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Researchers are challenging the long-standing belief that menopause directly causes psychological distress and mental health conditions in women.

Contrary to widespread assumptions, a research team revealed in a review that they found no evidence to support the notion that menopause universally elevates the risk of major mental health conditions such as depression, anxiety, bipolar disorder, or psychosis in all women.

However, they identified specific risk factors that may contribute to depressive symptoms during the menopausal transition, including a history of depression, severe sleep disturbances from hot flushes and concurrent stressful life events.

Co-senior author Hadine Joffe explained that if a person has never had major depression before, they are extremely unlikely to have clinical depression during the menopause transition stage.

This challenges the common notions linking menopause and mental health.

Life events vs. menopause transition

The researchers call for a careful assessment of mental health symptoms during menopause, urging clinicians to consider individual history and current life situations rather than attributing symptoms solely to menopause. They caution against the potential harm caused by misattributing psychological distress to menopause, which could lead to delayed diagnosis and treatment.

Despite the common perception of menopause as a time of emotional pain due to hormonal fluctuations, the study highlighted the significant impact of mid-life stresses and life events. This complicates efforts to disentangle the relative contributions of hormonal changes and external factors to mental health symptoms during menopause.

Recommended therapy implications

The findings have significant implications for clinical practice, suggesting that hormonal therapy may not be the appropriate first-line treatment for clinical depression during menopause. Instead, professionals are urged to consider patients' backgrounds, previous mental health diagnoses and current life situations when addressing mental health symptoms during menopause.

Moving forward, the researchers encouraged more personalized approaches to mental health care during menopause, ensuring that women receive appropriate support tailored to their individual needs.