Menopause and Mental Health: Understanding the Emotional Impact

Nigel Skinner
Nov 29, 2025
3 min read

Menopause is often spoken about in terms of physical symptoms — hot flushes, night sweats, changes in sleep, and shifts in hormones. But what many people don’t realise is just how profoundly menopause can affect mental health. For some, this transition brings unexpected anxiety, mood swings, irritability, sadness, or a sense of emotional instability that feels entirely out of character.

In this post, part of our wellbeing and psycho-education series, we’ll explore why menopause influences mental health, what symptoms to look out for, and practical steps to help you feel more grounded, balanced, and supported.

Why Menopause Affects Mental Health

Menopause is a hormonal transition — and hormones directly influence the brain. Fluctuations in oestrogen and progesterone affect serotonin, dopamine, and stress-regulation pathways. This means that menopause doesn’t just affect the body; it can significantly alter mood, energy, and emotional processing.

Common psychological and emotional symptoms include:

Heightened anxiety or panic
Feelings of low mood or depression
Irritability or emotional sensitivity
Difficulty concentrating or “brain fog”
Reduced confidence or self-esteem
Changes in motivation or energy
Sleep disturbances impacting mood further

These experiences are normal and surprisingly common, even though many feel unprepared for them.

The Role of Stress and Life Transitions

For many women, menopause coincides with multiple other life pressures:

Caring responsibilities
Work stress or career transitions
Relationship changes
Empty-nest adjustments
Ageing parents
Physical health shifts

When combined with hormonal fluctuations, the emotional load can feel overwhelming. Understanding that these overlapping transitions contribute to mood changes can be validating and empowering.

How Perimenopause Makes Feelings More Intense

Perimenopause — the years leading up to menopause — is often when symptoms are most unpredictable. Hormones can spike and crash rapidly, making the nervous system more sensitive to stress. This may show up as:

Sudden waves of anxiety
Feeling “on edge” for no clear reason
Emotional reactions that feel disproportionate
Feeling disconnected or unlike yourself

This isn’t a sign of weakness. It’s a natural response to internal physiological changes.

What Helps: Supporting Mental and Emotional Wellbeing

While menopause can be challenging, there are highly effective ways to support mental health during this time:

1. Talk Therapy

Counselling provides a space to understand emotional shifts, regulate stress, and build coping strategies. It’s particularly beneficial for anxiety, low mood, identity changes, and relationship strain.

2. Lifestyle Adjustments

Small, consistent changes can make a big difference:

Prioritise good-quality sleep
Reduce caffeine and alcohol
Build regular movement into your day
Practise grounding or breathwork
Set boundaries with stress and responsibilities

3. Understanding Your Nervous System

Many women find it helpful to learn how menopause interacts with stress responses and the fight/flight/freeze cycle. Combining this knowledge with polyvagal-informed techniques can reduce overwhelm.

4. Medical Support

GPs can help with HRT options, symptom management, and ruling out other health conditions that may mimic menopausal symptoms.

5. Connection and Support

Talking openly with trusted friends, partners, or professionals reduces isolation and helps normalise the emotional journey.

Menopause Doesn’t Have to Feel Overwhelming

Menopause is a significant life transition — emotionally, physically, and psychologically. Understanding its impact on mental health helps you respond with self-compassion rather than self-criticism. With the right support, most women find greater stability, clarity, and emotional balance as they move through this phase.

If you’re experiencing anxiety, low mood, irritability, or emotional shifts during menopause, you’re not alone — and support is available, contact Nigel at Enestee today.

Keep an eye open for my post about menopause aimed specifically at men.