Understanding Mental Health in Menopause

While menopause is commonly associated with physical changes like hot flushes and night sweats, the impact on mental health is often hugely underestimated and overlooked. Let's look at how disorientating menopause can be with our mental health.


Menopause is brought on by fluctuating hormone levels, particularly the decline in oestrogen and progesterone. These hormonal shifts can wreak havoc on a woman's mental well-being, leading to mood swings, anxiety, depression, brain fog, and cognitive changes.


What makes this journey even more overwhelming is how unpredictable symptoms can be. One day, you might feel like your old self, coping well with everything and on top of your game, and the next, you're engulfed in a cloud of hopelessness, feeling like you’ve hit rock bottom or crippled with anxiety. Or if you're like me, you got sucker-punched with that hat-trick. Menopause can make us want to hide, recluse, and isolate. Let's be clear here. This isn't you. It's your hormones.





Anxiety and depression are prevalent during menopause, yet they're often brushed aside as mere symptoms of hormonal changes. However, their impact can be profound, affecting every aspect of a woman's life.


And brain fog is not a menopause myth. Many women report experiencing forgetfulness, difficulty concentrating, and mental fuzziness during this phase of life. This cognitive decline can be frustrating and distressing, especially for those accustomed to sharp mental faculties. Simple tasks might suddenly feel daunting, leading to feelings of inadequacy and frustration.


Coping Strategies:


While navigating the menopause storm can be challenging, there are various coping strategies to help ease the journey:


  • Understanding that what you're experiencing is a natural part of menopause can be empowering. Educate yourself about the physical and mental changes associated with this transition.

  • Prioritise self-care activities that promote mental well-being, such as regular exercise, adequate sleep, healthy eating, supplementation, and relaxation techniques like meditation or deep breathing exercises.

  • Surround yourself with supportive friends, family members, or a therapist who can offer empathy, validation, and practical advice. Sharing your experiences with others who understand can also be incredibly comforting.


While the brain is incredibly complex, with various regions responsible for different functions, hormones act as messengers that communicate with brain cells, or neurons, to regulate processes such as mood, cognition, and behaviour.


Here are some key hormonal changes that affect the brain:



Oestrogen is the hormone primarily associated with female reproductive health, but it also exerts profound effects on the brain. Oestrogen receptors are found throughout the brain, particularly in regions involved in mood regulation, memory, and cognition. During menopause, when oestrogen levels decline, women may experience symptoms such as mood swings, anxiety, forgetfulness, and difficulty concentrating.


Oestrogen also helps coordinate our neurotransmitters, the chemical messengers, like serotonin for well-being, dopamine for pleasure, GABA for calming, and others that have a profound effect on our moods. Before menopause, our ovaries regularly produce oestrogen, which increases and drops alongside progesterone. However, when we are in menopause, oestrogen can fluctuate much more erratically from super high to very low, with much more significance….and oh my word, don’t we feel it?!



Progesterone conventionally has a calming effect on the central nervous system, helping support sleep quality and reducing insomnia. Progesterone also influences brain function, particularly in areas involved in mood regulation. Fluctuations in progesterone levels can contribute to mood swings and anxiety, especially during the menopausal transition, however, progesterone is actually in decline long before we reach menopause.



Although primarily considered a male hormone, testosterone is also present in smaller amounts in women and plays a role in brain function. Testosterone receptors are found in the brain regions involved in mood and sexual desire. Changes in testosterone levels, such as those seen during menopause, can impact mood, energy levels, and low libido.



Cortisol is often referred to as the stress hormone because its levels rise in response to stressors. While cortisol is essential for regulating metabolism, immune function, and stress responses, chronically elevated cortisol levels can have detrimental effects on the brain. Prolonged stress and high cortisol levels have been linked to cognitive impairment, mood disorders, and changes in brain structure, particularly in regions involved in memory and emotion regulation.


Thyroid hormones:

Thyroid hormones, including thyroxine (T4) and triiodothyronine (T3), play a crucial role in regulating metabolism and energy levels. Thyroid hormones also influence brain development and function, impacting mood, cognition, and emotional stability. Imbalances in thyroid hormone levels, such as hypothyroidism or hyperthyroidism, can lead to symptoms such as depression, anxiety, fatigue, and cognitive dysfunction.


These hormonal changes underscore the intricate relationship between the endocrine system and the brain. Disruptions in hormone levels can have far-reaching effects on brain function and behaviour, highlighting the importance of hormonal balance for overall well-being.




Mental health in menopause remains shockingly ill-explored, and the waters are further muddied by the unrelenting upheavals in women’s midlives. Midlife can be an emotionally turbulent time as children leave home, elderly parents health may start to deteriorate, divorces and transitions at work can make it harder to separate cause from effect.


So, with all this going on whilst our hormones are on a rollercoaster, life can feel very overwhelming. 1 in 4 women will feel this severely, and it will not be uncommon for them to experience very dark thoughts. This is why it is so important to talk about menopause and understand that it is your hormones wreaking havoc, and you can get on top of them.


If you’ve struggled with anxiety or depression in the past or if you have a history of PMT related mood swings or postnatal depression, those are indicators that your brain may be more sensitive to hormone changes in menopause. 


By acknowledging the destabilizing nature of this transition and implementing effective coping strategies, women can navigate through menopause with greater resilience and well-being. Remember, you're not alone on this journey, and seeking support is a sign of strength, not weakness.


Embrace self-compassion and patience as you navigate the menopause journey, knowing that brighter days lie ahead.




How has menopause affected your mental health?

Share your story with the Minerva community and feature in our journal – we will understand if you wish to remain anonymous. Email us at info@minerva-wellness.com to take part.