How can menopause affect mental health?

It was important for me to understand that my symptoms of anxiety, depression and grief all related to the menopause

Everyone's experiences are different. You may not experience all of the things listed on this page. And there may be things you experience that we've not mentioned.

Brain fog

Brain fog is a common effect of menopause. It's when we have problems with our memory, concentration and thought processes. You may notice that you:

• Can't think as quickly or clearly as before
• Struggle to find the right words or explain yourself
• Forget things like names, numbers or appointments
• Lose things more often
• Forget what you're talking about in the middle of saying it
• Go to places or rooms and forget why you went there
• Find it harder to focus on anything
• Feel easily distracted
• Find it harder to make decisions
• Struggle to switch between tasks
• Struggle more with motivation

Brain fog can be very difficult to cope with. You may feel frustrated or angry about not being able to think the way you used to.

Or you might worry that you have dementia or a brain condition. It may also make you feel more anxious or self-conscious around others or at work.

Feeling anxious

Feelings of anxiety are common in menopause. These can include:

• Worrying a lot about your life, other people, the world or the future
• Feeling scared or unable to do things you used to, such as driving, work tasks or social activities
• Feeling scared for no reason
• Feeling nervous or unable to leave your home
• Feeling bothered by things you never used to worry about
• Having panic attacks, often at night or at the same time as hot flushes
• Experiencing intrusive thoughts (distressing thoughts, feelings or urges that keep popping into your mind and won't go away)
• Going over things again and again in your mind (sometimes called 'rumination')
• Feeling paranoid or untrusting of others
• Feeling overwhelmed and unable to cope
• Thinking a lot about regrets or bad memories
• Experiencing phobias, which are new or worse than before
• Experiencing heart palpitations or a tightness in your chest
• Feeling like you have a lump or tension in your throat

Visit our pages on anxiety and panic attacks to learn more about the symptoms of anxiety, and how to cope.

My anxiety levels were through the roof. I ached, I was nauseous.

Feeling depressed

We all feel low or sad at times. But sometimes menopause can have a huge impact on our mood. You might feel:

• Sad or unhappy more often than usual or to a level that feels unusual for you
• Like you can't cope with daily life
• Like there's a heavy weight on your body or mind
• Like life is slow or empty
• Dread or despair about your life or the world
• Emotional or tearful a lot of the time
• Like you can't do the things you used to
• That things you used to do to improve your mood don't work anymore
• Hopeless about the future

Our pages on depression have more about the symptoms of depression and how to cope with them.

As the menopause closed in, I often felt very low.

Feeling empty or numb

Sometimes, menopause might make you feel like you're losing yourself. Or that you don't feel things as strongly as you did before. This can include feeling:

• Like you're not interested in anything any more, or can't be bothered
• That you don't enjoy things that you used to like
• As if your mind or personality is lost or broken
• Emotionless or indifferent about things you used to care about
• Dissatisfied with life but not sure why
• Like everything is pointless
• Bored all the time
• Unable to socialise or enjoy seeing other people
• That you don't have the same sexual interest or desire as before
• Like you don't feel the same levels of warmth, affection or empathy for others, including the people you love

Anger

You might find that you get angry, frustrated or irritable more often than you used to. Or about things that didn't bother you before.

You might find your anger difficult to predict or control. Or you might feel confused, scared or guilty about feeling angry. Especially if it feels out of character for you.

You may also feel angry if your experiences of menopause aren't listened to or taken seriously.

Anger is a natural, healthy emotion. It can help us in some situations. But there are times where anger can feel very difficult to cope with.

See our pages on anger to learn more, including advice on managing anger.

Learning to express my anger effectively helped me understand that there was a value in letting your anger out. The anger was so close to the skin that there was no hiding from it. You had to deal with it

Feeling bad about yourself

The effects of menopause can have a big impact on our self-esteem. You might have thoughts that make you feel:

• You have no worth or value any more
• You can't trust your own mind or judgement
• Self-conscious about the effects menopause is having on your mind, body or personality
• Less attractive or vibrant than you used to be
• Less confident or capable
• Less relevant or important
• Isolated, lonely or like nobody cares about you
• Sad or anxious about getting older
• Like the best parts of your life are over
• Like you're grieving for your old self
• Distressed about no longer being fertile or not having periods
• That the world or other people see you differently now

These feelings can be very difficult to cope with. But with time, treatment and support, these feelings can lessen or go away.

Our pages on self-esteem and loneliness have tips that may help.

