More women and those assigned female-at-birth (AFAB) are reporting depression during menopause, but can menopause cause depression? Here we explore the links between menopause and depression, how they influence each other, treatment options including lifestyle changes and medication and how to support a loved one struggling.

Quick facts:

• During menopause, your body goes through huge hormonal shifts. 
• These can cause mood changes and increase your susceptibility to depression and low mood. 
• Lifestyle changes as well as HRT and other medications can help alleviate symptoms. 
• If you’re struggling, reach out to a Menopause Specialist who can help you with a care plan.

Understanding menopause and mental health

Menopause is a natural part of ageing. It’s when your ovaries stop making the hormones oestrogen and progesterone. It marks the end of your reproductive years—you can no longer become pregnant and your periods stop.

Since your sex hormones, oestrogen and progesterone, affect so much of your bodily functions including how you think and feel, the hormonal shift can cause emotional and psychological symptoms. These shifts can put you at a higher risk of developing mood disorders like depression.

Changes in mood and energy can be frustrating and can have a knock-on effect on your relationships, work, life and confidence.

Potential psychological side effects of menopause can include:

• Anxiety
• Brain fog or poor concentration
• Anger 
• Irritability
• Forgetfulness
• Low self-esteem
• Low confidence
• Low mood, or feelings of sadness and depression

On top of this, having trouble sleeping during menopause is common, and lack of sleep can worsen other mental health symptoms.

Can menopause cause depression?

Lots of women experience difficulties with depression and their mental health during menopause, but what’s the link?

In multiple studies, it becomes evident that if you’re perimenopausal (the years before menopause when your hormones take a dip and you start getting menopause symptoms), you’re more likely to experience depression. 

Such an enormous shift in hormones can be life-changing. Many women feel hopeless, out of control, anxious and overwhelmed.

Studies found that more women in their menopausal years experience depression compared to pre-menopausal years. Additionally, women and those AFAB who have a personal or family history of depression are also more likely to experience a relapse during menopause.

One study suggests that those who have had premenstrual dysphoric disorder (PMDD), or postpartum depression are also more likely to develop depression during menopause.

So what’s the cause behind the correlation between the increased risk of depression during menopause? Simply put, hormones have a lot to answer for.

Primarily, a dip in oestrogen can cause depression, along with other menopause symptoms. Oestrogen plays an important role in mood regulation. Without it, neurotransmitters serotonin (known as the “feel good” hormone) and norepinephrine can be affected leading to depressive symptoms and mental health difficulties.

It’s important to note that depression during menopause is not a given. Not everyone going through menopause will experience depression. Symptoms vary for each individual.

There are lots of treatment options to reduce and prevent menopausal depression.If you or someone you know is struggling with menopause and mental health difficulties seek professional help from a Menopause Specialist or mental health professional.

Identifying depression during menopause

Signs and symptoms of depression during menopause include:

• Feelings of persistent sadness and low mood.
• Anger or irritability.
• Fatigue and low energy.
• Brain fog and difficulty concentrating.
• Overeating or undereating, and weight loss.
• Sleep issues.
• A lack of interest in things you used to enjoy.
• A change in sex drive.
• Low self-esteem and confidence.
• Physical aches and pains.
• Increased sensitivity to rejection.

These symptoms are not just related to menopause, they can overlap with other menopause symptoms, and be different for everyone.

The risk of developing depression seems to decrease in the 2-4 years after your last period. Menopause is marked by a single point in time when it’s been a year since your last period.

If you’re experiencing any of these symptoms, or want more support with depression or menopause symptoms, contact a menopause specialist who can advise you.

Factors contributing to depression in menopause

Depression during menopause can be influenced by several factors.

A genetic or family history of depression could influence the probability of you experiencing depression. Your medical history can play a part too. Having at least one chronic health condition like cardiovascular disease or diabetes can also double the risk of experiencing depression during menopause.

Studies say that potential biological risk factors for depression during menopause include vasomotor symptoms (VMS) like hot flashes and night sweats can increase the likelihood of depression. 

These symptoms can feel debilitating, and paired with tiredness, poor concentration and fatigue from the lack of sleep, can affect confidence and self-esteem often resulting in feelings of sadness and depression. Getting enough sleep is key to mood regulation.

If your roles change because of physical health problems that come with menopause, which, for example, cause you to take early retirement, some studies suggest that the risk of developing depression increases by 88%.

The Fawcett Society, in their report Menopause and the Workplace, found that 1 in 10 women leave their jobs because of menopause symptoms. Sadly, women and those AFAB aren’t getting the support they need at work. Hertility aims to change this by encouraging more employers to become Reproductively Responsible™.

Seeking help and treatment for depression

Seeking help for menopause-related depression is key to overcoming it. There are lifestyle changes as well as medical treatments available.

Natural treatment options for menopausal depression include making lifestyle adjustments. Well-balanced, gut-healthy nutrition and regular physical exercise can improve your mood and reduce the risk of depression during menopause, along with helping to alleviate other menopause symptoms.

Eating a nutritious diet

Firstly, eating well and often is important. Eating protein with every meal, staying hydrated and fuelling your body will keep your energy and mood stable throughout the day. Fibre with each meal will help to keep you fuller for longer and aid your digestion. Read our piece on ways your diet can help manage menopause solutions.

Experiments suggest that your gut has close links with and could play a crucial role in depression (the gut-brain axis).

