Mental health and the menopause

Posted by Devon Partnership Trust in Mental health, News, Recovery and wellbeing on 13th December, 2018

Helen, Psychological Wellbeing Practitioner at our Talking Health service, spoke openly to local freelance journalist Fran McElhone about mental health and the menopause:

A Devon mental health practitioner has spoken candidly about the impact the menopause had on her own mental health.

Helen from North Devon is a psychological wellbeing practitioner for the Devon NHS Partnership Trust and works with patients with long term physical health conditions who may also be experiencing a mental health problem like anxiety and depression.

The 57-year-old says the menopause took its toll on her own mental wellbeing at times and agreed to share her experiences in the hope of raising awareness about the link between the menopause and mental health.

The menopause can impact on a woman’s health both physically and psychologically, primarily due to the depletion of the hormone oestrogen in the body. In addition to hot flushes, the sweats and tiredness, heavy bleeding and vaginal dryness, some women also experience emotional and psychological symptoms such as anxiety, irritability, poor concentration and low self-esteem, which can often be mistaken for depression.

Helen hopes that other women experiencing similar symptoms such as low mood, anxiety and “brain fog” will not immediately think they too are “going mad”, but that these issues may be linked to hormonal changes in the body, and crucially, can be treated and will pass.

“I found it very difficult at times,” says Helen. “There were occasions I thought I was losing my mind. I was exhausted all the time and couldn’t order my thoughts and I had pain throughout my body and aches in my joints.

“So I went to see my doctor and at first it was suggested I could have fibromyalgia but I didn’t believe it so started looking into it and found the wonderful website Menopause Matters and realised I wasn’t losing it, I didn’t have arthritis, I was going through the menopause.”

For Helen, like for many women, symptoms first occurred in the perimenopausal stage during her 40s, several years before the start of the menopause.

“Things would take me longer to do, like writing up clinical notes,” Helen continues. “I’d feel more emotional and have trouble remembering simple things like what I needed to buy when I was out shopping. There were times when I’d start a sentence and then forget where I was going with it. This happened in a meeting once and, when you feel you’re not being as professional as you’d want to be, it really affects your confidence.

“A lot of my female patients say to me, ‘I think I’m losing my mind, maybe I’m getting dementia, my head is like a fog, I can’t order my thoughts, I’m tired all the time’ – one of the questions I always ask my female patients is where they’re at with the menopause.”

Helen points out that often the menopause is one of many significant events taking place the lives of women approaching 50, so social and emotional factors may all be playing a part in the way a woman experiences the change of life.

“Lifestyles have changed significantly for women reaching menopausal age,” continues Helen, who went through a redundancy aged 50, soon after her menopause got under way. “They may still be working, looking after sick or elderly parents, looking after grandchildren, or may be going through significant life changes like a divorce or bereavement as well.

“The menopause can make you feel like you’re on the scrap heap, like you don’t matter anymore, leaving you wondering where you fit in the world.

“You can experience mood swings and there are huge physiological changes going on as well so women can experience a raft of physical symptoms which can put a strain on intimacy and relationships.

“As practitioners we recognised that physical and mental health is intrinsically linked, and can’t be separated; so if someone has a long term physical condition, that could impact on their mental health, and vice versa.”

Helen stresses that while many women will not experience any psychological symptoms at all and therefore should not anticipate or worry unnecessarily about symptoms occurring. 

But she also believes the menopause should not be something women feel they can’t talk about for fear of being subjected to misplaced judgement or negative gender stereotyping, and there should be workplace support for women of menopausal age.

She adds: “Mental health problems are a natural part of life, like having a cold and we should be able to talk about it. 

“The menopause can affect every part of a woman’s life and for some women it’s hard to manage. Women should feel they can approach their managers and ask for adjustments in the workplace if needed, to help them cope.

“Women need to feel they can go and ask for help, that they can access mental health services either through their GPs or by self-referral, and they’ll be listened to, and know that there is treatment available which can help them manage their symptoms, and that they’re not losing their minds.”

NICE guidelines recognise that mental health issues can be part of the symptoms of the menopause and have a series of recommendations about how to deal with them such as Hormone Replacement Therapy (HRT) or Cognitive Behavioural Therapy (CBT).

Gynaecologist and obstetrician Dr Heather Currie, who founded Menopause Matters, an award winning website providing a raft of information about the menopause, said more needs to be done to raise awareness and understanding of the link between hormones and mental health. “Many women of menopausal age are affected by mental health issues,” she said. “But whereas women are prepared for hot flushes and sweats they aren’t necessarily expecting symptoms such as low mood or anxiety, which can have a huge impact on home and work life.

“We want women to be aware of that link and the appropriate treatment to help them cope with low mood, anxiety and sleep disturbance, which often creeps up on you.”