Unheard and Under-treated: Mental Health

Mental health during menopause

This week is mental health awareness week. So let’s talk about women’s mental health and menopause. Many menopausal, perimenopausal and women with POI (Premature Ovarian Insufficiency) suffer very severe symptoms which affect their overall wellbeing. They often suffer in silence.

Vasomotor symptoms are only some of the symptoms related to menopause. These are night sweats and hot flashes. As most of us have experienced, menopause symptoms are not only physical. The “mental” symptoms can be quite severe and unexpected such as anxiety, panic attacks, and depression.

Why Menopause and Depression?

It is not easy to find an explanation for the mental health symptoms related to the menopause. For the countless perimenopausal women questioning their sanity and memory, however, there is often a sense of bewilderment; yet their suffering is very real.

Even after this broad phenomenon in women experiencing menopause, somehow, the connection between reproductive hormones and mental health remains poorly understood and vastly under-researched. Of course, one can argue that taken all together the symptoms could and might drive you into a kind of depressive state. Being sleep-deprived, gaining weight, night sweats and hot flushes can send anyone a little crazy!

The sense of feeling less and less yourself or the sensation of being in someone else’s body are common. While all of these can lessen a person’s wellbeing, it does not fully explain the “depressive” state and other mental health symptoms.

Social factors

Despite the very well known effect of oestrogen levels on mood, there are other factors influencing women’s mental health. This particular phase of life is very often burdened with emotional stressors, such as ending or starting a relationship, grown children leaving home, financial or career changes (sometimes caused by menopause itself), concerns about ageing parents, and so on. At this point, looking at the potential effects of menopause and societal pressures, this period of life can sound overwhelming.

HR therapy

We know, and it has been demonstrated, that hormone replacement therapy (HRT) is of more benefit in menopausal mood disorders than anti-depressant therapy, but once again, we don’t fully understand why.

NICE guidelines from 2015 strongly recommend consideration of HRT and/or cognitive behavioural therapy (CBT) as first-line treatments for mood disorder arising in menopause. Instead, what we have is a situation where over half of GPs prescribe antidepressants ahead of oestrogen. This happens unfortunately nationwide. It is time to change the system. An increasing number of women are concerned about the first-line therapy prescribed by their GP.

Antidepressant to treat menopausal symptoms

Giving antidepressant to menopausal women is not a solution. While it may be easy to confuse menopause with depression, it is not the same thing!

Since they are not mentally ill, antidepressants will make no difference to menopausal women and in some cases, it can make them feel worse. Studies show that antidepressants to treat menopause aren’t that effective. Guess why? Because it is NOT the right therapy.

Studies show that antidepressants to treat menopause aren’t that effective

Any solution?

The first thing that needs to be done is to make your GP aware of the situation. Since they are general practitioners, sometimes they will not have extensive knowledge of menopause and treatments like menopause specialists would.

Even if they are not 100% sure, they need to address the women to menopause specialists, or women should request a referral to a menopause specialist themselves.

Giving the wrong therapy has only a detrimental effect on women who are trying to cope with menopause. All women should know they are not alone. There are many platforms where they can find advice and talk openly about their experience.

MegsMenopause is one of these platforms. Sign up to the MegsMenopause App which is a safe space for women to talk about menopause and share advice. Sharing is caring! Download here for Apple, and here for Android.

Alongside medical treatment, it’s important to keep up with your nutritional intake. The MenoBlend is designed to include all the nutrition that a menopausal needs to assist in a healthy lifestyle.

REFERENCES

‘Unheard and Undertreated’: Menopausal Mental Health (September Editorial)
Hannah Short

The menopause transition and women’s health at midlife: a progress report from the Study of Women’s Health Across the Nation (SWAN)
Samar R. El Khoudary, PhD, MPH, FAHA,1 Gail Greendale, MD,2 Sybil L. Crawford, PhD,3 Nancy E. Avis, PhD,4 Maria M. Brooks, PhD,1 Rebecca C. Thurston, PhD,1,5,6 Carrie Karvonen-Gutierrez, PhD, MPH,7 L. Elaine Waetjen, MD,8 and Karen Matthews, PhD1,5,6