Melbourne, menopause is experiencing a cultural moment.
Fed up of suffering in silence, women and their doctors around the world are speaking out and demanding access to open conversations and better menopause care.
For decades, some women have endured an enormous amount of unnecessary suffering around menopause. There have been countless stories of health professionals who have failed women, for example, by ignoring menopause symptoms and failing to provide the adequate care.
So this attention is long overdue.
But along with this attention have come many messages that menopause is catastrophic for mental health. For example, in a submission to the 2024 Australian Senate inquiry into menopause, which will present its findings on September 17, this stage of life was described as a time of "harm, despair and death" due to untreated menopausal mental illness.
Changes in estrogen levels during menopause have been reported to cause a "destabilizing" effect on the brain and mental health.
But while research shows that some women may be more mood-sensitive to estrogen changes than others, overall the best available data show that mental illness is not a central or common experience during the menopausal years. Anger is not a mental illness
Some middle-aged women report feelings of anger or rage around the time of menopause.
Anger is not a mental illness, but it should be monitored if it becomes severe or negatively affects your daily life. Being dismissed in a doctor's office because "my wife coped well with menopause" or because a family doctor explains that not trained to handle menopause and referring you to a specialist clinic that has a 12-month waiting list are legitimate triggers for anger and unnecessary suffering.
As a society, this anger can be mobilized to demand better care for menopause and aging women's health problems, while also providing appropriate care for distressing or shocking symptoms as needed.
Most Women Stay Mentally Well An article in the Lancet series on menopause and mental health reviewed findings from prospective studies that tracked changes in women's mental health during the menopause transition.
Specifically, depressive symptoms and disorders were analyzed, as well as anxiety, bipolar disorder, psychosis and suicide.
It found that rates of depressive symptoms remained relatively low during perimenopause, which is the time of irregular periods culminating in the last menstrual period at menopause. In the studies reviewed, between 17 and 28 percent of women Perimenopauses reported depressive symptoms compared to 14 percent and 21 percent of premenopausal women.
Only two studies have investigated the risk of developing major depressive disorder consistently assessed by a doctor, and neither found that women were at increased risk for new-onset depression during menopause.
Women usually begin to go through menopause around age 40. Data from the Australian Bureau of Statistics does not show any increase in the prevalence of depressive disorders in women of this age. On the other hand, it is men who experience a higher prevalence of depressive disorders in middle age.
In other words, the hormonal changes of menopause do not appear to have a "destabilizing" effect on the mental health of most women.
This information is important to help women feel more confident about the menopause transition. Attitudes toward menopause help shape younger women's expectations. A negative attitude toward menopause increases the future risk of developing depressive symptoms during perimenopause.
By avoiding unhelpful and inaccurate messages that menopause often spells disaster for mental health, we can help improve expectations for the next generation of women entering menopause.
However, research shows that certain subgroups of women are at risk of mental health problems during menopause and more could be done to support these groups.Risk factors for mental health
Most evidence has been collected on the connection between menopause and depression. While most women do not develop depressive symptoms or disorders during menopause, some women are at risk.
Several factors related to menopause and broader life circumstances help explain this. These include severe hot flashes, especially those that disturb sleep, going through a particularly long menopause, or reaching menopause due to surgery and not as a result of the natural aging.
When these collide with other risks (previous history of depression, life stress or minority status), then the risk of mental health deterioration is compounded.
Unfortunately, the lack of adequate medical training to manage menopause has only increased this burden. Supply issues with access to menopausal hormone therapy for those who need it is another factor at play.
While hormone therapy is very effective for symptoms such as hot flashes and night sweats, it has not been shown to treat symptoms such as depression, anger, brain fog, or fatigue that some women experience in middle age.
All of these factors go hand in hand with a broader culture that devalues the voices of aging women.The Road Ahead
The message that menopause is a time of decline and decay and that mental illness is common at this stage of life has its origins in the 1950s.
Dr. Herbert Kupperman and Dr. Meyer Blatt were the first to compile a scale to describe and measure "menopausal syndrome" and considered psychological symptoms to be fundamental to the experience of menopause based on their observations of women they treated in clinics. of menopause. They described the uterus as the "Achilles heel" of the organs and menopause as a "quite unpleasant and possibly dangerous" stage of life.
Women deserve better than these outdated messages because they are not backed by good science.
Likewise, dismissing women's mental health concerns in midlife, or the potential impact of menopausal symptoms on mental health, is equally problematic. Improve high-quality training in menopause management for medical students and professionals, along with improving the skills of psychologists and other health professionals, could go a long way to addressing this problem.
Perhaps most importantly, the voices of middle-aged women must take center stage.
As the next generation of women enter perimenopause, they likely hope to be wiser, more powerful, and compassionate versions of themselves due to the life experience and leadership opportunities gained with age. Balanced clinical care that recognizes and Treating any symptoms of menopause, without framing menopause as a disaster, would help empower these women to thrive during their midlife years. (360info.org) AMS
Fed up of suffering in silence, women and their doctors around the world are speaking out and demanding access to open conversations and better menopause care.
