October is Menopause Awareness Month — and when many people hear the word “menopause,” symptoms like hot flashes and night sweats are the first to come to mind. But for many women, the shifting hormones can also have a considerable effect on their mental health. National Mental Health Correspondent Dr. Nicole Clark has more.
We’re hearing a lot more about menopause these days, from celebrities, social media influencers, and menopause researchers. And as more people talk about it, some are also acknowledging that their mental health took a big hit during that period.
Up to 70% percent of women experience mood changes during perimenopause and menopause — which can range from irritability and loss of concentration to anxiety and depression.
“For some people, and we know this through the different points in the life course when the hormones play such a role — puberty, pregnancy, postpartum, and in the menopause — that some women seem to be more, in their neurobiology, more sensitive to those hormone shifts,” said Dr. Catherine Monk, the Diana Vagelos Professor of Women’s Mental Health in Obstetrics and Gynecology at Columbia University.
Dr. Monk leads a program at Columbia that helps patients within the OB-GYN department with stress, anxiety and depression.
In particular, it’s the ups and downs of two key hormones — progesterone and estrogen — that can wreak havoc on our mood during the menopausal transition. One reason is because these changing hormones can lead to night sweats and fragmented sleep.
“It’s very well established that disrupted sleep and not enough sleep, broken sleep, not being able to get back to sleep; that kind of insomnia really is corrosive for well-being and for mood,” said Dr. Monk.
Add to that the myriad of life changes that many people go through during their midlife years.
“It’s a time of shifting identity. If there are children, they’re often leaving the home around that period,” Dr. Monk said. “Marriages get reevaluated, reconfigured. There can be adjustment there. There can a time of reflection. Where am I now versus where I thought I would be?”
To address the hormonal changes, Dr. Monk says many women could benefit from talking to their doctor about hormone therapy, which involves taking medication that replaces the body’s declining levels of progesterone and estrogen.
“For many, many women, it is a life-changing treatment,” said Monk.
Other options for managing mental health involve antidepressant medication, which can treat anxiety and depression, talk therapy, and learning to more effectively deal with stress. One strategy Dr. Monk uses is called behavior activation, a process that involves becoming aware of things that lift your mood.
“Specific music, a specific coffee shop, a specific aunt you’d like to call that help you feel good. Find that joy. And then when you’re feeling down, you have a contract with yourself that you put your finger on one or the other, you do the behavior,” Monk said.
Learning to reframe overwhelm is another strategy that can help when life seems to be coming at us all at once.
“Managing, ‘okay, here’s my super long list. What’s realistic for today, or for this week, or what has to happen.’So it’s not truly changing things. It’s changing how we frame it, how we hold it in our minds,” Monk said.
That’s advice perhaps all of us could stand to remember.
Spectrum has done extensive coverage on menopause this month – check out more of that content here.
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