Perimenopause, the stage before menopause, can be a particularly difficult time for women, both physically and psychologically. Mental health issues – such as anxiety, depression, fluctuations in mood, and fatigue – are often some of the first symptoms to present themselves when a woman goes through perimenopause. This can be frustrating, upsetting, and can leave you feeling more than a bit defeated – especially since it can often feel as if you are undergoing it alone.
Perimenopause itself is rarely discussed, let alone the mental health symptoms that come with it. But the most important thing to remember is that you aren’t alone. These symptoms are common – Health & Her have conducted research that shows 9 in 10 women will suffer mental health issues as a result of perimenopause, 77% of whom have never struggled with mental health before.[1] The most common symptoms women suffering with perimenopause-related mental health demonstrated were low energy, lack of motivation, anxiety, low mood, depression, anger spikes, and feelings of worthlessness – so if you’re experiencing any of these, do not feel alone or isolated in these emotions. Women all around Britain are dealing with the same feelings and sharing the same experiences.
Through Menopause Awareness Month & World Perimenopause Day, Health & Her are working to bring attention to how mental health can be affected by perimenopause and menopause, and how best to get women back on their feet and feeling good. We are campaigning to raise awareness of perimenopause and mental health on a larger scale. Our research shows 9 in 10 women aren’t able to recognise the symptoms of perimenopause[2] – which is concerning, considering that 86% of women experience mental health changes as a result.[3] What we’re seeing is women not having full information about what is causing their issues, and not feeling able to speak to anyone about it.
It’s time to start talking about perimental health, as the best way to get on the road to feeling better is to understand why perimenopause can make you feel this way, how it can affect you, and most importantly, how to access the treatment and coping methods you need to get you better.
What are the symptoms of perimenopause?
Perimenopause is a stage that hasn’t received attention in the way menopause has, but it can have an equally important and dramatic – if not more so – effect on your mental health. Mental health changes are the earliest signs of perimenopause. It is vital to know the warning symptoms of perimenopause to ensure you get the right help if your mental health is affected – especially since our research shows on average the link between symptoms and perimenopause takes 14 months to recognise. As menopause specialist GP Dr. Heidi Kerr explains,
‘Increasing awareness to women about perimenopause is vital as the arrival of many troublesome symptoms unexpectedly in their 40s – not the assumed 50s – can have a dramatic effect on daily life at home, at work and in relationships. By having a greater understanding of the hormonal changes that are taking place and the impact they can have on their bodies, women will be able to make good decisions about their health at an earlier stage to help alleviate symptoms and improve their ongoing health. This will allow them to reap the benefits as they move forward into their next decade and beyond. If you’re having severe symptoms and think you’re experiencing perimenopause, speaking to a GP can help.’
How does perimenopause affect mental health?
There are a few ways that perimenopause can play havoc with your mental health in ways that are particularly difficult to deal with. This often requires a holistic approach to treat.
Your perimenopause could be causing;
Anger and mood swings
Little things that used to go over your head may be starting to bother you incessantly – like your partner’s breathing, your children’s incessant questions, or a particularly difficult task at work. Instead of getting through it, you may feel suddenly and extremely angry – so angry that it can be difficult to contain. These extreme emotions aren’t limited to anger, and can often be characterised by extreme panic or extreme worry. They are unpredictable and can leave you feeling a loss of control.
Fatigued, low-energy, and low-motivation
This is the most common reported symptom of menopause-related mental health, with our research finding 58% of women reporting lack of motivation and energy.[4] If you’re feeling tired, low-energy, unable to get up and go like you used to, your perimenopause or menopause might be to blame.
Anxiety
Characterized by a persistent feeling of worry, nervousness, and dread, anxiety can make it feel impossible to do the smallest and most routine of tasks without fear. You may find yourself overthinking and panicking about events that others don’t seem to think twice about, events that you used to attend with ease. Anxiety can also cause panic attacks and disturb your sleep patterns.
