing sleep difficulties can contribute to low mood.
For more information about the relationship between sleep and mental health, you can read our blog "How Much Does Sleep Really Affect Your Mental Wellbeing?"
Why can these changes feel so overwhelming?
Menopause and perimenopause don't happen in isolation. Many women are also experiencing other changes in their lives during this time, which can add to the emotional impact.
These may include:
Changes in family roles
Parenting teenagers or adult children
Relationship changes
Work and career pressures
Changes in identity
Caring responsibilities
Physical changes and body image
This is why menopause is not just about hormones. There can be biological, psychological and social factors happening at the same time, all of which can influence how we experience and respond to these changes.
For some women, it can feel like a lot of changes are happening at once, making it difficult to understand why they are feeling different or struggling more than usual.
When should you seek support?
It is normal to experience changes in mood, emotions and wellbeing during menopause and perimenopause. However, if these changes are becoming difficult to manage or are beginning to affect your relationships, work or day-to-day life, it may be helpful to seek support.
You may benefit from additional support if you're experiencing:
Symptoms that are affecting your everyday life
Anxiety or low mood that is becoming difficult to manage
Persistent sleep problems
Withdrawing from things you normally enjoy
Concentration difficulties that are affecting your work or relationships
Feeling like you don't quite feel like yourself anymore
Struggling to cope with the changes you're experiencing
Seeking support doesn't mean that something is wrong with you. Sometimes, having a space to understand what you're experiencing can make these changes feel more manageable.
How can psychology help?
Psychology can provide a supportive space to understand what you're experiencing and explore the emotional and psychological changes that can occur during perimenopause and menopause.
Psychological support can also help with managing stress and anxiety by developing strategies to cope with worry, overwhelm and changes in emotional responses.
Therapy can also support emotional regulation by helping you recognise, understand and manage difficult emotions. Learning these skills can make periods of change feel more manageable and help you feel more in control.
Support at Presence of Mind Psychology
Our Clinical Psychologist, Kate Miller, works one-on-one with clients experiencing the emotional changes associated with menopause and perimenopause.
Kate provides a structured 10-session program designed to support women who are struggling with the emotional and psychological effects of perimenopause and menopause.
If you feel that you could benefit from support, please feel free to contact our reception team at reception@presenceofmind.com.au.