GUIDE TO WELLBEING DURING MENOPAUSE

Understanding Mental Health During Perimenopause & Menopause and How to Provide Support

Life is made up of seasons — distinct life stages like childhood, adolescence, and adulthood that center around common experiences, roles, and changes. Menopause is one of these seasons: a natural transition that brings shifts on many levels. Along with that comes both challenges and opportunities for growth. Although half of the population will experience menopause, its impact on physical and mental wellbeing is often overlooked. This guide explores the various ways in which menopause impacts us (whether directly or through someone we care about), how to support those navigating (peri)menopause, and resources for further learning.

*A couple notes on terminology:

In this guide, we refer to “woman” as anyone who self-identifies as a woman, keeping in mind that there are countless ways to exist as a woman. As such, we pull from research on the factors that, overall, tend to impact women more as compared with similar-age peers.

Perimenopause is the transition to menopause. The transition is usually what we think of when we think of menopause — hormonal fluctuations. Menopause is the period of life after menstruation has stopped for one year and is characterized by consistently low hormone levels. In this guide, we will use (peri)menopause when ideas relate to both perimenopause and menopause.

Created in partnership with the Global Fund for Women’s Mental Health powered by kate spade new york

Internal Mental Health
Social Mental Health
Systemic Mental Health
Mental Health Strengths
How to Support

Internal Forces that Impact Mental Health During (Peri)menopause

Women can experience many changes during perimenopause and menopause on an internal (physical, emotional, or mental) level. Below are some of the more common internal forces that impact mental health during (peri)menopause. (Cleveland Clinic)

Many of these changes will feel like a relief to some, and a loss for others — it varies from person to person, but each change can be an opportunity to learn and grow.

It is important to note that each of these changes can be managed with appropriate attention and care. Your biology may be shifting, but you always have agency in how you navigate it.

Perimenopause can begin at different times and varies in length. Each of these shifts will look different based on your own experience, and that’s okay.

Physical shifts

Irregular or absent periods
Hot flashes
Dryness in skin, eyes, mouth, or vulva
Decrease in bone density and muscle mass
Thinning hair
Weight changes
Heart palpitations

Hormonal shifts

Decreased estrogen and progesterone can lead to physical (hair loss, decreased sex drive, bloating) and cognitive shifts (mood changes, fatigue, brain fog).
Other hormonal shifts such as follicle-stimulating hormone, luteinizing hormone, cortisol, and testosterone can cause a number of changes in the body.

Mental, emotional, and cognitive shifts

Mental sluggishness or difficulty concentrating
Low mood or depression
Brain fog
Increased worry or anxiety
Changes in mood
Sleep difficulties

Self-image shifts

Exploring personal meaning and feelings around aging, infertility, and gender
Reflections around the role of being a mother vs. the role of an empty nester
Refocusing on inherent self-worth, redefining value and confidence
Fluctuations in body image, positive or negative

Here are some of the social forces that impact mental health during (peri)menopause:

Career trajectory

For many women, (peri)menopause corresponds with the apex of their career. While fulfilling, this may also be a challenging or stressful period of transition. During this time, women may be more established in their role and take on more leadership and mentorship responsibilities. Their professional identity may also be more solidly defined.

Workplace environment

Navigating (peri)menopause in the workplace can be complex, depending on workplace policies and culture. Certain needs such as education around company policies, accommodations, and support from management may be needed during this transition.

Parenting and caregiving responsibilities

Often referred to as the “sandwich” years, this period may involve dual responsibilities to children and one’s own parents or in-laws.

Relationships with friends

Friendships may shift during this time. Some relationships may strengthen due to the shared experience of (peri)menopause while others may distance due to lack of relatability.

Relationships with romantic partners

Partnerships may change as well during this time as other aspects of life shift. Partners might become more distant or they may find themselves reconnecting emotionally as they have more time to spend with each other.

Systemic Forces that Impact Mental Health During (Peri)menopause

While every individual experiences (peri)menopause differently, there are some large-scale systemic forces that tend to impact the wellbeing of women in this life stage. Some of the more impactful systemic forces include:

The stigma of menopause

Menopause is often unfairly seen in a negative light that extends to the woman herself who experiences it.

Gendered aging

Aging women are treated differently than aging men – often overlooked or critiqued more harshly than their male peers because of their age and gender.

Lack of (access to) knowledge and education

Because of stigma and who tends to lead systems, there is very little broad-scale information or education around changes in mid-life for women.

Cultural ideas around value for women

While some women may feel devalued in menopause, others might feel empowered. Some might even feel both at the same time.

Mental Health Strengths During (Peri)menopause

(Peri)menopause can be a stressful time. It can also be a liberating time. It’s all about what you do with it. Here are some of the ways you can harness this season to build on your strengths.

