• Ruth Dewar

Menopause, Depression and Anxiety

Following on from my last blog about menopause and alcohol, here is my research into why, when entering menopause do so many women suffer from anxiety and depression.

Again I was completely overwhelmed by how complex the side effects of entering or being in menopause are, and again just how little research goes into finding a solution.

The influence of endocrine function (the body's hormone system) on the mood of the menopausal woman continues to be debated and researched. While many women present at the menopause with depression and anxiety, the reasons for these mood disorders cannot be attributed to menopause status alone. The influence of psychological factors, lifestyle, body image, interpersonal relationships, role, and sociocultural factors in predicting levels of depression and anxiety in the menopausal woman cannot be ignored. This chapter discusses the research to date on menopause and depression and anxiety.

The importance of understanding the individual menopausal experiences of women within the context of their lives while offering support, education, and validation is highlighted. The need for a multidimensional approach to treating the menopausal woman who presents with mood disorders is examined. Finally, this chapter makes it clear that psychosocial aspects of menopause management require further research, particularly on the experiences of women who enter menopause prematurely.

Clearly, the menopause involves physiological manifestations that result from hormonal changes, and for most women menopause is part of a normal transition. However, menopause does not happen in isolation from the social interpretations and psychological changes that may also occur in a woman’s life at the same time. It is important that any understanding of menopause is placed within the context of a woman’s life and includes consideration of her psychological state, psychological influences, cultural and social background, and the ageing process. The impact of the timing of menopause for women should also be taken into consideration, particularly when menopause may occur prematurely. Treatment of the menopausal woman should always incorporate a multidimensional approach, including consideration of physiological and psychosocial factors.

While it may seem that the menopausal experience can be generalized, it is necessary to understand and account for each woman’s individual experience of menopause. At this point it is also important to acknowledge that some women will experience a positive menopause and may see this time in their life as one for new beginnings. Each menopausal woman presents with her own life circumstances and experience. Each woman will have her own psychological history, life events, coping skills, family background, relationship history, body image, roles, social and cultural interpretation of how menopause affects her life. Each woman needs to be given the time to tell her own story.

In general, women have been found to be twice as likely as men to experience an affective disorder and anxiety disorder. Many clinicians are quick to point the finger at hormones and biological factors, such as menopause in the increased incidence of mood disorders in women. Interestingly, however, researchers have found that the prevalence of depression decreases with age and was experienced more by women in the childbearing years

It appears that women also believe that hormones account for their experiences of depression and anxiety. Many menopausal women present to their practitioner for the first time with depression and anxiety symptoms in their mid to late forties believing that they are caused by menopause. However, after a thorough history is taken, it is often discovered that the woman has experienced these symptoms previously. It may be that women feel that they can finally report they are depressed and anxious because menopause has legitimised these symptom??. Theories as to how changing hormone levels are thought to influence mood in menopausal women continue to be debated.

It has also been suggested that changes in hormonal levels might influence the brain through hypothalamic function and/or a change in amine metabolism. In a summary of studies on neurobiological effects of hormones, oestrogen and testosterone were present in areas of the brain thought to be relevant to emotional functioning. Withdrawal of sex hormones at the menopause has been thought to influence neuropeptides and neurotransmitters, resulting in depression, irritability, insomnia and anxiety in women -


Further reports have publicised that oestrogen might work like an antidepressant on neurotransmitters and their receptor, and that eostrogen in doses conventionally used to treat menopausal symptoms enhances mood in non-depressed women but is therapeutically ineffective for mood disturbances of a clinical magnitude.

Interestingly, the researchers found that, in this small group of women, the use of HRT for depressive disorder was beneficial regardless of whether women experienced hot flushes, sleep deprivation, or had a previous history of depression. The role of testosterone in depression is an important focus of current research.

