How Does the Menopause Impact Mental Health? A Clinical Psychology Podcast Episode.

In a previous podcast episode, What is the Menopause for Psychologists, we learnt about the menopause, how it impacts people and how educational and clinical psychologists can use this knowledge to improve lives. In this clinical psychology podcast episode, I want to go one step further and really drill down into how the menopause can impact a person’s mental health. By the end of this psychology podcast episode, you’ll understand how the menopause harms mental health, what is brain fog and other signs of the menopause and we’ll touch on how to support someone going through the menopause. If you enjoy learning about mental health across the lifespan, biological psychology and applied psychology, then this will be a great episode for you.

Today’s psychology podcast episode has been sponsored by Biological Psychology. Available from all major eBook retailers and you can order the paperback and hardback copies from Amazon, your local bookstore and local library, if you request it. Also available as an AI-narrated audiobook from selected audiobook platforms and library systems. For example, Kobo, Spotify, Barnes and Noble, Google Play, Overdrive, Baker and Taylor and Bibliotheca.

What is the Menopause?

To ensure that we’re all on the same page, I want to remind us what the menopause is before we explore how this natural biological process can impact people’s mental health.

As a result, the menopause is the time when periods stop and people can no longer naturally get pregnant, and this leads to a wide range of positive and negative impacts on our mind and body. Also, it’s important to talk about the menopause because whilst there are some symptoms that are very well-known, like a hot flush, there are other symptoms that aren’t as well-known.

In addition, menopause can impact a person for years before their periods fully end. As well as some people might not notice the effects of the menopause whereas other people can find them really difficult to handle and this can lead to negative mental health outcomes. This is why it’s important to be aware of the menopause, know the symptoms and understand that experiencing the menopause will get better over time with the right support as well as treatment.

Furthermore, in terms of who experiences the menopause, it commonly impacts females in their 40s and 50s. As well as it is possible to have early onset menopause, which is when your periods stop before the age of 45, or late onset menopause. This is when your periods stop after the age of 55.

On a final introductory note, I want to mention that the reason why I’m trying to be gender-inclusive when it comes to the menopause is because trans and non-binary people can also go through the menopause depending on their age, the biological sex they were assigned at birth, any hormone treatments that they’ve taken in the past or currently taking as well as if they’ve had any gender-affirming surgeries or treatments.

This is important to note because experiencing the menopause can be even more distressing for transgender and non-binary people because it might increase feelings of gender dysphoria and the associated negative mental health impacts. As well as treatment and support for the menopause when you’re transgender can be even more difficult because the services might not meet your needs or they aren’t inclusive.

What are the Physical Effects of Menopause?

Briefly before we explore menopause and mental health for the rest of the episode, I want to take a moment to introduce the physical effects of menopause. These effects can be different for everyone but they can include night sweats, hot flushes, changes to their periods, dry skin or eyes, increased sensitivity to stimuli, vaginal dryness, pain, discomfort and itching. This dryness can be made worse with sex.

Furthermore, the physical effects of menopause can include joint pain, feeling more clumsy than usual, feeling dizzy and vertigo, headaches, hearing buzzing or ringing in the ears, numbness or tingling in feet, arms, hands or legs, hair loss or hair growth and changes in body shape.

These physical symptoms can impact a person’s mental health so it’s important that we acknowledge the impact of physical health on our mental health. For instance, a person might be stressed or tired from coping with the physical discomfort and pain of menopause. Equally, a person might feel self-conscious or like they need to avoid certain situations or places because they don’t want others to see the physical symptoms of menopause.

How does the Menopause Impact Mental Health?

It should go without saying but everyone’s experience of mental health during menopause will be individualised and differ in terms of symptoms and severity. This is useful to point out because someone might be struggling with minor brain fog during the menopause but if they’re able to function across a range of domains of life, like work, relationships and their home life, then they might not need to see a mental health professional. Yet if someone is struggling with their mental health and it’s negatively impacting their life so they can’t function, then it might be a very good idea to seek out professional support.

As a result, in the rest of this episode, we’ll learn about symptoms like low mood, anxiety, anger, brain fog amongst other symptoms of mental health difficulties during the menopause. Then we’ll investigate how the menopause can impact existing mental health conditions and more.

How Can Menopause Impact Self-Critical Thoughts?

The menopause can have a massive impact on a person’s self-esteem for a range of reasons. For example, they’re experiencing all these changes, their quality of life is decreasing because of hot flushes and all the other physical and mental health symptoms and their connection to their womanhood is changing. For some people, the ability to have a period is very important to their identity as a woman, so the inability to have a period and being infertile can be very distressing.