Depression
Depression can often play hand in hand with anxiety and low energy. With a pervasive sense of low mood, fatigue, and unhappiness, depression can leave you feeling irritable, make it difficult for you to concentrate, and unable to take joy or pleasure in the activities you used to enjoy. It can often be accompanied by appetite changes, disturbed sleeping patterns, suicidal thoughts, and even physical pains like cramps and headaches. Studies have indicated that women going through perimenopause are more vulnerable to depression. Our research has indicated 44% of women reported feeling like they did not want to get out of bed in the mornings, while 1 in 10 admitted to having suicidal thoughts.[5] Depression can make you feel defeated, and leave your regular life feeling impossible.
Low self-esteem
That dress you used to love now hangs, hidden, at the back of your wardrobe. You feel unintelligent or silly at work even when you know you’re doing a good job. You don’t want to see or spend time with people as you constantly overthink or feel down about yourself – how you speak, how you look, how you think. 43% of perimenopausal women reported feeling like they didn’t want to see family or friends because they felt too low in themselves. Perimenopause and menopause can alter your self-confidence and leave you feeling worthless.
Brain fog
You may feel like you’re losing your memory – you can’t remember what was next on your to do list, you may have trouble concentrating on tasks, or may make small mistakes in your everyday routines. Brain fog is characterised by a loss of concentration and difficulty in remembering, and it can make work and life very difficult. 1 in 4 women admit to making mistakes at work, with 1 in 6 calling in sick to avoid work entirely.
Often these symptoms can appear together in clusters or one can feed into the other – like low-self esteem and depression. Treatment, then, can be a holistic approach that seeks to target all of them together.
1 in 10 have suicidal thoughts, 9 in 10 suffer mental health issues as a direct result of perimenopause, 37% haven’t sought any help, and 80% don’t talk to their partners.
What causes mental health issues during perimenopause?
Perimenopause and menopause cause fluctuations in various hormone levels, especially oestrogen and progesterone, and these hormonal changes can affect the mood, and can also worsen physical symptoms. Studies have demonstrated that mental health changes are especially common during perimenopause, when hormonal changes are at their most prominent. Beyond the hormonal changes happening within your mind, perimenopausal women are also vulnerable to mental health issues due to the difficulties the physical symptoms of perimenopause and menopause can have on the emotions, such as a lack of proper, good-quality sleep caused by insomnia, self-esteem issues caused by potential weight gain, and the strenuous physical effects of joint aches, hot flushes, and cramps. Combined with what is generally quite a stressful stage in life – looking after both parents and children, gaining more responsibility within career fields, and dealing with mortgages, house upkeep, and relationship stress – this stage in life can often leave you more likely to develop emotional strains. If you have had mental health issues in the past, perimenopause can also exacerbate these.
As menopause specialist GP Dr Kate Burns describes,
‘as well as mood swings being triggered by your hormone levels fluctuating up and down more than they usually would be during the menopause, as you progress through perimenopause the overall levels of oestrogen and progesterone in your body will also be slowly dropping as your ovaries slow down. Your body has to adjust to lower levels of these hormones which can also cause your mood to decline. There is also some evidence that lowering oestrogen levels may be linked to lowering levels of serotonin, a very important chemical in the brain that is closely linked with our mood and emotions.’
How to protect your mental health during perimenopause
There are a myriad of ways to help you through perimenopause and to treat any mental health changes you may be experiencing. There are a selection of tools and methods that can help aid you through the transition depending on the severity of your symptoms and your personal feelings.
- Visit your GP or a qualified menopause health professional. GPs can give you advice, an ear to listen to, and provide medical intervention if your symptoms are severe enough. If your symptoms are making it hard to go about your day to day life, you should visit a qualified professional to help discuss options like antidepressants or HRT.
- Supplements can provide a helpful option for women looking to seek a more holistic and natural approach. Specially formulated by expert nutritionists and using ingredients designed to target the areas that are feeling vulnerable, Health & Her offers a range of supplements that can help with specific symptoms such as brain fog, or wider ranges that focus on buoying up your mental health generally, such as the perimenopause mind+ supplement, specially designed to improve low mood, cognition, and improve the nervous system. An ideal option for women seeking a natural way to manage their perimenopause symptoms, it has been expertly formulated with a natural blend of vitamins, minerals and active botanicals to support hormone balancing, optimum psychological and cognitive function, energy levels and normal functioning of the nervous system.
