Menopause and Mental Health: The Quality of Life Among Women at Midlife and Beyond

Hormones are molecules produced by the human body to help regulate bodily functions. They are fundamental for the human body to function like a well-oiled machine. They affect several processes in the body that involve:

Similarly, female sex hormones are integral to women’s overall health. 

According to research, female sex hormones like estrogen, progesterone, and small amounts of testosterone play an essential role in not just sexual development and reproduction but also affect the structure of the female brain during important hormonal transition periods across a woman’s life. 

These hormones, that are all highly interconnected with each other, need to work together and are in sync with each other to maintain the mental and physical equilibrium in the female body.

An imbalance in the female sex hormones can affect natural processes like menstruation, pregnancy, and menopause. This can lead to problems that may include infertility, thyroid disorders, diabetes, weak bones, and even mental, and emotional health instabilities.

One such process that has both a physical and psychological impact on women’s health is menopause.

What Is Menopause?

Menopause is a natural event that all women experience around the average age of 50. 

Menopause occurs as a result of estrogen depletion when the ovaries stop releasing an egg each month or as a result of oophorectomy. The onset of menopause when the estrogen levels are falling is called the perimenopausal phase. The perimenopausal phase brings about a diverse set of effects on the female body. 

However, signs, symptoms, and the impact of perimenopause and menopause vary between individuals. Some may experience minimal symptoms for a duration of around 6-10 years, while others may have symptoms that are more severe or can last for 20 or more years.

Signs and Symptoms of Menopause

Some signs and symptoms of menopause that affect the physical, mental, and emotional aspects of a woman may include:

How Does Menopause Affect the Brain?

A woman can experience personality changes during menopause as the range of emotions she faces may threaten her sense of balance and well-being. Some signs may be very uncharacteristic of her, which may be changes that are stressful to accept.

Confused by these irrational, extreme and constantly fluctuating mood changes, menopausal women may feel angry, experience emotional outbursts like crying, be burdened by feelings of guilt, or sometimes even be disconnected from their emotional self.

Even though these changes are temporary, they may cause great worry, panic, and even disrupt the relationships they have with the people around them. Understanding the connection between menopause and panic attacks, along with other unexpected emotional experiences, can help affected women and their loved ones better navigate this critical stage in life and the changes it brings.

How Can Women Combat the Physical, Mental and Emotional Effects of Menopause?

A girl child attending puberty at the right age and having regular menstrual cycles, a woman conceiving naturally without medical intervention and passing on to menopause without any abnormal stressors or symptoms, indicates a well-functioning hormonal system. 

A healthy lifestyle and good mental health influence how our hormones are produced and how they function. These hormones become an indicator to the degree to which certain menopausal symptoms will affect a woman’s health.

1. Make an effort to understand the signs and symptoms.

How you react to menopause will partly influence how you handle symptoms. 

If you have been depressed or anxious in the past, it is possible that these may resurface with the onset of menopause. 

Be aware of what your triggers may be. Be prepared to handle the highs and even the lowest of lows. Monitor how you feel; including your stress levels, sleeping patterns, etc. 

Look at how you can seek help from support groups, physicians, therapists, especially if you are anxious and think you cannot handle these changes by yourself.

2. Create a lifestyle change.

Fatigue can cause you to be more prone to anger, anxiety, and emotional outbursts. Thus, getting adequate sleep will be crucial to controlling unnecessary stress and may even help to reduce potential symptoms. 

Being active helps you with both physical and mental health. It helps boost your moods and also induces good sleep. 

Activities that stimulate your brain also help rejuvenate your memory and focus, helping you avoid brain fog and unnecessary thoughts. Additionally, your diet has a significant impact on hormone levels. Having a well-balanced diet, rich in all the nutrients that your body needs, will ensure that your overall well-being is in check.

3. Take time out for yourself.

Keeping yourself busy or distracted may not always be the solution, even though those are great skills to employ at such a time. 

You may not always feel your best self, and you should know that it is complete alright. You may have several roles to play at home and at work. 

There may be difficulties in your relationships, or you may be worrying about your children, struggling to maintain a social life with friends, and also trying to manage pressure from work – but understand that you may not have the emotional energy for these sometimes. 

Prioritize your mental and emotional health by indulging in self-care activities that include calming techniques like meditation or yoga, gardening, painting, walks or chats with a loved one, watching a movie, treating yourself to a relaxing bubble bath or a spa day. 

Finding an outlet to channel all your negative energy and thoughts can be immensely helpful.

4. Know that these effects are temporary.

How you view yourself influences the symptoms you face during menopause. 

Hair fall, sagging skin, wrinkles are all a part of the process. Some women are fearful of changes and the effects of aging. These changes come about because of excessive worry and stress as well.

Accepting these changes will make it easier to tackle some emotional stresses you may feel during this time. Take time out to analyze what is going on in your life and how you can best manage it. 

Typically, mood changes during menopause caused by hormonal changes are not permanent. Having said this, if your depression, anxiety, or negative feelings seem to be getting in the way of your relationships or daily life, seek professional help.

When To Seek Help and the Available Treatment Options

Transitioning into menopause can be a turbulent time for some women. But these changes also affect the chemical in your brain and in turn your mood. 

These changes can make you feel anxious or depressed. Therefore, it is worth seeking professional help if these symptoms occur when you are below the age of 45 and if these cause excessive stress on your relationships. 

Fortunately, you do not have to live with major depressive symptoms, anxiety, or hot flashes. There are a few treatment options designed to help you manage menopausal symptoms.

1. Hormonal replacement therapy (HRT) 

HRT involves the intake of estrogen or a combination of estrogen and progesterone to replace the decline of these hormones in your body at the time of menopause. 

HRT is highly effective in relieving menopausal symptoms, especially hot flashes and night sweats. However, HRT is not recommended for all women. Hence, it is necessary to visit a healthcare professional to determine if HRT is an option for you.

2. Neurofeedback therapy 

Many of the symptoms of menopause originate in the brain. By helping the brain function better through the intervention of neurofeedback therapy, you can get help stabilizing and regulating the many symptoms of menopause like anxiety, anger, depression, memory, focus, motivation, migraine, sleep, stress among the many symptoms of menopause. 

Neurofeedback therapy for stress and managing other negative emotions is devoid of medication or any hormonal treatments to promote well-being.

3. Medication 

Medication for psychological conditions (e.g. depression, anxiety) or physiological conditions (migraines, sleep) may be prescribed to balance your hormones temporarily and regulate the symptoms.

4. Alternative treatments and therapies

Herbal remedies, natural hormones, and certain holistic treatments are also said to be used to alleviate symptoms of menopause. Physicians may also recommend seeing a psychologist or psychiatrist to design mental health plans that can alleviate menopause stress and to address your specific needs.

Menopause is not an illness; it is just a phase of life. Both physical and mental health are intrinsically linked. 

Women should not anticipate or worry about these signs and symptoms as many will not experience these physiological symptoms and the different personality changes during menopause. Women should not be afraid to talk about menopause out of fear of social taboos or judgements.

Communicate with your partner or family and don’t hesitate to ask for their support. 

It is important for women to impart this knowledge to those around them to build a strong support system. 

Bring any questions or problems to your healthcare provider so that they can help you devise a healthcare plan that can offer optimal support at this stage of life and put you on a path to wellness.

Dr. Upasana Gala is the founder and CEO of Evolve Brain Training, a Neurofeedback-centered institute that focuses on using non-invasive brain training techniques to maximize the brain's true potential.

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