“For years, Jasmine considered herself steady, resilient and surprised by life’s unexpected turns. Then, in her late forties, things began to shift. One moment, she felt fine; the next, she found herself overwhelmed by sadness. Hot flashes nudged her from sleep. Her mind felt foggy while trying to meet deadlines at work. She thought perhaps she was simply under pressure, until a trusted friend asked, “Could this be menopause?”
Like Jasmine, many other women enter the menopausal transition in a state of unawareness about how deeply it can affect their emotional world. Faced with the familiar physical symptoms like hot flushes, night sweats, skipped periods, there lies a complex two-way interaction of hormones, brain chemistry and life stressors. Being Aware of this connection is vital for those who are experiencing it, but also for the families, partners, workplaces and communities that support them.
Although menopause is often associated with physical symptoms such as hot flashes and irregular cycles, its emotional and psychological impacts often go unnoticed. This silence can leave many women feeling isolated, overwhelmed and confused.
Clarifying the fact that hormonal transition impacts mood and mental health during menopause, we can progress toward greater empathy and more effective support.
What is Menopause?
Menopause mark the end of a woman’s reproductive years, officially diagnosed after 12 months without menstruation ( North American Menopause Society, 2021). This transition typically occurs between ages 45-55 but can vary widely. During menopause, the body naturally slows down the production of key hormones like Estrogen and Progesterone, which are mainly released by the ovaries. While the physical symptoms of menopause, such as hot flashes, night sweats and sleep disturbances, are well known, the mental health aspects are equally impactful but less visible ( Freeman et al., 2020).
Read More: How Does Menopause Affect Mental Health: Psychologist Speaks
Shifting Hormones and Emotional Variability
Estrogen plays a vital role in brain health, particularly by regulating neurotransmitters like serotonin and dopamine, which are important to managing mood, anxiety and cognitive function ( Gordon et al., 2015). When estrogen levels fluctuate and eventually decline during menopause, many women find themselves facing increased emotional sensitivity, mood shifts and psychological discomfort. This suggests that hormone-driven mood changes are biological rather than purely psychological responses.
Read More: The Role of Dopamine in the Mind
Frequent Mental Health Concerns During Menopause
Countless Women experience a range of emotional and psychological symptoms during menopause, including:
- Depression: Ongoing feelings of sadness, hopelessness or disinterest in daily activities can arise or intensify during this phase( Freeman et al., 2004). The studies have shown that the likelihood of experiencing major depressive episodes nearly doubles in the perimenopausal stage compared to earlier, premenopausal years (Bromberger et al., 2011).
- Anxiety: Heightened worry, restlessness and irritability are common ( Freeman et al., 2005). Anxiety may intensify due to disrupted sleep patterns triggered by night sweats, leaving women feeling restless and emotionally unsettled.
- Shifting Moods: Frequent and unpredictable emotional shifts, like moving quickly from contentment to frustration or sadness, are commonly influenced by hormonal changes during menopause ( Kawasumi et al., 2020).
- Cognitive Difficulties (“brain fog”): Problems with memory, attention and concentration often occur and add to emotional distress. (Weber et al., 2013).
Biological Mechanisms
Hormonal shifts during menopause are influenced by some key areas of the brain that are responsible for managing emotions, like the amygdala and prefrontal cortex. (Bath et al., 2015) As estrogen levels decline, its protective role in the brain diminishes, disrupting neurotransmitter balance and affecting how the body responds to stress.
Additionally, menopause often coincides with significant life events like ageing parents, career pressures, children leaving home, etc, which can compound stress and emotional challenges (Avis et al., 2015).
Read More: Early Menopause and Risk of Cognitive Decline
The Role of Psycho-social and Environmental Factors
Hormones are part of the puzzle, but context matters. Midlife often brings multiple overlapping stressors: ageing parents, children leaving home, career transitions or relationship shifts (Avis et al., 2018). These factors can amplify mood symptoms. For some women, cultural attitudes further complicate matters. In societies where menopause is rarely discussed, emotional changes may be dismissed (“just tired”), leaving women to navigate them alone. A recent study found that women with higher education and employment status reported lower anxiety during menopause, highlighting the protective role of awareness, engagement and structure. (Kumari & Priyamvada,2025).