I tried so hard to value who I was, but it proved impossible.

Suicidal feelings

Having thoughts or feelings about suicide while going through menopause is common.

You may think about ending your life or plan how you might do so. These thoughts might feel scary, confusing or overwhelming. Or you may feel numb and empty while having these thoughts.

You may find that sometimes you feel very suicidal, but quite quickly your mood changes and you feel ok. These feelings can be difficult to understand or control. Or you may find that you're having these thoughts all the time.

You might worry about sharing these thoughts with other people.

If you're feeling this way, remember that you're not alone. And that things can get better with time, treatment and support.

Our pages on suicidal feelings have more information.

I’d never experienced suicidal feelings before, so literally did not know what to do, who to speak to, or what to ask for.

Sleep problems

Sleep problems during menopause are very common.

You may find that you struggle to get to sleep, or that you wake up a lot. You may experience night sweats or hot flushes while trying to sleep. Or feel anxious or panicky while trying to sleep.

Not getting good quality sleep can have a big impact on your energy levels and wellbeing.

Our pages on sleep problems have more information.

Poor sleep – I'd wake with my heart racing or my bladder fizzing.

Physical effects

The physical effects of menopause can be different for everyone. But they may include:

• Hot flushes (sudden feelings of heat in your face, chest and neck, sweating and feeling dizzy)
• Night sweats (waking up very wet from sweating, sometimes needing to change clothes or your sheets)
• Increased sensitivity to stimuli, such as feeling startled by sudden noises or more bothered by tastes, smells and sounds
• Changes to your periods, such as irregular, heavy or painful periods
• Vaginal dryness, itching, pain or discomfort, sometimes made worse by sex
• Dry skin or eyes
• Hearing ringing or buzzing in your ears (tinnitus)
• Feeling dizzy and as if everything around you is spinning (vertigo)
• Feeling more clumsy than usual
• Headaches
• Joint pain
• Numbness or tingling in your legs, feet, arms or hands
• Urinary tract infections (UTIs), needing to wee more often, or being unable to control when you wee
• Hair loss or hair growth
• Changes to your body shape

These physical symptoms can all affect our mental health and wellbeing. For example, you might feel tired or stressed from coping with pain or discomfort. Or you may feel self-conscious or that you need to avoid certain situations or places.

It can feel like things will never get better or you might worry they'll get worse. 

The Menopause Charity has more information about the physical effects of menopause and how to cope with them.

I also lost my libido totally which was the most upsetting thing as I felt it has created a gap between myself and my partner.

Menopause and existing mental health problems

If you already live with a mental health problem, you may find that menopause affects it. 

During menopause, you may find that:

• The symptoms of your mental health problem become worse, or you notice new symptoms
• It feels harder to manage your mental health problem
• Things that used to help your mental health don't work as well
• You need to make changes to treatments or self-care for your mental health

But not everyone finds that their mental health problem becomes worse during menopause.

You may not notice any difference. Or your mental health problem may become easier to manage. And any things you do to help your mental health may help with menopause too.

If you feel like menopause is making it harder to cope with a mental health problem, talk to your GP. Our page on treatment for menopause has more information.

I have battled with my mental health to one degree or another. I thought it was managed until my hormones started changing when I entered perimenopause. This totally set me off, my moods dropped one minute then I was ecstatically happy the next. I hated my hormones, my mind, and my body.

How do I know whether menopause is the problem?

Menopause doesn't happen in isolation. While experiencing menopause, you may also be coping with other things.

This could include work stress, relationship problems or money worries. You may have health issues or caring responsibilities.

Or you may have experienced trauma, discrimination, abuse or bereavement. And you may be distressed about events in the news.

All of these things can affect our mental health. So it can be hard to work out if menopause is the cause.

Often, our wellbeing is affected by a mixture of things. Getting treatment and support for the symptoms of menopause may not help with everything in your life. But it might make you feel more able to cope.

And seeking help for your mental health may also help you to cope with menopause. Our A-Z of mental health has information about different mental health problems, including how to get support.

Menopause and money worries

Menopause can have an impact on our finances. And worrying about money can affect our mental health.

The effects of menopause might impact your ability to work. Or you may worry about the costs of treatment.

If you're on HRT, you may be able to save money with a prescription payment certificate (PPC). See the NHS information about PPCs to learn more. 

Our pages on money and mental health have tips for coping with money worries.

Published: September 2024

Next review planned: September 2027

References and bibliography available on request.

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