One in six women experiencing suicidal thoughts during perimenopause and menopause are being missed or not treated appropriately with hormones, a new study has found.

New clinical research published by Liverpool John Moores University and Newson Research highlights the scale of psychological distress during menopause, and the importance of recognising suicidality as a distinct and often missed symptom.

In a study of 957 menopausal women, nearly one in six reported suicidal thoughts at their first appointment at Newson Clinic, and over 70% had at least moderate depressive symptoms.

Symptom improvement

Following menopause treatment, including hormone replacement therapy (HRT), mental health improved significantly, with depressive symptoms reducing by nearly half. The largest improvements were seen in women using combined HRT, particularly regimens that included testosterone, although benefits were observed across most treatment types.

Crucially, suicidal thoughts reduced by over 90% among women who reported them at their first appointment, highlighting the potential impact of hormone-informed care.

Researchers found that suicidal thoughts did not consistently match how depressed women appeared on standard questionnaires, meaning standard screening tools used by healthcare professionals could potentially miss women at risk.

Study authors say the findings highlight the urgent need for hormone-specific mental health screening, as well as the potential role of HRT in supporting mental health during menopause.

Needless suffering

Dr Louise Newson, GP and hormone specialist at Newson Clinic, said: 'Mental health symptoms of low mood, anxiety and intrusive thoughts are very common during perimenopause and menopause. More women experience suicidal thoughts than has been realised before and many women are needlessly suffering.

'Suicide rates are highest in women aged 45 to 50, which is the common age for perimenopause and menopause. What is striking in this research is the dramatic reduction in suicidal thoughts following hormone treatment, including in women receiving HRT with testosterone.

'At the same time, hormone prescribing is lower than it was 25 years ago due to unfounded fears about risks, with many women not offered hormones treatment at all and some being told they cannot be prescribed testosterone within the NHS.

'We are hearing these stories more and more, and there is a real concern that missed opportunities for hormone treatments are leaving women unsupported with their lives at risk when the consequences can be devastating.”

Avoidable gaps in care

This research adds to growing evidence that menopause is a critical period for mental health, and that personalised, hormone-aware care can make a vital difference.

Pooja Saini, Professor in Suicide and Self-harm Prevention at Liverpool John Moores University, said the study findings clearly demonstrates that perimenopause and menopause must be recognised as critical periods within national mental health and women’s health policy.

‘Too many women are being assessed with tools that do not fully capture the hormonal drivers of suicidal thoughts, leaving gaps in care that are both avoidable and dangerous,’ she added.

‘There is now an urgent need for integrated clinical pathways, improved training for healthcare professionals, and consistent access to evidence based hormone treatments across the NHS. Policymakers and health systems must respond to this evidence to ensure that women are not left without the support they need at a time when timely intervention could be life saving.’

Read the full study findings here.