- HRT to help with hormone levels. If your symptoms are hormone related, your GP may recommend starting you on Hormone Replacement Therapy to stabilise your hormonal changes and prevent oestrogen depletion. This might seem a bit intimidating at first, but HRT can do wonders in helping stabilise your hormones, improving your mood and also helping to prevent problems such as osteoporosis and heart disease. For more information, here’s everything you need to know about HRT.
- Sleep aids and advice for insomnia. If lack of sleep is making you irritable, anxious, and low-energy, different tools can help you get your sleep routine back in order. Advice such as finding a regular sleep pattern, cutting down on stimulants, and seeking out solutions such as CBT or lavender sleep aids could help normalise your sleeping routine and leave you feeling better mentally. Here is more information and advice on how sleep affects your mental health and how to improve sleep during menopause.
- Dietary plans to help keep you healthy. Diet can have a huge impact on your energy and emotional well-being. Cutting down on certain foods that exacerbate your symptoms can lessen fatigue, and keeping an overall healthy diet can work wonders in helping you feel better. For more advice on how to improve mood with food, here are diet and emotional changes to help with menopause moods.
- Exercise programmes to keep active and encourage endorphin release. Exercise can be a stalwart line of defence in helping improve your mood. By releasing endorphins, exercise can provide a burst of happiness and energy that can help power you through the day, while certain exercises such as yoga during menopause have been linked to improvements in mood and relaxation. Here are the best exercises for menopause.
How do I identify whether what I’m going through is perimenopause?
Health & Her has created an easy symptom tool to help you understand whether your combination of mood issues is indicative of the early signs of perimenopause.
If you have one or more of these symptoms, alongside changing periods, consider going to consult with a professional to see what your options are for help. The Health & Her App is available to download on the iOS App Store and the Android Play store. Studies have shown that logging your symptoms has been linked to proven health benefits such as symptom reduction, heightened quality of life, and better health awareness.[6]
When Should I See a Doctor?
If your mental health is impeding on your everyday life and making it hard to get out of bed, do regular tasks, and causing you to feel like you have little hope, the best thing to do is always to go see a professional GP who can listen carefully to what you’re experiencing and then discuss potential suitable treatments to help you feel better. They can offer a range of other solutions that can have you feeling back at your best. Check in with your local NHS GP to talk through how best to treat your mental health and menopause.
What treatments can the NHS offer?
The NHS and your GP could provide a variety of options to help treat your mental health. As Dr Kate Burns describes, ‘depending on what combination of symptoms you are experiencing and their severity, a trial of HRT may be recommended. Alternatively, for some women antidepressants may also be appropriate. Regardless, it is always vital to consider additional, non-medical ways to help improve your mental health and wellbeing; such as cognitive behavioural therapy (CBT), mindfulness, yoga, exercise and healthy eating.’
Millions of women go through perimenopause and menopause annually, and many of them are struggling with mood issues and mental health changes, with little information or support from those around them. If you are struggling, more than anything, it is important to remember that you are not alone – and there is hope! Perimenopause has been linked to issues with mood and emotion in thousands of women, and up until recently, there hasn’t been a lot of material disseminated on why that is, or how to get better.
Health & Her want to say enough is enough. You deserve to get the help and treatment you need, and the support you need to get you feeling like your best self – and there’s no shame in that.
References and Sources
[1] As evidenced by a survey of 2,000 UK women aged 46-60 who have experienced perimenopause, carried out by OnePoll on behalf of women’s health website and free app Heath & Her.
[2] Ibid
[3] Andrews, R., Hale, G., Lancastle, D., John, B. (2020). Evaluating the effects of symptom-monitoring interventions on menopausal health outcomes: a systematic review.
[4] Out of 2,000 women aged 46-60
[5] As evidenced by research commissioned by Health & Her and carried out by Censuswide. 1,001 women between the ages of 45-60 were surveyed.
[6] Out of 2,000 women aged 46-60
