Menopause and Mental Health: Why "It's Just Hormones" Isn't the Whole Story
For me it was the spike in anxiety that appeared out of the blue, the heaviness of heart that surfaced without explanation, and that feeling of not recognising myself anymore. Talking with other women, they highlight the brain fog and sudden forgetfulness that arrived just as unannounced.
There has been a welcome shift in recent years. Menopause has been taken out of the category of things we don't speak about, and is finally being talked about, researched, and written about with the seriousness it deserves. The hot flushes, the sleepless nights, the joint pain, the gastrointestinal implications, all of it is getting more airtime than it ever has before, and we can be genuinely thankful for that.
What has taken a little longer to catch up is the emotional and psychological side of this transition. That part of the conversation is growing too, and I think it matters that it does.
But I have found myself wondering whether this growing awareness is something of a two-edged sword.
The comfort of knowing there is a reason
There is a comfort in learning that there is a hormonal explanation for the emotional changes we are experiencing. And when there is a reason, there is usually a path forward too, toward acceptance, and toward actually reaching out for support instead of quietly enduring. That relief is real and it matters.
The cost of a label
But I also think about the way we grew up. Many of us came of age in a culture where a girl's or young woman's emotions could be waved away with a knowing look and a comment about "that time of the month." It was dismissive then, and I wonder if we are at risk of a similar dismissiveness now, just with a different label attached.
This kind of minimising can delay the moment a woman reaches out for real support. And it can happen from the outside too. Partners, colleagues, even well-meaning friends can hear "menopause" and stop listening for the seriousness underneath it, as though naming the cause makes the experience smaller than it is.
There is another layer here too. Naming everything as "just menopause" can quietly erase the other things that are genuinely happening in a woman's life at the same time: ageing parents, children who need her, her own health concerns, a shifting sense of who she is professionally, strain in the relationships that matter most. Menopause rarely arrives alone. It lands in the middle of a full life, and all of it deserves to be seen.
What the research actually tells us
The hormonal piece is real, and it helps to understand it rather than dismiss it. Oestrogen and progesterone do not only regulate the reproductive system. As clinical neuropsychologist Dr Nicola Gates writes in The Feel Good Guide to Menopause, "oestrogen plays a role in memory and brain metabolism." These hormones also influence neurotransmitters involved in mood and stress regulation, which is part of why the menopause transition can bring anxiety and low mood even for women who have never struggled with either before.
The scale of this surprised me too. UK Biobank data on more than 128,000 women found that in the four years surrounding the final menstrual period, a woman's risk of a first episode of major depression rose by 30 percent, often with no prior history of depression at all. A major 2024 Lancet series on protecting mental health through the menopause transition reached a similar conclusion, and smaller studies looking specifically at stress, resilience, and psychological symptoms across the different menopausal stages have found the same pattern showing up again and again.
Where the hope comes in
Dr Nicola Gates writes about menopause with real hope, and with a clear message that conscious, thoughtful effort during this time genuinely improves your wellbeing. This is not something that simply happens to you while you wait it out. It is a chance to look after yourself in a new way, and to make decisions that are actually aligned with your values, rather than the ones you inherited or defaulted into years ago.
One thing that resonates with me is the idea that this is a moment to talk. It might be time to talk to a professional who genuinely understands menopause and its impact on mood, someone who will not wave your experience away with a shrug. It might be time to talk to the friends already in your circle about what you are carrying. Or it might be a quiet signal that it is time to build that circle, to nurture a small group of women you can be honest with, because the people around you right now may not all be the right people for this particular conversation. We are relational beings. We heal, settle, and find our footing again largely in connection with others, especially others who understand exactly what we are carrying because they are carrying something similar.
What this comes down to is taking one more step. Not just accepting what is happening to you, but actively choosing what comes next. Seeing menopause not only as something to endure, but as a genuine opportunity to improve your mental and physical wellbeing, on your own terms.
If you are in the middle of this transition and finding it harder than you expected to hold everything together, please know that what you are feeling has real, understood roots, and that there is genuine support available. You do not have to laugh it off, and you do not have to carry it alone.
If this resonates and you would like to talk it through, I offer a complimentary 15-minute phone consultation, no obligation. You can reach me at anneke@anestacounselling.com.au or 0452 129 860.
References
Di Florio, A. et al. (2024). Nature Mental Health, UK Biobank study on psychiatric diagnoses around the final menstrual period.
Brown, L., Hunter, M.S., Chen, R., et al. (2024). Promoting good mental health over the menopause transition. The Lancet, 403(10430), 969–983.
Gates, N. (2019). The Feel Good Guide to Menopause. HarperCollins Australia.
Kuck, M.J. & Hogervorst, E. (2024). Stress, depression, and anxiety: psychological complaints across menopausal stages. Frontiers in Psychiatry, 15:1323743.