For decades, some women have endured an enormous amount of unnecessary suffering around menopause. There have been countless stories of health professionals who have failed women, for example, by ignoring menopause symptoms and failing to provide the adequate care.
So this attention is long overdue.
But along with this attention have come many messages that menopause is catastrophic for mental health. For example, in a submission to the 2024 Australian Senate inquiry into menopause, which will present its findings on September 17, this stage of life was described as a time of "harm, despair and death" due to untreated menopausal mental illness.
Changes in estrogen levels during menopause have been reported to cause a "destabilizing" effect on the brain and mental health.
But while research shows that some women may be more mood-sensitive to estrogen changes than others, overall the best available data show that mental illness is not a central or common experience during the menopausal years. Anger is not a mental illness
Some middle-aged women report feelings of anger or rage around the time of menopause.
Anger is not a mental illness, but it should be monitored if it becomes severe or negatively affects your daily life. Being dismissed in a doctor's office because "my wife coped well with menopause" or because a family doctor explains that not trained to handle menopause and referring you to a specialist clinic that has a 12-month waiting list are legitimate triggers for anger and unnecessary suffering.
As a society, this anger can be mobilized to demand better care for menopause and aging women's health problems, while also providing appropriate care for distressing or shocking symptoms as needed.
Most Women Stay Mentally Well An article in the Lancet series on menopause and mental health reviewed findings from prospective studies that tracked changes in women's mental health during the menopause transition.
Specifically, depressive symptoms and disorders were analyzed, as well as anxiety, bipolar disorder, psychosis and suicide.
It found that rates of depressive symptoms remained relatively low during perimenopause, which is the time of irregular periods culminating in the last menstrual period at menopause. In the studies reviewed, between 17 and 28 percent of women Perimenopauses reported depressive symptoms compared to 14 percent and 21 percent of premenopausal women.
Only two studies have investigated the risk of developing major depressive disorder consistently assessed by a doctor, and neither found that women were at increased risk for new-onset depression during menopause.
Women usually begin to go through menopause around age 40. Data from the Australian Bureau of Statistics does not show any increase in the prevalence of depressive disorders in women of this age. On the other hand, it is men who experience a higher prevalence of depressive disorders in middle age.
In other words, the hormonal changes of menopause do not appear to have a "destabilizing" effect on the mental health of most women.
This information is important to help women feel more confident about the menopause transition. Attitudes toward menopause help shape younger women's expectations. A negative attitude toward menopause increases the future risk of developing depressive symptoms during perimenopause.
By avoiding unhelpful and inaccurate messages that menopause often spells disaster for mental health, we can help improve expectations for the next generation of women entering menopause.
However, research shows that certain subgroups of women are at risk of mental health problems during menopause and more could be done to support these groups.Risk factors for mental health
Most evidence has been collected on the connection between menopause and depression. While most women do not develop depressive symptoms or disorders during menopause, some women are at risk.
Several factors related to menopause and broader life circumstances help explain this. These include severe hot flashes, especially those that disturb sleep, going through a particularly long menopause, or reaching menopause due to surgery and not as a result of the natural aging.
When these collide with other risks (previous history of depression, life stress or minority status), then the risk of mental health deterioration is compounded.
Unfortunately, the lack of adequate medical training to manage menopause has only increased this burden. Supply issues with access to menopausal hormone therapy for those who need it is another factor at play.
While hormone therapy is very effective for symptoms such as hot flashes and night sweats, it has not been shown to treat symptoms such as depression, anger, brain fog, or fatigue that some women experience in middle age.
All of these factors go hand in hand with a broader culture that devalues the voices of aging women.The Road Ahead
The message that menopause is a time of decline and decay and that mental illness is common at this stage of life has its origins in the 1950s.
Dr. Herbert Kupperman and Dr. Meyer Blatt were the first to compile a scale to describe and measure "menopausal syndrome" and considered psychological symptoms to be fundamental to the experience of menopause based on their observations of women they treated in clinics. of menopause. They described the uterus as the "Achilles heel" of the organs and menopause as a "quite unpleasant and possibly dangerous" stage of life.
Women deserve better than these outdated messages because they are not backed by good science.
Likewise, dismissing women's mental health concerns in midlife, or the potential impact of menopausal symptoms on mental health, is equally problematic. Improve high-quality training in menopause management for medical students and professionals, along with improving the skills of psychologists and other health professionals, could go a long way to addressing this problem.
Perhaps most importantly, the voices of middle-aged women must take center stage.
As the next generation of women enter perimenopause, they likely hope to be wiser, more powerful, and compassionate versions of themselves due to the life experience and leadership opportunities gained with age. Balanced clinical care that recognizes and Treating any symptoms of menopause, without framing menopause as a disaster, would help empower these women to thrive during their midlife years. (360info.org) AMS
