How menopause has a deep effect on mental wellbeing

22 May 2024
Aiswarya Menon Written by Aiswarya Menon
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Aiswarya is a writer and brand strategist. She is also a secret student of psychology and spends...


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It is yet another day at the HUDCO office off Ishwar Bhuvan Road in Ahmedabad. The beige-colored walls, identical chairs and computer set-up in each room, and humdrum ceiling fans create a normal, albeit tepid environment. 

Except it isn’t for Anita Menon, the 55-year-old Deputy General Manager at HUDCO. Her usually kind, smiling eyes flit across the room to the corridor outside her office. She is sweating profusely, and her face has turned red. As she scrambles to find her water bottle, she notices her hands quivering. 

Anita feels as if she has been plunged into a radiation lab when she experiences a sudden surge of heat through her body. Her heart races and a wave of dizziness washes over her.  

She feels confused. Flustered. Scared. 

Multiple thoughts run through her head: Am I having a heart attack? Should I call an ambulance? Should I inform my husband or my children? Has the room always been this bright?

She musters the courage to walk to the washroom and splash cold water onto her face. The tap water seems ice cold, but she welcomes it wholeheartedly. She can feel her body’s temperature dropping and her heartbeat returning to normal. As she stares into the mirror, she starts sobbing.  

Anita recollects this incident as her first menopausal symptoms. She recalls having minor one-off instances before this, but that day at her workplace is burned into her memory. 

“I used to feel sad, angry and cry without reason, but I always chalked that up to life’s stress,” she explains further.

While physical symptoms like hot flashes are often discussed, the emotional impact is usually swept under the rug. Especially in India, when it comes to talking about a woman’s emotional behavior—it is either not given adequate consideration or chalked up to overreaction. However, the emotional and mental impact during menopause can be just as profound. The reason? A complex fluctuation of hormones plays a vital role not just in our physical health but also in our emotional well-being.

What is menopause? 

How menopause has a deep effect on mental wellbeing

During the fertile years, a woman’s body relies on a well-coordinated team of hormones: estrogen, progesterone, and follicle-stimulating hormone (FSH). Estrogen, often referred to as the “feel-good” hormone, regulates mood by influencing neurotransmitters like serotonin, which promotes feelings of happiness and well-being. Progesterone acts like a calming conductor, balancing the effects of estrogen. FSH stimulates the ovaries to produce eggs, but its levels rise significantly during menopause.

Menopause, typically occurring between the ages of 45 and 55, is a natural biological process marking the end of menstrual cycles. As a woman approaches menopause, in the biological context, her ovaries have stopped producing most of their estrogen and progesterone, and the body gradually winds down egg production, release, or ovulation. This decrease triggers a domino effect. FSH levels surge, but with no eggs left to stimulate estrogen and progesterone production plummets. This hormonal imbalance disrupts the delicate hormonal symphony that once kept her mood stable.

Stages of menopause

Think of menopause as a play in three acts. The first act, perimenopause, is like the rising curtain. This transitional phase, usually starting in your 40s, sets the stage for hormonal changes. Your periods might become irregular, and you might experience hot flashes or mood swings – it’s your body’s way of rehearsing for the next act.

Act two is the big reveal: Menopause, officially marked by twelve months without menstruation. However, this doesn’t mean the curtain falls entirely. Symptoms like hot flashes and sleep disturbances might linger, but you’re no longer fertile.

The final act, postmenopause, is all about navigating the new normal.  Menopausal symptoms may ease or continue, but fertility is a thing of the past. This act is your chance to embrace this new chapter and focus on your well-being.

Dr. Anna Barbieri, MD, FACOG, NCMP, a board-certified gynecologist and integrative medicine specialist and a certified menopause practitioner by the North American Menopause Society, notes in an article:

“As estrogen, progesterone, and testosterone levels shift during the menopause transition, our entire person is affected. Estrogen alone affects 100+ body parts, so it makes sense that we feel these shifts everywhere. Levels continue to change, so symptoms evolve over time.”

Women account for 48.4% of the Indian population, as per World Bank’s estimation. Of these, a staggering percentage are unaware of the stages of menopause or the duration of their transition. How staggering? In a recent survey conducted by Menoveda, where twenty thousand women between the ages of 40 and 55 were surveyed, the findings include:

  • 67% of women were unable to identify all three phases of menopause  
  • 81.4% of women did not know how long their transition would last
  • And 80% reported their mental and physical health being impacted during menopause

The mental health impact of menopause

Research published by the National Institutes of Health sheds light on the impact on mental health as the body goes through the stages of menopause. Women are two to four times more likely to experience major depression during menopause than at any other time in their lives. This increased risk is partly attributed to estrogen’s decline in mood-regulating properties.

How menopause has a deep effect on mental wellbeing

The Menopause Guide by WebMD explains those emotions beyond sadness. This is how shifts in hormones can manifest: 

  • Anxiety: An abrupt change in the amounts of estrogen could cause a feeling of fear and anxiety similar to stress responses.
  • Irritability: A mismatch between serotonin and estrogen may result in frustration and a short temper.
  • Brain fog: Estrogen receptors are present in the brain regions responsible for memory and focus. Cognitive functions like forgetfulness and difficulty concentrating may suffer if estrogen levels fall below normal. 
  • Loss of libido: In terms of sexual desire, estrogens matter. A decrease in sexual satisfaction as well as libido may occur due to reduced levels of estrogen. 

