About menopause

I didn’t understand what was happening to my cognitive and mental health. All I knew was that I was having my first crisis and I was alone and unsupported.

What is menopause?

Menopause is when our periods stop and we can no longer naturally get pregnant.

Menopause can have a huge impact on our bodies and our minds. Some physical symptoms of menopause, such as hot flushes, are better known.

But menopause can also have a big effect on our mental health and wellbeing. And menopause can affect us years before our periods fully end.

Some people may not notice the effects of menopause. But others may find them difficult to deal with. Research shows that experiencing mental health symptoms is a common part of menopause.

It's important to remember that things can get better with time, and with the right treatment and support.

What's the difference between menopause, perimenopause and post-menopause?

It can be confusing to understand all the different terms about menopause.

• Menopause means the point when you've completely stopped having your periods for one year. Technically, menopause only lasts for one day. But it's often used as an umbrella term to describe the whole time when you experience symptoms of perimenopause, menopause or post-menopause.
• Perimenopause means the time before you've stopped having periods for a year, but you're experiencing symptoms of menopause. Perimenopause can last for many years.
• Post-menopause means the time after menopause. You may still experience symptoms of menopause but they usually get easier over time.

When we talk about menopause in these information pages, this includes perimenopause and post-menopause. You may also hear other terms to describe menopause, such as 'the change'.

Sometimes, you might feel like your experiences 'don't count' as menopause until your periods have stopped. Some doctors can have this attitude too.

But the physical and mental health symptoms of menopause often start in perimenopause. And this can be when they're most noticeable or difficult to cope with. You shouldn't have to wait until your periods have stopped to receive treatment and support.

Why does menopause affect mental health?

During menopause, our hormone levels change a lot.

Starting in perimenopause, our bodies make less of three hormones - oestrogen, progesterone and testosterone.

These hormones all help our brain to work. They can help us think more clearly and improve our mood. They also interact with other hormones in our brain, such as dopamine or serotonin.

When our body starts making less of these hormones, our brain may not get what it needs to work in the same way as before. This can also happen when our hormone levels go up and down during menopause. It can have a big impact on how we think, feel and behave.

In perimenopause, these hormone levels go up and down even more. This can mean that we feel these effects more during this time.

The physical effects of menopause can also be painful, uncomfortable or upsetting. Our bodies may change in ways that feel hard to accept. This can be distressing.

Menopause can come at a time when we're dealing with other difficult things in our lives, or our lives are changing.

And awareness and support for menopause can be limited or hard to access. This can make us feel alone or unheard.

All of these things can have a big impact on our mental health.

I spent possibly hundreds of hours at work hiding in my car, crying and having panic attacks

Who experiences menopause?

Menopause affects those of us who have periods. It most commonly affects people in their 40s and 50s.

It's possible to experience early menopause. This is when your periods stop before you're 45. Or late-onset menopause. This is when your periods stop after you're 55.

Trans and non-binary experiences of menopause

If you're trans or non-binary, you may go through menopause. If and when you experience the effects of menopause may depend on:

• Whether you've had any gender affirming treatments or surgeries, and when you had these
• Your age
• The gender you were assigned at birth
• Any hormone treatments you've taken in the past, or currently take

These will also affect how you experience menopause.

Experiencing menopause can have additional challenges if you're trans or non-binary. It may increase feelings of discomfort with the gender you were assigned at birth. You may also feel like menopause information or services don't meet your needs or aren't inclusive.

If you're experiencing menopause symptoms, there's no shame in seeking help. You deserve to feel supported. The Rock my Menopause website has information that may help.

Our useful contacts for LGBTQIA+ mental health lists organisations that can offer support.  

Early menopause

Early menopause is when your periods fully stop before you're 45 years old.

It can happen for lots of different reasons.

Your ovaries may stop producing the same levels of hormones naturally. This is sometimes called Premature Ovarian Insufficiency (POI).

Some treatments and medications can cause early menopause. This can be temporary.

These treatments include some types of chemotherapy used to treat cancer. And some hormonal treatments used to treat endometriosis or premenstrual dysphoric disorder (PMDD).

Temporary menopause is sometimes called chemical menopause or induced menopause.

If you have your ovaries removed by surgery at any age, you will experience menopause straight away. This is sometimes called surgical menopause.

Early menopause can have the same mental and physical effects as any menopause. You may also experience:

• Distress or shock at experiencing menopause earlier than you expected
• Worry, grief or anger about how this may affect your choices around having children
• Loneliness or isolation, or like the people around you don't understand
• Concern about what this might mean for your health

Support for early menopause

Speak to your GP if you think you might be experiencing early menopause.

The Daisy Network offers information and support if you've been diagnosed with premature ovarian insufficiency.

Cancer Research UK and Macmillan Cancer Support have information about early menopause triggered by cancer treatment.

For more information on endometriosis, visit Endometriosis UK.

Doctors did not suggest that my difficulties could be about experiencing menopause. Looking back I was ‘too young’ to be identified (late 30s).

Menopause and stigma

Many of us have heard of menopause, but it doesn't mean we all fully understand it.

Physical effects, such as hot flushes, are spoken about more than mental health effects. This may make it harder to recognise these mental health symptoms, or to share your experiences.

Menopause is something that many people don't take seriously. You may hear people trivialising or joking about it. This can be frustrating.

Many people don't understand how painful or distressing the effects of menopause can be. This might make you feel like you're supposed to just put up with it. Or that you should keep your experiences to yourself.

Attitudes towards menopause can be sexist and ageist. There are offensive views about women having less value as they get older. And sexist stereotypes about 'hysterical' or 'weak' women can mean that women aren't taken seriously when they seek support.

Not all doctors have enough training in menopause. And research into menopause is limited. This can have an impact on treatment and support for menopause.

Some menopause services, support groups or campaigns may not meet your needs or represent your experiences. This can be distressing if you feel like you're not being heard or supported.

For those of us who belong to certain groups, we may find it harder to cope with menopause. This can be because we don't have the same access to treatment or services. Or because of stigma and discrimination.

These groups include:

• People of colour
• People experiencing housing problems or homelessness
• People with existing mental health problems
• Disabled people
• People who are in prison
• Refugees and asylum seekers
• LGBTQIA+ people
• People experiencing poverty

Our pages on racism and mental health, LGBTQIA+ mental health, housing and mental health, and money and mental health have information that may help.

Self-stigma

We may also hold negative opinions about ourselves and menopause. For example, we may judge ourselves for how we look, feel or act. Or have negative opinions about what menopause means for our lives or future.

This is sometimes called self-stigma. Self-stigma can impact our self-esteem. And it can make the symptoms of menopause harder to cope with.

The hardest thing I have found during menopause is talking to people about it. Everyone has a tale to tell or a judgement to make about menopause, but everyone’s story is different.

Published: September 2024

Next review planned: September 2027

References and bibliography available on request.

If you want to reproduce this content, see our permissions and licensing page.