You've heard of the emotional impact of menopause on women, but did you know that it can also cause anxiety and depression? Mental health is a topic that many people don't want to discuss due to concerns of stigma, fear, and perceived repercussions of the diagnosis. However, if this topic is raised with compassion and understanding, the patient will likely become more comfortable and open to the conversation. I found that this strategy to be very effective in my practice. Patients need to know that the fluctuations in hormone levels are a normal stage of life, which is no different when a woman first entered puberty decades previously.
The Journal of Clinical Endocrinology & Metabolism discovered through research that progesterone and estradiol levels fluctuate during this time in a woman's life, which causes mood changes like depression. The emotional impact of menopause on women can be challenging to discuss, but you owe it to yourself and your patients to be proactive in this discussion.
During perimenopause and menopause, many hormonal changes occur that might lead to temporary mood changes, including symptoms of depression and anxiety. The incidence of depression doubles during perimenopause, which is the time before menopause where female hormones fluctuate wildly. Women who have struggled with depression or anxiety before might see an increase in symptoms at this stage as well. So intuitively, this should encourage health care providers to have this conversation early. It should be open and matter of fact, normalizing mental health concerns in this demographic.
So, how do we prepare our patients and ourselves about this fact? First, we must remind them that depression is a common condition, and women who have had depression early in life would be prone to a more significant emotional impact. In practice, we need to normalize the talk about mental health.
As mentioned previously, a significant proportion of women who develop mood issues during perimenopause have had them in the past. Depression in the perimenopausal phase rarely ever "comes out of nowhere." Unfortunately, individuals might not have been diagnosed with depression when they were younger, despite having apparent signs and symptoms significantly impacting their lives. As we know, there is still significant headway that needs to be made in the mental health discussion.
Perhaps, society is more likely to use the term "mid-life crisis," which honestly might result from subclinical or undertreated depression. Changes in your physical health at the time of menopause may also drive mood changes. For example, anxiety may be triggered by an overactive thyroid gland. Hormonal shifts can lead to a lack of sleep and create hot flashes that make it hard for women who go through menopause to get the rest they need during their nightly slumber periods.
So how does one protect themselves from these various issues? Protecting oneself boils down to taking a holistic approach to health. Women need to be mindful of the health of their relationships, making sure they surround themselves with supportive individuals. As with other medical conditions, healthy lifestyle choices help support optimum health. So, menopause isn't the time to slow down and become sedentary. Unfortunately, this period is also close to when many women stop working and retire. It is so important to be deliberate and stay active to help mitigate the undesired effects of menopause. Being self-aware and monitoring one's mood is also really important. Before life feels like it's getting out of control, you must connect with health care professionals who understand this topic and provide various therapeutic strategies to help you live your best life.
To enjoy emotional balance, during perimenopause, self-nurturing and work obligations need to balance. Many women can identify their sources of tension or stress but still find it challenging to take time for themselves. Usually, by menopause, women have completed their family, and their children are typically reasonably independent. If a woman hasn't already done so, they must permit themselves to prioritize their mental and physical selves. The first step when dealing with any challenge is to pause and identify what the concerns are. Getting perspective in the situation is critical and prioritizing one's mental health. After recognizing the problem(s), the next step is to take empowered action and find people to support and encourage you and keep you accountable.
Let's demystify the talk about mental health and our menopausal patients. This stage of life can be a rollercoaster. For their sake and the sakes of their family and those they interact with, it is our duty to provide compassionate, quality care and discuss the emotional impact of menopause.