As a result of this large impact on self-esteem, people going through the menopause might experience thoughts like they’re less confident and capable than they used to be, they can’t trust themselves or their own judgement, and they don’t have any value or they’re worthless anymore.

Another set of negative thoughts about themselves can include that the menopause makes them less attractive, relevant or important than they used to be. A person might be self-conscious about the effects that the menopause is having on their personality, mind and body. As well as they might feel like they’re lonely, isolated or no one cares about them.

A final set of negative thoughts include grief over your old self, feeling like the best parts of your life are over, as well as feeling anxious or sad that they’re getting old.

If you’re going through the menopause, these feelings can be overwhelming and hard to cope with, so it’s important that mental health support is provided to help people deal with these self-critical thoughts. Since over time and with the right support, these feelings can be reduced or gotten rid of entirely.

On the whole, the menopause can harm mental health because it can lead to people feeling bad about themselves. They might believe that they cannot trust their own judgement, they’re less confident or capable than before and they’re grieving for their old self amongst other negative thoughts.

If you apply this to clinical psychology, then I want to mention here that at first, especially if you’re a male clinical psychologist, you might believe that you need to rework your entire way of working just because the root of the client’s mental health difficulties is the menopause, but I don’t believe that’s entirely true. Of course, you will need to individualise your psychological treatment to the client’s needs like always. Yet even though the client is going through the menopause, you still need to help the client grow a more resilient and stable sense of self and help them come to terms with their new reality, similar to how you would with any other client going through a major life event.

And having knowledge about the menopause, what it is, how it works and how it impacts mental health can be a great way to support a client and have some understanding of what they’re going through.

How Does Menopause Impact Feelings of Numbness or Emptiness?

Another way how menopause impacts a person is by making them feel like they’re losing themselves, or a person undergoing menopause doesn’t feel things or emotions as strongly as they used to. This means that a person might not enjoy things that they used to, they might believe that their mind or personality is broken or lost, or they’re emotionless or indifferent about things they used to care about.

Equally, the person undergoing to the menopause might be dissatisfied with their life without knowing why, they might believe everything is pointless and they might be unable to socialise or enjoy seeing other people.

A final set is people might not have the same sexual interest or desire as they did before the menopause and they might feel like they don’t have the same levels of affection, empathy and warmth for others as before the menopause, even for the people they love.

This is important for us to focus on for a moment from an identity perspective, because your identity was centred around being active and always doing a lot of things. Then during the menopause, you find that you don’t enjoy activities or doing things as much as you used to, this is likely to be very jerking and it will harm your mental health. You would have lost a massive part of who you are and this might make you feel very numb and empty as a person, and this is only because you’re going through the menopause.

As a person, this will likely be distressing because you might panic about if you’ll ever enjoy those activities again, if you’ll ever be able to be busy again and enjoy it, and most importantly, you’ll likely panic about who you are if you aren’t busy and doing activities.

This is why some identity work might be useful from a psychological perspective.

However, if we explicitly apply this for aspiring and qualified clinical psychologists, then using our toolkit of psychological techniques, like behavioural activation, we need to give clients hope for a better future and we need to guide them towards getting back into the activities they love. Or we need to help give them the tools to find new passions, new interests and create a new identity for themselves so they can fill the gaps that were lost during the menopause.

How Does Menopause Impact Anger?

One cultural narrative that I always dislike aimed at women is the idea of women being horrible, angry people during periods and that their biology makes them foul to be around. That isn’t true and it is a harmful narrative to push about women.

Anyway, a third way how menopause can impact people is that people undergoing menopause might be more frustrated, irritable and angry compared to usual, or that things that didn’t used to bother them, now do. As well as their anger might be difficult to control or predict, they might feel scared or guilty or confused about feeling angry. Even more so if this is out of character for the person.

This is even more likely to happen if their experience of the menopause isn’t being listened to or taken seriously. Something that is unfortunately, and rather disgustingly, all too common.

Nonetheless, it’s important to realise that anger is a normal and healthy response that can actually help us in certain situations. Therefore, whilst anger can be difficult to cope with, it’s important that aspiring and qualified psychologists work with clients to understand the root of their anger, understand that it’s a healthy and normal reaction to express and how they can deal with their anger in a more adaptive way if needed. This would benefit clients because it would reduce their guilt and self-critical thoughts about their actions that would harm their mental health.

What is Brain Fog During Menopause?

Brain fog is a very common symptom of menopause because it can negatively impact a person’s thought processes, memory as well as concentration. This means that a person with brain fog might lose things more often, forget what you’re talking about in the middle of saying it, being easily distracted or forget things like numbers, appointments or names.

