The advice below is general advice. For any specific tailored advice relevant to your health conditions, please talk to your health professional.
As we transition through menopause, shifting hormone levels, particularly declining oestrogen, can have a noticeable impact on mood (1).
This emotional shift often coincides with what’s known as the “midlife collision” – a period in a woman’s 40s and 50s when hormonal changes intersect with significant life stressors (1).
It’s important to talk about these changes openly and without shame. Too often, we feel this must be silently endured in what can be a deeply challenging time. But sharing experiences, seeking support, and acknowledging the impact of this life stage can be incredibly empowering.
This week, we focus on the role lifestyle medicine can play in supporting our mental wellbeing during menopause.
Lifestyle medicine is not a substitution for medical treatment – it’s a powerful foundation. The IMS White Paper (2) emphasises that lifestyle medicine should be viewed as a core component of menopause care. It can complement hormonal and non-hormonal therapies as well as other forms of medicine, enhance their effectiveness, and in some cases serve as a standalone approach for women who prefer non-pharmacological strategies or are unable to use medications.
Why Mental Wellbeing is Important in Menopause
Oestrogen helps regulate neurotransmitters like serotonin and dopamine, which play a vital role in emotional wellbeing. As levels drop, it’s common to experience increased anxiety, mood swings, or low mood, even for those who’ve never faced mental health challenges before (1).
Mental health symptoms linked to menopause:
- Sadness
- Irritability
- Hopelessness
- Anxiety
- Less able to concentrate or focus
- Low motivation
- Tiredness
While many of us will experience these in milder forms, some women can experience more severe symptoms of depression, including thoughts of suicide. This is more likely in those who have experienced major depression in pre-menopause (1). If you or someone you know is struggling, it’s important to seek professional support. You’re not alone, and help is available.
Symptoms of Menopause can Impact Mental Wellbeing
Some of the other symptoms of menopause, such as hot flushes, night sweats, sleep and sexual disturbances, brain fog, and weight gain, can complicate things and overlap with or intensify mental health challenges such as anxiety, low mood, and irritability (1).
The Midlife Collision and Stress
Feeling stressed during midlife is common as we balance family and work commitments while experiencing the physical, psychological, and metabolic shifts of menopause (1). This can have an impact on our mental health and complicate understanding whether mental health changes are related to menopause.
Stressors may include:
- Caring for ageing parents
- Navigating evolving relationships
- Supporting growing children
- Managing career transitions
- Ageing
- Illness
- Body changes
- Reassessing personal identity
Perceived stress is linked to worse menopause symptoms such as increased hot flushes and night sweats (2). Women experiencing high stress also report lower mood, poorer sleep, and greater difficulty coping with daily challenges (2).
How To Support Your Mental Wellbeing During Menopause
For some of us, mental health issues and other changes can impact how we live our lives.
Menopause offers us an opportunity to take stock of all aspects of our health and consider lifestyle and other changes to be strong and vital during menopause and beyond.
While each of us experiences menopause differently, our recommendations to improve mental wellbeing during this time include:
1. Visit Your GP or Menopause Health Practitioner
Because of the complex and overlapping nature of mental and physical health changes during menopause, talking with your GP or Menopause Health Practitioner is the best place to start. They can take a holistic approach to help you identify symptoms around physical and mental health changes.
Understanding mental health during menopause can include:
- Identifying your stage of menopause and physical/cognitive symptoms
- Discussing mental health symptom history
- Discussing current mental health symptoms
- Understanding the role lifestyle behaviours have on mood (sleep, exercise, diet)
- Understanding life stressors contributing to your symptoms
Speaking with your GP about your menopause symptoms, mental health, and life stressors can help them recommend the best options for your situation. Options may include lifestyle changes, psychological therapies, and medications such as menopausal hormone treatment (MHT) or antidepressants (1).
2. Consider Menopausal Hormone Treatment (MHT)
If you are not on MHT (also referred to as HRT), your GP may suggest starting this therapy as a first step. There is evidence that oestrogen can have an antidepressant effect on peri-menopausal women (1). It can also improve many of the physical symptoms, such as hot flushes and sleep disturbances, that can impact mood and overall wellbeing.
3. Mindfulness
Mindfulness helps calm the nervous system and improve emotional regulation (2). It can reduce anxiety, improve sleep, decrease hot flushes, and increase resilience during the menopause transition (2). Some different ways to incorporate mindfulness include:
- Mindful breathing: Focused breathing techniques like box breathing or 4-7-8 breathing can quickly calm the mind.
- Body scan meditation: A guided practice that brings awareness to physical sensations and helps release tension.
- Mindful walking: Gentle movement combined with present-moment awareness.
There are some great apps available that make it easy to learn different mindfulness techniques, including Headspace and Smiling Mind.
4. Evaluate Life Stressors and Identify Areas for Change
Take some time to take stock of what’s currently causing stress. Consider using a journal or worksheet to explore:
- Daily demands: What feels overwhelming or draining?