(Peri)menopause can be a time to…

– focus on your own wellbeing and general health

– let go of expectations from others

– step into mentorship or creativity

– enjoy increased autonomy

– develop deeper self-love

– get to know your body and physical capabilities in a new way

– be more career-driven, if that fuels you

– be more family-driven, if that fuels you

– reimagine the future or prepare for other life transitions

– appreciate your own wisdom and perspective

– rediscover what brings you joy

Notice we say “can be.” (Peri)menopause is yours to define. Remember that during a time where you might feel helpless to biology, you have a choice in how you react. You can lean on others for support. You can find providers who take treating the symptoms of (peri)menopause seriously. You can develop skills to increase self love during this time. It may take more effort, but you will thank you in the long run.

Encourage consultation with doctors – Talking to a doctor can help them address any changes that impact daily life (e.g., address hormonal supplementation and any lifestyle changes).

Encourage mental health support – Speaking with a mental health provider can help to improve mental wellbeing and increase their level of support during the (peri)menopause transition (e.g., address identity, mood, etc.).

Educate yourself – Learn more about (peri)menopause from your healthcare providers, educational materials, or the resources we’ve linked below.

Participate in support groups – Offer to attend a support group with your loved one to hear about others’ experiences and build community.

Ask your loved one what they might need – The best way to support someone is to understand and be responsive to their needs. Everyone will be comfortable with different levels of support, so it’s important to check in to learn what you can do to help.

Give people experiencing (peri)menopause space – Remember that this is an adjustment period for some and they may want space to figure out what they need. Offering your support and then letting them call on you if they want to is still supportive.

Be patient if you notice mood changes – There may be times when you notice changes in someone’s mood who is experiencing (peri)menopause. This is a normal part of this transition, and it is important to practice patience. If you feel concerned about their wellbeing, you may gently bring up what you’ve observed and ask about ways you can support them.

Be willing to listen – You might not be experiencing (peri)menopause, but by being willing to listen, you can be a positive support to someone who is.

Create open dialogue – Normalizing conversations around (peri)menopause can reduce the stigma and create a more comfortable environment for others to share their own experiences.

Share information – Accessibility to education around (peri)menopause is still limited, and by sharing resources, you can help someone else on their (peri)menopause journey or increase awareness for those not experiencing (peri)menopause.

Facilitate treatment – Support access to hormone replacement therapy (HRT) and other forms of treatment through advocacy, donation, and spreading awareness.

Support legislation – Advocate for research and legislation that advance menopause awareness, treatment, and workplace protections.

Promote education – Engage in planning conversations with healthcare providers about (peri)menopause and mental health so that people can be more prepared for and encouraged about the road ahead.

Mental Health Resources

APA: The American Psychiatric Association (APA) is a professional organization advocating for improved psychiatric care, supporting education and research in mental disorders.

ADAA: The Anxiety & Depression Association of America promotes the prevention, treatment, and cure of anxiety, depression, OCD, PTSD, and related disorders.

BBRF: Brain & Behavior Research Foundation is a nonprofit that funds scientific research on mental illness, aiming to understand causes, improve treatments, and prevent psychiatric disorders.

DBSA: Depression and Bipolar Support Alliance is a nonprofit providing support, education, and advocacy for people living with depression or bipolar disorder and their families.

The Endocrine Society: The Endocrine Society offers resources, tools, directories, support groups, blogs, and downloadable guides to help people understand and navigate menopause.

Grown Woman Talk by Dr. Sharon Malone: This book blends medical insight, personal stories, and empowerment to help women better understand and take charge of their health during midlife and beyond.

Let’s Talk Menopause: A nonprofit focused on raising awareness, educating both women and healthcare providers, and advocating for better care during perimenopause and menopause.

The Menopause Society: A nonprofit that offers evidence‑based resources and credentialing to health professionals, education to the public, to improve women’s health through menopause and beyond.

Menopause in the Workplace: The Health Action Alliance offers a Menopause in the Workplace toolkit for employers, a suite of practical resources designed to help companies create menopause-friendly workplaces.

MHA: Mental Health America is a nonprofit that promotes mental health through public education, advocacy, and support resources to help people understand mental health.

NIH Office of Research on Women’s Health: A federal organization that coordinates and promotes research on women’s health across National Institutes of Health.

Office on Women’s Health: A government agency that provides reliable information, resources, and programs on women’s health topics and works to ensure women have access to care and support.

One Mind: A nonprofit that aims to drive innovation, fund mental health research, and push for systemic change to improve mental health outcomes in the workplace and beyond.

Society for Women’s Health Research: An organization focused on closing the gender health gap by advancing research on how diseases affect women differently and educating the public and policymakers about women’s health issues.

If you or someone you know is experiencing a mental health crisis, use the resources below:

Special thanks to the Global Fund for Women’s Mental Health powered by kate spade new york for funding this important work.

GUIDE TO WELLBEING DURING MENOPAUSE