Some researchers have reported that psychological symptoms, such as depressed mood, irritability and anxiety, are experienced more severely at the perimenopause rather than post-menopause. Again It is further suggested, however, that this increase in severity is more likely to be experienced in the peri-menopause stage in women who have experienced a prior depression. Women in the transition from peri-menopause to post-menopause also experienced increased sleep disturbance, thus affecting negative mood and anxiety

What the research has so far consistently concluded: It appears that the most conclusive finding in regard to menopause and its link with depression is that depressive disorders cannot be predicted by menopausal stage alone; the impact of psychosocial influences on depression must be factored in recent research has consistently found that depression is predicted by the following psychosocial influences in women’s lives rather than menopausal status

  • prior depression

  • a negative attitude to menopause and ageing

  • increased stress and ‘daily hassles’

  • experience of more severe menopause symptoms

  • The inhibility to "cope" with more severe menopausal symptoms

  • physical inactivity

  • smoking

  • dissatisfaction with relationships/or no partner

  • low socioeconomic class and/or unemployment

  • Increasing alcohol intake along side prescribed medication.

Prevailing symptoms of depression and anxiety include

  • fatigue

  • low mood

  • unable to sleep

  • mood swings

  • tearfulness / sadness / deep sadness

  • unable to make sound or rational judgements

  • Low libido

So what can be done to conclude and to navigate this chapter? Is HRT the only source of intervention and does one size fit all?

A huge percentage of the client's at NU-U are struggling with one or more of the above factors, and are either peri-menopausal or in full blown menopause. I listen intently to each and every story and it is true that, on top of the hormonal fluctuatiuins and changes, the socioeconomic factors also play. huge roll.

What seems to be key in surviving this chapter is the level of support available.

We are currently experiencing a nationwide shortage of suitable HRT options and the health service is hugely underfunded in this area as well as mental health. This does not paint a promising picture for those of us needing help moving forward.

HRT is a balancing act and should be tailored to the individual woman wherever possible. This with a light antidepressant has been found beneficial for most women but not all.

Other alternatives to low energy, foggy memory, low concentration and weight gain (all impacting on the way we think and feel) such as bioidentical hormone replacement therapy have been found to be very effective as this assess the indvidual based on her own unique hormone cycle. Bioidentical treatments have not only been found to combat the most common symptoms of menopause but it is also hugely beneficial in the way we look and age.

So what is the catch? Unfortunately this treatment is incredibly expensive and as such not available on the NHS. You will have to fund this yourself.

There are a whole host of Doctors on the web offering this treatment, so do your reasearch and compare pricing and treatment plans.

Check out


The Natural Doctor have a renowned, double doctorate holding doctor –Dr Nyjon Eccles BSc, MBBS, MRCP, PhD who can help you to get back to yourself with his custom-designed testing panels, made to measure prescriptions and even his own supplements. He makes sure that women are no longer limited in their choices between enduring menopausal symptoms or risking the side effects of synthetic hormone therapy (HRT) with treatments that are unique in combining bioidentical hormone therapy with a functional nutritional medicine approach.

What can we do ourselves to combat any depression or anxiety?

  • Walk - get outdoors - the weather is better so there's no excuse!

  • Talk - keep talking to your girlfriends. The chances are they are feeling the same

  • Diet is key. Good food choices - good feeling inside

  • Supplements - Check out lyma - supported by Vogue Forbes and a whole host of influentials, this supplement boasts 10 powerful natural ingredients engineered to be bioavailable to the body. It uses carrier molecule technology so it can be usefully absorbed and the maximum benefit felt. This supplement can help with sleep, health and resilience, sharpness of the mind and has mood balancing capabilities!!

  • Cut back on alcohol. Whilst we THINK it is helping with the anxiety or stress, it is in fact adding to it. Alcohol is a depressant. End of ... whilst the short term high or feeling nothing is ok... the long term side effects can be devastating on a peri-menopausal or menopausal women. Throwing us even more out of balance than we already are. Alcohol is also proven to exacerbate hot flushes and rises in temperature.

  • Yoga and mindfulness practices - get doing it - at home if you have to - Yoga with Adrianne is my YouTube go to!!

  • Get following the powerofpositivity on Instagram, their (and many others) really help keep a positive mindset each day.

This is such a huge subject and I could write about this forever, but I hope that what you read and this small snippet into this subject you will find helpful and will point you in the right direction somehow if you need help.

If you are struggling with any of the above just reach out. You are not alone!!!

The British Menopause Society www.thebms.org.uk

#togetherwearestronger #menopausematters

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