Mental wellbeing during the menopause

The symptoms of the menopause are far reaching and commonly extend beyond the well documented hot flushes and night sweats. It may surprise many to know that experiencing low mood and anxiety around the menopause transition is extremely common and these symptoms often have a significant impact on quality of life.

Changes in mood often coincide with other life stresses such as children leaving home, aging parents and career pressures- all things that are difficult to cope with on a normal day let alone when one is feeling irritable and anxious due to hormones changing.

’I just don’t feel like myself’ ‘Everything feels flat’ and ‘I’ve completely lost my joy and sparkle’ are all things we commonly hear women say when they come and see us at our clinic.

Sadly there is still a stigma around both menopause and mental health and women often describe feeling a shame attached to the changes they feel in their emotional wellbeing around the time of the menopause. This can make it very difficult to find the courage to discuss these feelings with a friend or partner and women can feel isolated and alone.

For some women the psychological symptoms may be something they have not experienced before and they may not immediately attribute them to the perimenopause or menopause.

Can my hormones really affect my mood around the perimenopause and menopause?

The answer is yes! In the same way that mood fluctuations are common throughout the menstrual cycle (known as premenstrual syndrome or PMS) feeling low around the time of the menopause can also be, in part, attributed to changes in hormone levels.

The hormones oestrogen and progesterone are linked to regulation of happy neurotransmitters such as serotonin which help to give us a sense of wellbeing. The changes in these hormone levels may cause a drop in serotonin and consequently a negative effect on mood.

In addition, the hormone progesterone (or rather its metabolite allopregnanalone) has anti-anxiety effects and an overall positive effect on mood for many women so fluctuating levels of this hormone around the menopause transition can contribute to mood changes such as feeling more irritable and anxious.

Sleep and mood

There is a strong link between sleep and mood (see our sleep info page) and poor sleep around the menopause and perimenopause can have a detrimental impact on emotional wellbeing and mental health. Unfortunately low mood and anxiety are well known to interfere with sleep so it can quickly become a vicious cycle with one symptom driving the other round and round.

Am I depressed?

Mood changes around the menopause and perimenopause do not automatically mean you are suffering from clinical depression and these two things are not the same- though women who have suffered from mental health problems in the past, may be more likely to develop clinical depression at this time.

Our emotions are extremely complex and can be affected by many facets of life. It is important to carefully unpick symptoms of low mood and changes in emotional wellbeing in order to provide a management plan that is right for each individual.

What might help me to feel better?

1.) Diet and lifestyle eating and sleeping well can improve mood and exercise, is well documented as having a positive effect on mental health.

We offer a diet & lifestyle consultation which can help address these factors – please see our appointments and bookings page.

2.) Cognitive Behavioural Therapy (CBT) looks at how thoughts and feelings can impact our behaviour/ the way we react to things, and is an extremely powerful tool in improving negative thoughts associated with low mood and even physical symptoms, that may be associated with anxiety.

If you are interested in CBT please see our info page including our up and coming CBT courses run through Chelvey Menopause.

3.) HRT hormone replacement therapy can help to improve psychological symptoms around the perimenopause and menopause and can help women to feel themselves again.

4.) Antidepressants whilst antidepressants are not first line for mood related changes in the menopause transition, some women may not wish to use HRT and others may need an antidepressant in addition to HRT


“I can honestly say I felt completely seen and heard”

“I felt you took the time to ask me questions and truly listen which entirely validated my experience and feelings”

“Very clear in her explanations and listened to my concerns. I felt very reassured that a plan is in place”

“Thank you so much for your care and attention”