By Barbara Fretz, Registered Clinical Counsellor, living in the South West of Western Australia

A nurse at a local doctor’s surgery I spoke with recently exclaimed, “Menopause and mental health? What do you mean by that?” After explaining to her about my community talks to women in this space, the same nurse retorted, “We should start screening women for these issues”. Yes, exactly!

My own journey with menopause has been eight years and counting. 80% of women experience troublesome menopausal symptoms and of those, 20% will have severe symptoms which can negatively affect a woman’s mental and physical wellbeing. I am one of those 20%. Over these years I have met a number of GPs and specialists, read many journal articles, and tried umpteen hormonal and non-hormonal treatments, but as much as I wanted ‘fast’ solutions to get me out of my misery, there was no one person, one source, or one treatment to help.

Here are some introductory, yet important information about menopause and mental health and wellbeing.

Vasomotor symptoms (hot flushes and night sweats) are one of the most reported symptoms. Many women feel embarrassed and anxious when their hot flushes happen in public or at work. This can cause some women to socially withdraw which puts more pressure on her mental health. Night sweats disrupt sleep length and patterns, causing tiredness, frustration, anxiety, and mental fogginess. Over many nights of ‘sweats’ which go untreated, these sleep disruptions can exacerbate to insomnia, which is chronic and more difficult to treat thus causing more exhaustion, stress, and cognitive impairment. The good news is that for most women, our ‘hot bodies’ will start to cool as you transition into post menopause.

Mood swings and depressive symptoms are also very common due to fluctuating hormones and for women who are estrogen-sensitive and/or have a history of depression, this stage of life can pose serious risks to mental health. 40% of women experience symptoms of depression during perimenopause, yet it often goes undetected and untreated because many healthcare providers are not screening for it and are not prepared with treatment options.

Although many menopausal symptoms can be treated very effectively with menopause hormonal therapy (formerly known as HRT), many women shy away from hormones and/or other medically based treatments. Thankfully, there are very efficacious non-hormonal treatments based on research evidence. A recent British study showed that psychotherapy such as Cognitive Behavioural Therapy (CBT) and to a lesser extent hypnotherapy are as effective as hormonal therapy for symptoms such as vasomotor, sleep, anxiety, stress, depression, and perhaps weight gain.

It is now the time to expose menopause’s effects on women’s mental health such as we have done with pre-menstrual syndrome and post-partem depression. With the risk factors for depression during perimenopause, our healthcare providers need to be better informed. Moreover, giving women who are not depressed a prescription for anti-depressants when they need treatment for menopausal symptoms is not productive nor effective.

Barbara is currently offering free talks to RRR women as she appreciates that the combination of COVID-19 on mental health and menopause may be overwhelming for some. She also runs CBT groups and individual sessions for women who are looking for an effective, non-hormonal treatment for menopausal symptoms. For more information or to connect with Barbara Fretz, you can find her here.