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How does menopause affect a woman mentally?
 Not uncommonly, women going through menopause can experience emotional symptoms, such as emotional instability, depression, anxiety and insomnia. Some women also feel quite upset because they see menopause as signifying the end of their reproductive capacity, and therefore they may feel insecure about their sexuality. The climateric symptom of vaginal dryness also affects their ability to enjoy sexual intercourse, and this can be an additional factor that causes distress for some. About 20 per cent of women have some of these emotional problems.
It has been suggested that the abrupt hormonal changes (in particular, the drop in oestrogen levels) affect mood and behaviour by altering the equilibrium in several brain neurotransmitter systems. Another theory is the domino theory – that the physical discomfort (of night sweats and hot flushes) provokes physical changes (e.g. sleep disturbance) which then consequently affects mood stability.
In some of the women we’ve seen at the KKH Women’s Mental Wellness Service, emotional instability was also caused by other issues occurring around the time of menopause, especially with respect to their marital relationship. Loneliness can be a major difficulty to grapple with, as their children grow up and leave home (the so-called empty nest syndrome), and/or because they retire, and no longer have a professional role that they had come to identify themselves with.
For some of the women I’ve seen, it’s also got to do with the fact that after so many years of marriage spent focusing on the kids, now that the kids have left home, they realise how much they’ve grown apart from their husbands because they had little time to communicate and nurture their relationship. Some women even no longer feel in love or comfortable with each other…this can lead to dissatisfaction and disharmony in the marriage. Since physical health also affects emotional wellness, at this age, when they are more vulnerable to physical illnesses, their depression is also in part due to their health problems.
What are prescribed ways to cope with menopause?
For those with prominent emotional symptoms, psychological therapy and medication can be beneficial in alleviating the distress. The guiding principle really is for an individualised approach, so we look at what are the symptoms, and what are the stressors or difficulties the woman is facing, and then treat accordingly.
- Therapy helps to address problems, and may be individual therapy to help with stress management, or role changes, or couple therapy to deal with marital issues that may be exacerbated at this time.
- Antidepressants, especially the Selective Serotonin Reupate Inhibitors have been shown to be beneficial for perimenopausal depression, and may even help to alleviate the physical symptoms like hot flushes. For those with significant anxiety symptoms, anxiolytics are needed, and similarly, sedatives for those with prominent insomnia.
- Exercise and healthy lifestyle changes are important, as is getting involved in fulfilling activities, or even yoga & qigong.
Ref: Z00
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Why Does Menopause Happen?
Perimenopause
What Are The Symptoms of Menopause?
Menopause: What Should You Do
Menopause and Your Diet
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