How does menopause impact mental health?

March 18, 2021

It’s not all hot flushes and HRT. Here’s how (and why) menopause impacts mental health.

We all know that menopause can be a challenging time for women, with a variety of difficult symptoms to endure. But it’s more than just hot flushes, poor sleep and prickly skin that can make anyone who’s perimenopausal or menopausal feel uncomfortable throughout their day. In some cases, this life stage actually leaves a lot of women feeling like they’re losing their mind. They feel they may never go back to ‘normal’.

The impact on mental wellbeing is often overlooked. Many people do not realise that mental health issues are genuine symptoms of menopause.

Linda Gillham (Healthy Minds Lead Practitioner at Peppy) says “A lot of women don’t actually realise that they’re perimenopausal when they start having anxiety issues, panic attacks and mental health problems, often for the first time. It can be a frightening experience”.

How menopause affects mental health

Symptoms of the menopause can include:

  • low mood
  • anxiety
  • self-esteem problems
  • sleep issues
  • and even depression.

“Of course ageing can also affect mental health, as can the pressures and stresses of being in the ‘sandwich generation’, between demanding children and elderly parents, which often coincides with the menopause. So if a menopausal woman experiences depression it’s hard to say for sure that it’s caused by hormonal changes. The menopause certainly makes it harder to cope with the many challenges that crop up in this age bracket.”

Very often women are still in full time work while going through the menopause. At a time in life when ageism can often rear its ugly head, going through major hormonal changes can really impact on mental health, because those changes cause brain fog and affect concentration, meaning women feel anxious about being seen as ‘past their sell-by date’ in terms of efficiency and mental sharpness.


The reason people experience these problems

“We need oestrogen and if the levels of this hormone in our body are all over the place, that can trigger anxious thoughts, which can then trigger negative feelings which in turn trigger anxious and self-conscious behaviour,” says Linda.

And hormone fluctuations can also cause insomnia and fatigue, which can be hugely distressing at work. As one Peppy user said, “I was tired beyond belief, I ached everywhere … I reached a point where I think I thought I was going mad. All of these symptoms were making me believe that something was genuinely wrong with me”.

There’s also forgetfulness, or brain fog. “Often called ‘cotton wool brain’ you just lose your clarity of thought and can’t order your thoughts in a clear way,” says Kathy Abernethy, Director of Menopause Services at Peppy. These moments can be hugely distressing, but how we handle them can make a huge difference.

“Say you’re doing an important presentation,” says Linda, “and right in the middle of it you can’t think of the next word. You can either think ‘OK, it will come back’ and then it probably will, or you can get yourself in a very high state of anxiety and think ‘Oh. no, everyone’s looking at me, everyone’s judging me. I’m never going to get my brain back’.”


How these mental health issues can affect your home and work life

Family relationships can become strained during this phase of a woman’s life, while low moods and a sense of isolation are common. “Due to changes in serotonin in the brain you can find yourself feeling quite flat or emotionally low for no apparent reason,” says Linda. “Some women also feel intolerant, ratty and tearful. These mental health issues can leave menopausal women feeling quite desperate”.

Poor sleep due to menopausal symptoms can also make for a miserable time. “The tiredness is partly due to hormonal fluctuations, but also night sweats can disrupt your sleep, so you don’t get enough rest. Difficulty getting to sleep and staying asleep exacerbate this, leaving menopausal women tired, emotional and irritable,” adds Linda.

Perhaps understandably, showing up to work every day and trying to perform at your best while going through this can be difficult, especially as things that you would normally do very confidently can become a challenge and anxious thoughts can become overwhelming.

“But it’s not easy to say ‘Sorry I made that mistake, I’m going through the menopause,’” says Linda.  It’s certainly much more difficult when you are working with men and younger people who may not understand,”.

This is why, from a company perspective, offering workplace menopause support can make a huge difference. “If employees have access to mindfulness classes, as well as a support group for menopausal women, it can really help them get through this. Many women say that they feel so alone and sharing what they’re going through with someone who’s in the same boat can be so liberating”.

Sometimes that’s all people need, some reassurance that they’re not going mad – they’re just menopausal. “It’s just so validating to get that kind of support within your company – it’s worth its weight in gold,” says Linda.


Organisations that are serious about supporting mental health and wellbeing need to offer menopause support so that while women are going through it their distress is minimised. A subject that was once brushed under the carpet or even taboo is now talked about openly – so make sure you take it seriously, know the facts and offer the support that’s needed.

Peppy tips

  • Individuals: take a breath. As tempting as it may be to click send on that email or react instinctively, the best way to act is to take a step back and remember that menopausal rage or intolerance may be playing its part.
  • Organisations: don’t just offer blanket, one-size-fits-all mental health support; give your people access to specialist mental health support specifically for menopause. If sleep issues are affecting a member of staff, consider offering flexibility so they can perform at their best.



What’s making me so angry?


Women's Health

Expanding inclusion: Addressing the overlooked stories of women left behind

Achieving true inclusion isn’t about grand gestures; it’s about the little moments and the individual stories. It's listening to "THAT Woman" – you know, the one who’s brilliant but maybe a bit misunderstood or overlooked at work. We should be giving her the mic and making sure we're all ears.


A decade too late? The hidden costs of menopause


Navigating silent grief: How employers can support employees through baby loss

Every year, an unsettling statistic resounds across the UK – at least 1 in 4 pregnancies end in miscarriage. This striking number implies a significant portion of your workforce has, or will, experience this traumatic event. Our new research, conducted by Censuswide in partnership with the British Infertility Counselling Association and Fertility Matters At Work, with over 1000 employees, delves deep into the subject, bringing to light the scale of the issue as we explore in this article. This is Baby Loss Awareness Week, there's no better time for employers to address and provide the needed support for this heart-wrenching loss.


How to help new parents return to work after parental leave

Navigating the transition back to work after parental leave is a journey filled with excitement, anxiety and a host of unexpected challenges. The real experience of returning to work is often more complex than policies and guidelines can capture. Here's an in-depth look at the unspoken realities and how employers can provide the support new parents truly need.


The long road to PCOS diagnosis

Over 1 million people in the UK are living with undiagnosed polycystic ovary syndrome (PCOS). But is this just another period problem for women to learn to live with, or is the long and complex road to diagnosis something employers should be doing something about? 

Men's Health

Men matter: Addressing the impact of male fertility on business

From our school days, we're taught about the 'birds and the bees' with an unmistakable emphasis on female fertility, when in fact male-factor infertility makes up around 50% of all cases. In our modern age, it's astounding how this outdated narrative continues to dominate not just societal discourse, but also workplace health policies across the globe. It's time we rebalanced this equation. Men's fertility is an integral part of the reproductive story and needs equal attention and support.


Miscarriage in the workplace – the do’s and don’ts

Experiencing a miscarriage is massively traumatic, both physically and emotionally, with long-term feelings of grief and loss. Whether you’re a close friend, family member, colleague or line manager, this is a difficult issue to tackle. But it needs to be tackled – with sensitivity.


Why Businesses Can’t Afford NOT to Support Menopause