One of menopause’s signs is disturbed sleep patterns, with night sweats and hot flashes accompanying it. Sleep deprivation is a notorious risk factor for depression and anxiety, which also affect mental health.

Another aspect is the complicated relationship between hormones and neurotransmitters. Serotonin is vital for mood regulation, while other neurotransmitters, like dopamine, which stimulates positive emotions and motivation, can be affected by hormonal alterations.

Menopause can cause emotional instability. The different symptoms women experience depend significantly on their bodily composition and consciousness level, making identifying and sorting facts from misinformation challenging. These are not just “off days” or “crankiness” but rather genuine, serious mental health problems that must be attended to.

Societal attitudes and cultural beliefs concerning menstruation and menopause also contribute to mental health issues during the menopausal period. Women might feel they are alone and misunderstood as they go through this stage in life, thus experiencing feelings of disgrace and inadequacy. These challenges worsen due to a lack of information about how to navigate these aspects associated with menopause. If women don’t know where to seek assistance from, their mental health might deteriorate further, putting them at higher risk of anxiety and depression.  

Sarita Bahl, aged 60, Director at Bayer Foundation India, a Mumbaikar, says menopause occurred quite late for her. “I remember crying in the middle of the day. But it was a stressful time for me on the work front, so I always thought stress was the reason for my emotional upheaval.”

When asked if someone shared age-old tips on how to handle menopause, Sarita laughs. “My mother never spoke to me about menstruation, let alone menopause. There is a stigma around menstruation, especially in India.”

Why aren’t women made aware of the biological and physiological changes during menopause? Is it because we live in a patriarchal society where the woman’s worth and importance lie in her ability to bear children? Is it because, as women, we are expected to battle our demons silently? Or, just like sex education and menstruation is a taboo topic in India, does menopause also fall under the same category?”

Nishitha Pillai, a forensic psychologist and a PhD scholar at National Forensic Sciences University, Delhi, shed light on the intricacies of human psychology and provided clarity.

“Talking about my mom’s menopause phase, I still remember her going through that phase. She used to get irritated now and then for the smallest of things, and initially, it was difficult for my younger brother, Nidhish, and me to understand what was happening with her because we were new to that thing. It didn’t strike us that she was reaching that age where we might be going through menopause. So we also used to get irritated. But when it became frequent, I realized that it was a pattern, and that’s when I decided to go and ask my mom. 

Nishitha says that her mother didn’t understand what was happening with her body – common enough, given that the topic is still taboo. 

“Another thing that I’ve noticed is that a lot of women start suppressing their mood swings, or they try to blame themselves because they feel like they’re getting angry about useless or pointless things. In such a scenario, ultimately, they will vent it out or go into a depressed state,” explains Nishitha. 

The Menoveda Survey highlighted a whopping 78% of women felt unimportant, unnoticed, and frustrated during the menopausal transition.

It’s important, Nishitha adds, in this phase, that the family is there for the woman, to understand and offer empathy. 

How to take care of yourself during menopause

Understanding these biological and neurological processes is empowering, as Nishitha notes.  When women realize that their emotional shifts are a normal part of menopause, not a personal failing, it takes away the feeling of guilt, shame, and inadequacy. Some tools that can help are:

How menopause has a deep effect on mental wellbeing
  • Healthy habits: Prioritize sleep by establishing a regular sleep schedule and creating a relaxing bedtime routine. Exercise regularly to boost mood and energy levels, and eat a balanced diet rich in fruits, vegetables, and whole grains. These lifestyle changes can significantly improve your overall well-being.
  • Stress management techniques: Relaxation techniques like deep breathing, yoga, or meditation can help manage anxiety and improve sleep quality. Mindfulness meditation can also help you become more aware of your emotions and develop healthy coping mechanisms.
  • Seek support: Talk to your doctor about your emotional well-being. Don’t hesitate to seek professional help if you’re struggling with symptoms like depression or anxiety. Consider joining a support group to connect with other women experiencing similar challenges.

Menopause brings a range of mental health challenges that women face, often silently and alone. Understanding these biological reasons, addressing the social and cultural stigma, seeking professional help, practicing self-care, and creating a support network are all essential strategies for managing these challenges and promoting mental well-being during menopause. 

“Since menopause isn’t a widely discussed topic, it has to be addressed in a very well-structured way so that everybody gets to know it and we can provide the best support and care to the women in our house when they’re going through this phase in their lives. Family and society can help women process this transition better by being patient, understanding, and caring,” says Nishitha.

Nishitha recollects that once the family was made aware of the changes her mother was going through, things got better. When Nishitha’s mother lost her patience, the remaining family members maintained their patience. The clear communication, acknowledgment and acceptance of her bodily changes eventually reduced the intensity.

“The other thing is to give them space. Even when your mother or spouse is lashing out, don’t engage with her. Let her process her emotions. Once she has calmed down, talk to her to find out if she is okay and just be there for her,” notes Nishitha.  

While unconditional love and support contribute, Nishitha vouches that focusing on one’s personal self without the shackles of societal, familial, societal or professional constraints is important. Having a proper routine where women take time out to inculcate hobbies and self-care activities like meditating or physical exercise can work wonders for mental health. “Try to break down the monotony of mundane life by inculcating hobbies or activities that make you happy. What will happen is that those hobbies will make you feel good about yourself and your life and consequently help you process emotions better,” concludes Nishitha.  

If you like this story, you may want to read how to navigate the symptoms of PMDD.

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