The Menopause Symptoms People Don’t Talk About Enough, From Experts

Menopause is currently having a renaissance in social discourse, and it's for the best. Beyond the tired stereotypes of hot flashes and mood swings, there's a growing conversation around the full spectrum of physical symptoms, leading to a welcome destigmatization of the menopause experience. 

However, one aspect that we think deserves even more attention is the mental health changes that often accompany perimenopause and menopause.

There’s a plethora of reasons that anxiety and depression spike during menopause, so we’ll group them into three categories: Hormonal fluctuations, bodily changes, and lifestyle shifts.

Hormones

Let’s start with the nitty-gritty: Hormones. During menopause, levels of estrogen and progesterone plummet. 

“These hormones play a crucial role not just in our reproductive health but also in modulating our bodies’ neurotransmitters like serotonin, dopamine, and norepinephrine, which influence mood and emotional well-being,” explains board-certified OB/GYN Stephanie Hack, M.D.

She continues, “The decline in these hormones can lead to increased vulnerability to depressive and anxious emotions1 for many women.” 

On top of that, “Estrogen has neuroprotective properties; its reduction can affect brain function and mood regulation, leading to feelings of depression and anxiety,” Hack says. 

The bottom line: Estrogen and progesterone taking a back seat directly impacts brain function and mood. This is pretty unavoidable, but not unmanageable—more on that in a bit. 

Full-body symptoms

So we know that hormones can directly influence mood, but these hormonal changes in menopause also spark a number of symptoms that have a trickle-down effect on mental health. 

For example, Hack explains that fluctuations in hormone levels can lead to symptoms like night sweats and insomnia. Whether you’re in menopause or at not, consistently getting poor sleep can set you up for anxiety and a lower mood than usual. 

Lifestyle changes

Hormones and symptoms aside, menopause often aligns with other significant life transitions, which can be difficult to manage even without the dip in hormones and other compounding symptoms. 

Knowing why certain thoughts and emotions are more likely to pop up can offer some comfort, and we’ve checked that box above. But as both Hack and Teymoorian express, there’s a more than a few paths to emotional support during menopause. Below, some worthy starting points.

Lifestyle

Hack suggests keeping nutrition and exercise at the forefront of your routine. Rather than forcing yourself to follow a specific diet, limit foods that can negatively impact your mood. 

“For example, clinical studies have shown potential causal effects of refined carbohydrates on mood, noting an increase in depressive symptoms2 in healthy volunteers,” she says. Here, more nutrition tips to support menopause. 

You can also turn to exercise for mood support. “Physical activity increases endorphins and serotonin levels, which can boost mood,” Hack says—so keep up with the workouts you enjoy.

RELATED: This Activity May Relieve Menopause & Menstrual Symptoms, Study Finds

Community

“Connecting with friends, family, or support groups for women going through menopause can also provide emotional comfort and reduce feelings of isolation,” Hack says. 

Building community is great for your mental health, as you probably already know, but that’s not where the perks stop. Creating and maintaining meaningful relationships can have a positive ripple effect on other, often unexpected, areas of health. 

A review of 34 different clinical studies on social connectedness and long-term care outcomes found positive associations between a strong sense of connection and a long list of physical health outcomes, including sleep, nutrition, stress, frailty, fatigue, and even overall mortality. Pretty impressive, right?

Professional support

Finally, don’t gaslight yourself. If you're struggling mentally or physically, you should ask for help. While menopause symptoms, both mental and physical symptoms, are normal, they shouldn't be interrupting your life entirely.

“Often women are so busy with life in general, and they ignore symptoms or push them off as temporary,” Teymoorian says. “I suggest seeking medical help immediately, in fact, it is a good idea to begin discussing these issues with your doctor before they start,” she adds. 

From a dip in hormones to a lack of quality sleep and beyond, there are more than a few reasons menopause can spark feelings of anxiety and depression for many women.

Experts recommend honing in on diet and exercise that makes you feel your best, and putting your mental health first by asking for help.