- Relationships: Are there tensions or unmet needs?
- Work–life balance: Is your career fulfilling or exhausting?
- Health and body: Are physical symptoms affecting your mood or confidence?
- Time and energy: Are you overcommitted or lacking rest?
Once you’ve identified stressors, choose one or two areas to focus on. Then evaluate what’s in your control, support needed, opportunities for boundaries, and any habits you can build or let go of. Talking this through with friends, a counsellor, or a partner can help you through this process. You don’t have to carry the burden alone. Research shows that symptoms like anxiety and depression often ease post-menopause, especially when women feel seen, supported, and understood (3).
5. Moving for Wellbeing
Exercise boosts our mood by increasing feel-good brain chemicals (serotonin, dopamine, endorphins). It also helps regulate the nervous system and reduce stress hormones like cortisol (4). Read Moving Through Menopause: Why Exercise Matters More Than Ever for some ideas on how to move for wellbeing, health, and vitality.
6. Eating for Wellbeing
The SMILES trial is a landmark study that showed how diet can directly impact mental health, particularly in people experiencing depression (5). They provided a modified Mediterranean diet rich in whole foods: vegetables, fruits, whole grains, legumes, nuts, fish, lean meats, and olive oil. Read Knowledge Is Power: How Lifestyle Medicine Supports Menopausal Health and How to Nourish Your Body Through Peri-Menopause for further information on nourishing food choices to support mind and body.
7. Cognitive Behavioural Therapy (CBT)
CBT can help some women with menopausal symptoms (sleep/hot flushes/mood) (6). Group and individual CBT can help you to change unhelpful ways of thinking, feeling, and behaving (6). You can find out more about CBT here: Cognitive behavioural therapy.
8. Non-Hormonal Therapies
If hormone therapy isn’t suitable or preferred, there are non-hormonal medications that can help manage menopause symptoms and support mood (6).
Options include:
- SSRIs/SNRIs: Help with mood and hot flushes (e.g. Paxil, Effexor).
- Gabapentin: Eases hot flushes and improves sleep.
- Trazodone: Supports sleep and mood.
- New options: Fezolinetant and Elinzanetant target hot flushes without hormone.
These medications are prescribed by your GP or Menopause Healthcare Professional (6).
Where To Go for Help for Depression and Mood Changes
If you are experiencing severe mental health symptoms of depression or thoughts of suicide, help is available.
- Call or text 1737 – Free, confidential support from trained counsellors
- Depression Helpline – 0800 111 757 or text 4202
- Lifeline – 0800 543 354 or text 4357
- Call 111 or go to your local emergency department
- Visit your GP
- Find a Psychologist
Menopause is a significant life transition that affects both body and mind. Understanding the effects of hormonal changes, stress, lifestyle, and mental health empowers us to take proactive steps toward lasting wellbeing. This stage offers a unique opportunity to pause, reflect, and reassess all aspects of our health – physically, emotionally, and spiritually. By embracing lifestyle medicine, non-hormonal/hormonal therapies, and professional care, we can navigate menopause with strength and confidence. Most importantly, when we speak openly and seek support without shame, we tap into the collective wisdom of women and create space to thrive together.
References
- Australasian Menopause Society. (n.d.). Menopause and mental health. Australasian Menopause Society. Retrieved November 3, 2025, from https://www.menopause.org.au/health-info/fact-sheets/menopause-and-mental-health
- Anekwe, C. V., Cano, A., Mulligan, J., Ang, S. B., Johnson, C. N., Panay, N., … Nappi, R. E. (2025). The role of lifestyle medicine in menopausal health: a review of non-pharmacologic interventions. Climacteric, 28(5), 478–496.
- Avis, N. E. et al. (2013). Menopause, 20(10); Bromberger, J. T., & Kravitz, H. M. (2011). Obstetrics and Gynecology Clinics of North America, 38(3).
- Wellbeing Info. (n.d.). 5 ways to wellbeing. Retrieved October 31, 2025, from https://wellbeinginfo.org/self-help/wellbeing/5-ways-to-wellbeing/
- Jacka, F. N., O'Neil, A., Opie, R., Itsiopoulos, C., Cotton, S., Mohebbi, M., Castle, D., Dash, S., Mihalopoulos, C., Chatterton, M. L., Brazionis, L., Dean, O. M., Hodge, A. M., & Berk, M. (2017). A randomised controlled trial of dietary improvement for adults with major depression (the 'SMILES' trial). BMC Medicine, 15(1), 23. https://doi.org/10.1186/s12916-017-0791-y
- Australasian Menopause Society. (n.d.). Non-hormonal treatment options for menopausal symptoms. Retrieved October 31, 2025, from https://www.menopause.org.au/health-info/fact-sheets/non-hormonal-treatment-options-for-menopausal-symptoms