Personal Stories Highlighting the Struggle
Many women feel isolated because mood symptoms are often dismissed as “just part of menopause “ or confused with ageing or personal weakness. Mitra, a 53-year-old teacher, recalls: “ I felt like I was losing myself, crying for no reason, angry over small things. It scared me. But nobody talked about how menopause could affect my mind. Mitra’s story uncovers the experiences of countless women, highlighting the importance of increasing awareness and ensuring accessible mental health support during menopause.
The Overlooked Intersection of Menopause and Mental Health Stigma
Despite the prevalence of mood symptoms during menopause, many women hesitate to talk about their struggles. According to the Menopause Society, women in the perimenopausal and post-menopausal phases are particularly vulnerable to depression and anxiety, yet the mental health implications are often unaddressed by clinicians ( Menopause Society, 2024)
Cultural stigmas around mental health and ageing often leave women feeling isolated. Dr Maria Sanchez, a psychiatrist specialising in women’s health, says, “There‘s still a taboo about acknowledging emotional difficulties during menopause. Many women feel pressure to simply ‘push through’ menopause or dismiss it as a phase they shouldn’t talk about (Sanchez, 2020).
This cultural silence can result in missed diagnoses and delayed care, often worsening the emotional and physical toll. Breaking this silence through open conversation and widespread education is crucial. Menopause must be recognised not as a private burden, but as a shared experience that deserves understanding, visibility and compassionate support. Like Mitra, every woman has the right to understand and changes occurring in her body and mind, and to receive informed, empathetic support along the way.
Managing Mood Changes During Menopause
Mental health challenges during menopause are real, but there are ways to manage them effectively:
Medical Interventions: Hormone Replacement Therapy (HRT) can stabilise estrogen levels, improving mood symptoms in many women ( Soares & Zitek, 2008).
Hormone Replacement Therapy ( HRT) is often effective in alleviating both physical and psychological menopause symptoms by stabilising estrogen levels ( Maki & Jaff, 2019). However, it’s not suitable for everyone and should be discussed carefully with a healthcare provider.
Non-hormonal options include:
- Psychotherapy: Cognitive Behavioural therapy ( CBT) has demonstrated efficacy in reducing menopausal mood symptoms ( Hunter & Rendall, 2007).
- Lifestyle Interventions: Regular physical activity, balanced nutrition, stress management techniques like mindfulness and good sleep hygiene can all support mood and cognitive function (Harvard Health, 2020).
- Pharmacological Treatments: For persistent mood disorders, antidepressants such as selective serotonin reuptake inhibitors ( SSRIs) may be prescribed for persistent depression or anxiety during menopause (Freeman et al., 2014). An integrated approach that attends both to hormones and the distraught social context produces the best outcomes.
Read More: Do You Know How Menopause Affects a Woman’s Mind?
Looking Ahead: Research and Awareness
Women benefit immensely from emotional and practical support. Partners, friends and workplaces that understand and validate menopausal changes can reduce isolation and distress. For example, A mid-career professional shared that communication from her manager about menopause made her feel “ seen and human again”,’ a small gesture, yet meaningful.
New research is shedding light on personalised treatment options for mood changes during menopause, taking into account each woman’s unique genetic makeup, hormone levels and psychological background ( Santoro et al., 2016). Building awareness among women and healthcare providers alike is essential to ensure more comprehensive and compassionate care.
Conclusion
Menopause is a deeply personal transition in both aspects of life – biological and emotional, that unfolds differently for every woman. The hormone-driven mood changes during this phase can significantly impact mental health, yet they often go unrecognised or misunderstood. By raising awareness, encouraging open dialogue and integrating medical and psychological support, we can help women to manage this transition with dignity and resilience. Understanding menopause and its emotional side isn’t about treating symptoms; rather, it’s about honouring the full experience of women’s health and well-being.
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