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Menopause is a natural transition that signifies the end of a woman’s reproductive years, usually occurring between the late 40s and early 50s. Or as author Patricia Akins put it: “Menopause is like autumn leaves falling; it’s a natural shedding of the old to make way for the new”.

Just like the leaves in autumn, a woman’s estrogen and progesterone levels fall to prepare for a new phase in life, resulting in the end of menstrual cycles. The hormonal changes during menopause can lead to a range of physical and emotional symptoms, including mood swings and, in some cases, depression. 

Menopausal depression is a global issue, affecting more than one-third of women:

Prevalence of menopausal depression
Menopausal women35.6% 
Perimenopausal women33.9%
Postmenopausal women34.9% 

This one third of women may greatly benefit by being aware of the telltale signs and coping methods for menopause depression.

Menopausal depression is influenced by various risk factors that can heighten a woman’s vulnerability during this transitional phase.

Sexual Dysfunction

Painful intercourse and decreased sexual desire can affect self-esteem and intimate relationships, potentially leading to feelings of depression and isolation.

Irregular menstrual periods

The unpredictable nature of menstrual cycles during perimenopause can cause stress and anxiety, contributing to mood swings and potential depressive episodes.

Osteoporosis

The increased risk of osteoporosis during menopause can cause significant anxiety and worry about long-term health, which can contribute to depressive feelings.

Hot flashes and night sweats

Hot flashes and night sweats can be very uncomfortable and often lead to disrupted sleep. Poor sleep quality is closely linked to an increased risk of depression.

Sleep disturbances

Difficulty falling asleep or staying asleep is common during menopause. Insufficient sleep can exacerbate mood disorders and make managing stress more challenging. 

Yes, menopause is not just associated with depression, but can lead to it, even though it’s often not the sole cause.

The transition to menopause, known as perimenopause, involves complex physical and emotional changes. These changes can gravely impact a woman’s mood and overall mental health. 

Hormonal fluctuations

Perimenopause, the phase leading up to menopause, is often characterized by irregular menstrual cycles. This period involves significant changes in hormone levels, particularly estrogen and progesterone, which don’t just regulate the menstrual cycle, but also influence brain chemicals like serotonin. Serotonin is crucial for mood regulation, so when hormone levels drop, it can lead to mood swings and even depressive episodes. This is especially true for individuals with a prior history of major depression.

New stressors

Perimenopause typically occurs in a woman’s 40s, a time when many face additional life stressors. These can include caring for aging parents, dealing with career pressures, managing health issues, and coping with children leaving home. Each of these situations alone can be stressful, but together they can create a perfect storm that exacerbates mood swings and contributes to feelings of depression. The emotional strain from these life changes, combined with hormonal and sleep issues, can make this period particularly challenging for many women.

Does menopause make you tired and depressed?

Sleep disturbances are another common issue during perimenopause. Many women experience insomnia, often triggered by nighttime hot flashes, which are sudden feelings of intense heat. Poor sleep quality doesn’t just leave you feeling tired; it can significantly increase the risk of developing depression. When you’re not getting enough rest, your body and mind don’t function at their best, making it harder to manage stress and maintain a positive outlook.

Studies show mood changes in up to 23% of peri- and postmenopausal women. This isn’t surprising, as the end of fertility and midlife changes often lead to reflections on mortality, life’s purpose, and family. 

Some ways to help regulate mood during menopause, including: 

  1. Avoid Triggers: Identify and avoid triggers that worsen mood swings, such as caffeine, alcohol, and high-stress situations.
  2. Sleep Well: Aim for 7-9 hours of quality sleep each night. Establish a regular sleep routine and create a relaxing bedtime environment to improve sleep quality.
  3. Exercise Regularly: Engage in physical activities like walking or swimming. Regular exercise helps release endorphins, which are natural mood lifters.
  4. Healthy Diet: Eat a balanced diet rich in fruits, vegetables and whole grains. Good nutrition supports overall well-being and can help stabilize your mood.
  5. Reduce Stress: Practice stress-reducing techniques such as deep breathing, meditation, or gentle exercise. Reducing stress can help manage mood swings.
  6. Stay Socially Connected: Maintain social connections with friends and family. Social support can provide comfort and reduce feelings of isolation.
  7. Talk Therapy: Consider talking to a therapist or counselor. Professional support can help you navigate emotional changes and develop coping strategies.
  8. Hormonal Therapy: Consult with a healthcare provider about hormonal therapy options. It can help balance hormone levels and alleviate mood swings.
  9. Try Herbal Supplements: Some herbal supplements, like black cohosh or evening primrose oil, may help manage symptoms. Always consult with a healthcare provider before starting any supplements.