Eating 30 different fruits and vegetables, ideally as many different colours as possible, each week is recommended by nutrition experts to support your gut health. Probiotics like live yoghurt, tempeh and kimchi also keep your gut happy.

Getting regular physical exercise

Incorporating regular physical exercise can help to reduce depression and anxiety during menopause. Exercise releases endorphins—the feel-good hormone. It’s also thought that physical exercise has beneficial effects on mental health through distraction and boosting self-belief.

Getting regular physical exercise also supports your energy and boosts your general health and wellbeing. It keeps your heart healthy, helps you maintain a healthy weight, and reduces the risk of chronic health conditions. Bonus!

Having a support system

Exercising with friends can also boost your mood and sense of community and belonging, which can help to reduce the risk of developing depression during menopause. 

Social interactions are important too. Feelings of isolation and loneliness increase the likelihood of depression. This sense of belonging and interactions with others contribute to happiness and worthiness.

Getting enough sleep

Work on getting 7-10 hours of sleep each night to reduce symptoms of depression like tiredness, fatigue and poor concentration. Many report hot flushes and night sweats affecting their sleep. Sleep disturbances can exasperate depression during menopause, so taking time to catch up on some shut-eye will support you.

Having coping strategies

Having coping strategies to help you cope with depression is important. Cognitive Behavioural Therapy (CBT) has been shown to help, along with relaxation techniques like yoga, breathwork, mindfulness and meditation.

Taking Hormone Replacement Therapy (HRT)

Hormone replacement therapy (HRT) is a synthetic hormone medication that replaces the hormones lost during menopause. This hormone rebalancing can support mood regulation.

Setting boundaries

Fostering your version of self-care and maintaining your boundaries can be useful for reducing depression too. Some people struggle to set boundaries with their loved ones, saying “yes” to everything, but this can lead you to feeling overwhelmed. Practice saying no and protect your peace. You can’t pour from an empty cup!

Supporting loved ones through menopause

Supporting loved ones through menopause-related depression and mental health difficulties can be challenging. It requires empathy, patience and understanding. You could, however, provide support by educating yourself on menopause and depression and fostering open communication. Additionally, encourage self-care practices and offer practical support.

Assist your loved ones with daily tasks or chores to alleviate some of the stress that might be weighing on their mind. Fatigue and low energy can make it difficult to stick to a normal routine. Preparing food or doing the washing up could be a big help to them during challenging times.

Tailor your support to your loved one’s needs and be adaptable in your approach—how you support them best could change over time.

The relationship between menopause and mental health, specifically depression, sheds light on the complexities faced by women and those AFAB undergoing this challenging transition. The hormonal shifts during menopause can impact mental health and wellbeing with evidence pointing to an increased risk of depression.

Recognising depression during menopause means understanding the way it presents and considering contributing factors such as hormone fluctuations, life stressors, and individual health history. It’s crucial to note that the experience is highly individual and the signs and symptoms can vary.

Seeking help and treatment options is key to getting clarity in menopause-related depression. This might include therapy or counselling, lifestyle changes, and medication such as hormone replacement therapy (HRT). The key is to encourage open communication and provide a supportive environment for those navigating through this challenging phase.

Everyone’s experience with menopause and depression is different. There is no one-size-fits-all approach to finding solutions and treatment plans. For family and friends, supporting a loved one through menopause involves empathy, patience and a willingness to adapt.

Find more clarity on menopause and depression with personalised advice from a menopause specialist.

Menopause and depression FAQs:

What are the common emotional changes during menopause?

Common emotional changes during menopause include:

• Feelings of persistent sadness and low mood.
• Anger or irritability.
• Fatigue and low energy.
• Difficulty concentrating.
• Overeating or undereating.
• Weight loss.
• Sleep issues.
• Lack of interest in things you used to enjoy.
• Change in sex drive (libido).
• Low self-esteem and confidence.
• Physical aches and pains.
• Increased sensitivity to rejection or criticism.

How can I differentiate between menopause symptoms and depression?

Navigating the distinction between menopause symptoms and depression can be tricky, but it’s crucial to recognise that depression is depression, whether it’s tied to menopause or not.

The approach to alleviating depression symptoms remains mostly consistent (except for HRT if you’re in menopause), although the methods should be personalised for each individual.

Nonetheless, there is potential overlap, and seeking guidance from a healthcare professional can bring clarity. Typically, women and those AFAB experience menopause between the ages of 45-55.

If other menopause symptoms coincide with the onset of depression, reaching out to a menopause specialist becomes even more important. Exploring holistic therapies, therapy or Hormone Replacement Therapy (HRT) could be beneficial in managing both menopausal and depressive symptoms.

While many women are prescribed antidepressants, HRT might also be an effective option for you. Individual responses vary, so consult with a professional to discuss and consider the best treatment options. Consider experimenting with both approaches to determine which one resonates better with your unique situation.

Are there lifestyle changes that can help manage menopausal depression?

Lifestyle changes that can help to manage menopausal depression include eating a nutritious diet, steering clear of alcohol, getting regular physical exercise, managing your stress levels with tried-and-tested coping strategies that work for you, getting enough sleep (7-10 hours per night) and having supportive people around you to talk to.

This might be family and friends, or it could be a healthcare professional.

What role do healthcare professionals play in managing menopause-related depression?

Healthcare professionals play a crucial role in addressing menopause-related depression by offering valuable insights confirming whether you’re experiencing this specific form of depression and discussing treatment options for you.

Hertility’s Menopause Specialist appointment can give you the guidance and specialist advice you need – including prescribing HRT.