Although we know that changing levels of the hormones progesterone, estradiol and testosterone experienced during perimenopause and menopause can cause emotional and mental health challenges, their impact is often overlooked or ignored, especially by healthcare professionals.

A study of 42 perimenopausal and menopausal women who experienced suicidal thoughts or mental health problems has revealed the range of experiences – with some women feeling hopeless, overwhelmed or like they have nothing left to give while others had thoughts of not wanting to be alive, and some had made suicide attempts.

Their experiences of perimenopausal depression, recorded in their own words, shed a light on the severity of the psychological symptoms that can be experienced:

‘I got overwhelmed by the slightest thing, like taking a parcel to the post office. I just couldn’t do it. It was too much.’

‘There was a period where I gave up. . . I just wanted it all to end.’

‘I went out with the intention of ending my life. I had a plan, I knew exactly what, where, when, how… I would really have to fight hard not to go out and actually follow through with the plan that was in my head.’

Asking for help

The treatment women received varied, with some reporting delays in receiving appropriate hormone replacement therapy (HRT) and misdiagnoses, such as being prescribed antidepressants instead of HRT, worsening their mental health symptoms.

‘I went to the GP… she said you just have to get over it. She said you can’t take a tablet for everything.’

‘They seemed really willing to repeatedly prescribe loads of different forms of drugs, and yet unbelievably resistant to prescribing my own hormones back to me.’

Several women shared that they underwent ‘pretty brutal’ electroconvulsive therapy (ECT) for their symptoms, even after suggesting to their doctors that they symptoms may be hormone related.

However, women reported significant improvements in their mental health symptoms after being prescribed HRT. Several women found that a combination of HRT and antidepressants was effective for them in managing the psychological symptoms of their perimenopause. Making lifestyle changes and finding support, such as talking to other women with similar experiences was also helpful.

The research highlighted that, as suicide rates among women aged 45–55, (the average age of menopause), being notably higher, it’s important that healthcare providers receive improved training around mental health and hormones, and that women have better access to hormone treatments as well as holistic care.

You can read the research here.