Coping with and treating menopausal depression involves a multifaceted approach tailored to each individual’s needs. This may include lifestyle changes, medical treatments, and psychological support. 

Psychotherapy

Psychotherapy is a crucial component in the treatment of menopausal depression. It involves talking to a trained mental health professional to explore and address emotional and psychological issues. Some types of psychotherapy include:

  • Cognitive Behavioral Therapy
  • Interpersonal Therapy
  • Psychodynamic Therapy
  • Mindfulness-Based Cognitive Therapy

These therapies offer emotional support, coping strategies, deeper understanding of emotional states, improved relationships, and overall enhanced well-being. 

Medications

The best treatment for menopausal depression often involves of psychotherapy and medications. Doctors may prescribe medications such as selective serotonin reuptake inhibitors (SSRIs) and serotonin and norepinephrine reuptake inhibitors (SNRIs) to treat menopausal depression. These antidepressants work by adjusting neurotransmitter levels in the brain, which can help alleviate symptoms of depression. 

Estrogen therapy

While the FDA has not specifically approved estrogen therapy for treating perimenopausal depression, it can help improve overall mood by alleviating symptoms such as hot flashes, sleep disturbances, and mood swings that can contribute to depression. 

Regular physical activity

Studies have shown that regular physical activity can help reduce the risk of depression during menopause. Exercise boosts the production of endorphins, the body’s natural mood lifters, and helps regulate sleep patterns. So, incorporating activities like walking, yoga, or swimming into your routine can be a simple yet effective way to improve your mood and overall health during this transition. 

Natural remedies

Natural remedies can be considered for treating menopausal depression, with varying degrees of effectiveness. 

St. John’s wort and black cohosh can significantly alleviate mood and anxiety changes during menopause. 

Ginseng may improve mood and anxiety, though more research is needed to confirm its efficacy.

A combined supplementation of calcium and Kava has been found to significantly reduce anxiety in some trials, but caution is advised regarding its use. Kava is a root that has historically been used by pacific islanders for its calming effects.

Being treated at a luxury wellness clinic, such as SENSES Welllness Clinic, offers valuable benefits for managing menopausal depression. These clinics pursue a holistic approach, integrating advanced medical treatments with traditional healing practices to address both physical and emotional symptoms. Personalized therapies help alleviate depression and anxiety, while the serene environment promotes overall wellbeing. This comprehensive care ensures women receive the support they need to improve their mental health and quality of life during menopause.

Menopause can have a grave impact on mental health, often leading to symptoms of depression due to hormonal changes and life stressors. Recognizing the prevalence and risk factors of menopausal depression is essential for timely intervention and effective treatment. 

However, it’s important to note that feeling bummed out or having a low mood about menopause doesn’t necessarily mean you have depression. Distinguishing between temporary mood fluctuations and clinical depression is crucial for appropriate support and treatment.

  1. Jia Y, Zhou Z, Xiang F, Hu W, Cao X. Global prevalence of depression in menopausal women: A systematic review and meta-analysis. J Affect Disord. 2024 Aug 1;358:474-482. doi: 10.1016/j.jad.2024.05.051. Epub 2024 May 10. PMID: 38735578. Available at: https://pubmed.ncbi.nlm.nih.gov/38735578/#:~:text=A%20random%20effects%20model%20was,39.1%20%25
  2. Psychiatric considerations in menopause | MDedge Psychiatry Available at: https://www.mdedge.com/psychiatry/article/175738/depression/psychiatric-considerations-menopause/page/0/1 
  3. Depression, Mood Swings, Anxiety, Sexual Side Effects of Menopause  Available at: https://www.menopause.org/for-women/sexual-health-menopause-online/causes-of-sexual-problems/depression-mood-swings-anxiety 
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  5. Maki PM, Kornstein SG, Joffe H, Bromberger JT, Freeman EW, Athappilly G, Bobo WV, Rubin LH, Koleva HK, Cohen LS, Soares CN; Board of Trustees for The North American Menopause Society (NAMS) and the Women and Mood Disorders Task Force of the National Network of Depression Centers. Guidelines for the evaluation and treatment of perimenopausal depression: summary and recommendations. Menopause. 2018 Oct;25(10):1069-1085. doi: 10.1097/GME.0000000000001174. PMID: 30179986. Available at: https://pubmed.ncbi.nlm.nih.gov/30179986/ 
  6. J Korean Acad Psychiatr Ment Health Nurs 2023; 32(3): 325-339. Published online: September 27, 2023 DOI: https://doi.org/10.12934/jkpmhn.2023.32.3.325  Available at:https://jkpmhn.org/journal/view.php?number=518
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