There are many symptoms people can experience before, during, and after menopause. One less-recognized issue is its impact on mental health.
The Royal College of Psychiatrists (RC Psych) says only about 1 in 5 females know menopause can be linked to mental health conditions such as depression and bipolar disorder. In a 2026 position statement, the college outlines concerns and calls for greater research, training, and public awareness about how hormonal changes at midlife can affect mental health.
Clinicians report rising rates of insomnia, depression, anxiety, concentration problems, memory difficulties, and body image issues that correlate with menopause. Menijie Boduryan-Turner, PsyD, a clinical psychologist, said many women remain unaware of these connections because menopause has historically been treated primarily as a medical or reproductive event rather than a broader health issue that includes mental well-being.
Public awareness of some menopause symptoms is far higher: surveys cited by RC Psych show 81% of females recognize hot flashes as associated with menopause and 64% link it to reduced libido, while just 21% are aware of the mental health association. RC Psych president Lade Smith emphasized that menopause is a universal life stage for half the population and framed its mental health implications as a societal concern.
RC Psych’s position statement lists key aims: expanded training for psychiatric professionals; improved public and professional understanding of menopause-related mental health risks; equitable identification of and access to support and appropriate treatments; interdisciplinary approaches to menopause care across health systems; consideration of impacts on family relationships; and highlighting research and treatment gaps.
The statement notes that perimenopause—when hormonal fluctuations begin—commonly brings anxiety and low mood. For some, these changes significantly raise the risk of new, serious mental health conditions: perimenopausal individuals are reported to be more than twice as likely to develop bipolar disorder and roughly 30% more likely to develop clinical depression. Hormonal shifts can also precipitate relapses or new onset of eating disorders, and suicide rates are higher among people at menopausal age.
Clinicians stress that greater awareness can reduce stigma, encourage help-seeking, and foster compassionate support. Boduryan-Turner described working with clients who experienced severe depression and suicidal ideation during midlife, underscoring the need for better education and resources.
Regarding treatment, the statement highlights that hormone therapy can be important for females with preexisting mental illness entering menopause, addressing both physical and psychological symptoms. Some experts recommend combining hormone therapy with cognitive behavioral therapy (CBT) rather than relying solely on antidepressants for perimenopausal anxiety and low mood. Older evidence suggests depressive episodes during menopause may respond less well to selective serotonin reuptake inhibitors (SSRIs) and have higher discontinuation rates due to adverse effects for some individuals.
Nissa Keyashian, MD, a psychiatrist, recommended seeking clinicians with women’s health expertise in HRT and menopause, noting that many HRT formulations exist to balance risks, side effects, and emotional well-being benefits. Amy Roskin, MD, JD, an OB-GYN, emphasized the importance of healthcare provider support to diagnose and manage menopause-related mental health challenges.
RC Psych also calls for more research to fill knowledge gaps and to guide care for complex groups. Priority research areas include understanding how perimenopausal hormonal fluctuations affect medication effectiveness in people with severe mental illness (SMI); addressing overlapping health risks—such as osteoporosis and cardiovascular disease—that are more common after menopause and often worse in females with SMI; meeting the social and medical needs of those experiencing menopause alongside substance use disorders; and giving psychiatric research greater attention to female hormones and their interaction with biological, psychological, and social factors.
In summary, RC Psych’s position statement urges improved training, awareness, interdisciplinary care, and focused research to better identify and treat the mental health consequences of menopause, while clinicians encourage women and health professionals to recognize and address these issues earlier and more effectively.


