A review reveals that while some groups are more susceptible, symptoms are not shared by all.

Debunking Myths: Recent Studies Probe the Association Between Menopause and Psychological Anxiety

Contrary to long-held beliefs, a recent research review conducted by experts from Harvard-affiliated Brigham and Women’s Hospital, along with international collaborators, challenges the notion that menopause universally leads to psychological distress. Published in The Lancet, this review is the third in a series of menopause-themed papers. The comprehensive analysis found no concrete evidence supporting the idea that menopause significantly increases the risk of mental health conditions, such as depressive symptoms, major depressive disorder, anxiety, bipolar disorder, and psychosis.

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         "It is highly unlikely that you will experience your first 
         episode of clinical depression during the menopause
         transition if you have never experienced major depression
         before."

              Harvard Medical School psychiatry professor Hadine Joffe
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The researchers did identify specific groups more vulnerable to mental health issues during menopause. Factors contributing to an increased likelihood of depressive symptoms included a history of previous depression, severe sleep disturbances from nocturnal hot flushes, and concurrent stressful life events.

In addition to dispelling negative expectations associated with women entering middle age, the researchers emphasized the potential harm of attributing psychological distress solely to menopause. Such misattribution could delay accurate diagnosis and treatment.

Co-senior author Hadine Joffe, a professor of psychiatry at Harvard Medical School, stressed, "The key takeaway for women and their healthcare providers is that there's no reason to assume that a person's mental health issues and menopause symptoms are connected. While it's not a given, we don't want to downplay the possibility that some women may have mental health issues when going through menopause."

The menopause transition, spanning four to 10 years and typically commencing around the age of 47, involves hormonal and menstrual changes. Despite being associated with emotional challenges due to hormonal fluctuations, this phase coincides with mid-life stresses and events, such as job or relationship changes, making it complex to separate the impact of these factors.

Reviewing previous studies on the incidence of mental health conditions during menopause, the researchers highlighted the importance of prospective studies that consider mental health pre-menopause. While some studies showed an association between depressive symptoms and menopause, severe clinical depression during this phase was predominantly observed in individuals previously diagnosed with the condition.

The research found no compelling evidence universally elevating the risk of anxiety, bipolar disorder, or psychosis during the menopause transition, with limited literature available on these associations. As the majority of menopause studies are conducted in high-income countries, the applicability of these results to lower- and middle-income regions remains uncertain. Furthermore, the impact of menopause on transgender and gender-diverse individuals is still poorly understood.

The researchers cautioned against considering hormonal therapy as a first-line treatment for clinical depression during menopause. Instead, they advocated for a holistic approach, taking into account patients' backgrounds, mental health history, and current life situations when addressing mental health symptoms during menopause.

In conclusion, the negative media portrayal of menopause and its impact on mental health should be reconsidered, urging clinicians to explore individuals' mental health before menopause to better understand the potential biological, life stage, or trajectory-related factors contributing to mental health challenges during this transitional phase."