Menopause and Mental Health

By Ashley Barnes, M.S.


Menopause describes the point in time where changes in a woman’s hormones lead to the end of menstrual cycles. It usually is diagnosed after a woman has gone 12 months without a menstrual period.

The menopausal transition most often begins between ages 45 and 55. It usually lasts about seven years but can be as long as 14 years. The duration can depend on lifestyle factors such as smoking, age it begins, and race and ethnicity. During perimenopause, the body’s production of estrogen and progesterone, two hormones made by the ovaries, varies greatly (2021).

Johns Hopkins Medicine notes that “many healthcare providers actually use the term menopause to refer to the period of time when a woman’s hormone levels start to change. Menopause is said to be complete when menstrual periods have ceased for one continuous year. The transition phase before menopause is often referred to as perimenopause. During this transition time before menopause, the supply of mature eggs in a woman’s ovaries diminishes and ovulation becomes irregular. At the same time, the production of estrogen and progesterone decreases. It is the big drop in estrogen levels that causes most of the symptoms of menopause” (2023). 

Mental Health Symptoms

Some mental health-related symptoms of menopause include:

  • Increased anger and irritability
  • Increased anxiety
  • Self-esteem challenges
  • Confidence challenges
  • Low mood and feelings of sadness or depression
  • Poor concentration – often described as ‘brain fog’ and/or lost words
  • Trouble sleeping

Mental Health Impact

The drastic changes in hormones can impact one’s mood in ways that may impact relationships, work, tasks of daily living, and other areas of life. Like puberty, this pivotal change marks a milestone and a new stage in one’s life. This new stage often prompts mixed emotions for women such as anxiety and grief, as profound changes take place in the body.

Perimenopause and menopause often coincide with other big changes in a woman’s life. Women are typically in their 40’s to early 50’s when they experience these hormone fluctuations; this is also the stage of life where other notable events impact emotional health, such as health problems, aging parents, children leaving home, and/or career pressure. These external pressures can accentuate mood swings, even to the point of triggering or worsening depression and anxiety symptoms.

Seek Support

In addition to seeking medical support, mental health support can be especially helpful in addressing emotional and mental health concerns that are brought on by menopause:

Psychiatrists have extensive training in the area of assessment and will be able to best determine if what you are experiencing meets the criteria for a diagnosis like anxiety or depression. Collaboratively, you and your doctor will develop a treatment plan which may involve medication management.

Psychotherapy, also known as “talk therapy,” has also been studied to be extremely effective in the treatment of anxiety and depression symptoms. Psychotherapy gives us the opportunity to work through our thoughts and feelings in an effective and healthy manner, all while receiving support from our therapists and developing coping strategies. 

Ketamine is an effective option for treatment-resistant depression. Ketamine, when administered by a mental health care professional at the clinically appropriate dose, targets neurons in a way that stimulates the activity of neurotransmitters in a way that combats depression symptoms. 

Ketamine-Assisted Psychotherapy (KAP), a combination of psychotherapy and ketamine treatment, is another effective way to combat treatment-resistant depression. In KAP, a therapist guides the patient through the session, engaging the patient in sensitive and attentive psychotherapeutic work to process the experience. 

Please contact us at the Mental Health Center for sensitive, attentive mental health care. We look forward to supporting you!


Johns Hopkins Medicine (2023). Introduction to menopause. Retrieved October 27, 2023, from

National Institute on Aging (2021). What is menopause. Retrieved October 27, 2023, from,between%20ages%2045%20and%2055