Background: Menopause, characterised by significant hormonal changes, can greatly impact mental health. While physical symptoms are well-known, the psychological effects, particularly suicidality, are underexplored. Suicide rates among women aged 45-55, the typical menopausal transition age, are notably higher, potentially linked to hormonal fluctuations that affect mood regulation. Despite this, little qualitative research exists on the relationship between perimenopause and mental health challenges, including suicidality.
Objectives: This study explores the mental health challenges, especially suicidality, experienced by women during perimenopause and menopause. It seeks to understand the factors contributing to these experiences and the role of healthcare in addressing them.
Design: Qualitative semi-structured interviews explored women's experiences of perimenopause and menopause, with a particular focus on mental health challenges including suicidality. The interviews were conducted and spanned from March 2023 to February 2024.
Method: Semi-structured interviews were conducted with 42 women, recruited from a private menopause clinic and the general population. Interviews, lasting 30-45 min, explored participants' mental health experiences during perimenopause and menopause. Data were analysed using reflexive thematic analysis, with NVivo 14 used for data management.
Results: Participants reported varying degrees of suicidality from abstract thoughts to suicide attempts. Feelings of hopelessness and entrapment were common triggers. Delays in receiving appropriate hormone replacement therapy (HRT) and misdiagnoses, such as being prescribed antidepressants instead of HRT, worsened symptoms. Women reported significant improvements in mental well-being after receiving timely HRT. Peer support and lifestyle changes were also identified as beneficial.
Conclusions: Improved training for healthcare providers, timely HRT access and holistic care are crucial for addressing perimenopausal mental health challenges. Women's Health Hubs, as outlined by the Women's Health Strategy for England, offer a potential solution for integrated care.
Keywords: hormones; menopause; mental health; suicidality.
Women’s experiences of mental health struggles and suicidal thoughts and behaviours during menopauseMany women go through emotional and mental health challenges during perimenopause and menopause: the time in life when periods become irregular and eventually stop. These changes are caused by shifting hormone levels, but their impact on mental health is often overlooked or misunderstood. This study spoke to 42 women who experienced suicidal thoughts or mental health problems during this phase of life. Some had mild thoughts of not wanting to be alive, while others had made suicide attempts. Most had not experienced these feelings before. They described feeling hopeless, overwhelmed, or like they had ‘nothing left to give’. Many struggled to get support and were misdiagnosed with depression or anxiety, even when their symptoms were linked to menopause. The research found that proper hormone treatment, especially hormone replacement therapy (HRT), helped many women feel better. However, long delays in getting the right care made symptoms worse for some. Women often had to fight to be taken seriously by healthcare professionals. They also felt isolated, confused and unsure of what was happening to them. Some found support through talking to others going through the same thing, lifestyle changes, or having understanding workplaces. Feeling heard, validated and supported made a big difference. This study shows that mental health struggles during menopause are real and can be serious. Better understanding, quicker access to hormone treatment and more support from health professionals could save lives. More open conversations about menopause, especially the emotional side, are urgently needed.