In addition, someone with brain fog might not be able to think as clearly or quickly as before, they might struggle to find the right words or explain themselves and they might go to places or rooms and then forget why they went there in the first place. As well as they might struggle with motivation or switching between tasks.

Now this is important to bear in mind because generally speaking, the menopause starts between the ages of 45 and 55. This is still within a person’s working life. Therefore, it doesn’t really matter what sort of job you do, whether you’re an office worker, a teacher, a psychologist or personal assistant. You still need to be able to concentrate, remember information and explain yourself clearly and professionally. Brain fog can rob you of these abilities and for me, that is terrifying.

As a result, it’s little wonder that brain fog can be very difficult to cope with because a lot of people feel angry and frustrated about not being able to think how they used to. As well as people might be worried that they have a neurological condition or dementia so this can make people feel even worse about themselves, and it can make them anxious or self-conscious around others at work.

If we apply this knowledge to educational and clinical psychology, then brain fog is important to know about because within the mental health and educational services we work in, we might have a peer going through the menopause. This means they might experience brain fog, they might forget things, make mistakes and their work performance might decrease. Understandably whilst this might "harm" the service because it means productivity might decrease, clients and cases might be delayed and other issues might arise. We shouldn't be angry at the woman because this isn't her fault. 

Instead, we need to bring some of the compassion, empathy and non-judgemental attitude from the therapy room into our working environment. We need to be kind to the person experiencing brain fog, we need to support them and we need to challenge people who are being unfair. 

Of course, these errors are likely to be frustrating because it creates more work for everyone else. Yet the menopause doesn't last forever, but if you shout, berate or belittle the person with brain fog, then the harm that you do to your working relationship can last forever. 

And I know from personal experience, and if we draw on Ecological Systems theory, if there's a disruption or degrading of relationships between peers, then this can create a ripple effect that negatively impacts other areas and people. 

For example, if there's a breakdown in the relationship between senior management and teachers or a psychologist because they're experiencing the menopause and brain fog, with senior management failing to understand how it impacts a person. Then the working environment is likely to be more stressful for the teacher or psychologist, so they might have to put more effort into covering themselves and preventing themselves from getting into trouble with senior management. Instead of them focusing as much on their students or their clients, and their therapeutic work or teaching quality might suffer as a result.

This is why it's important to be understanding, supportive and compassionate to peers going through menopause and experiencing really awful symptoms like brain fog.

How Does Menopause Impact Sleep?

As I spoke about in a previous podcast episode “How Does a Consistent Sleep Schedule Improve Mental Health?”, sleep is a very important factor in maintaining our mental health. If your sleep gets disturbed or if you experience too much sleep deprivation then this can negatively impact your mental health and make symptoms even worse. Therefore, sleep problems are very common during menopause and people might find that they struggle to get to sleep or that they wake up a lot. This can happen because of night sweats as well as hot flushes, or the anxiety and low mood associated with menopause can also disrupt sleep. As a result, it’s important that you try to develop a consistent sleep problem, you learn about good sleep hygiene and if the reason for sleep problems is related to anxiety or panic, then it can be useful to talk to a mental health professional. Since after these anxious symptoms are dealt with, a person’s sleep quality should improve.

Personally, if we apply this knowledge to clinical psychology, then I like to compare a consistent sleep schedule as a type of mental health first aid. Since during the worst of my Post-Traumatic Stress Disorder and my anorexia, my inability to sleep and my weird sleep schedule really did harm my mental health. It was only when I forced myself into a more consistent sleep schedule that I was able to improve my sleep, my mental health and it decreased the worst of my symptoms. Therefore, for aspiring and qualified clinical psychologists, it can be really important to address sleep early on in therapy, because if a client is coming to therapy dysregulated, tired and unable to focus then they aren’t going to be in the right headspace to engage with therapy as much as if they were fully rested and were sleeping well.

Of course, some of their sleeping difficulties will be tied to their mental health, but sometimes it might not be. For example, in menopause, the sleep problems tend to be down to the physical symptoms and they can make mental health symptoms worse. It stands to reason that if you target the sleep problems then you might be able to prevent the mental health symptoms from getting worse.

Just some thoughts.

How Does Menopause Impact Anxious Feelings?

Another common feeling during the menopause is anxiety, and this can make people worry a lot about themselves, others and the world or their future, people might be scared for no clear reason as well as they might be scared or unable to do things that they used to do. For example, their anxiety might stop them from driving, going to work or doing social activities with friends and loved ones.

Equally, anxiety might make someone going through the menopause to become paranoid, experience overwhelm, make them think a lot about bad memories or regrets. As well as they might experience heart palpitations or tightness in their chests, they might have tension or a lump in their throat and they might experience phobias. Whether these are new or menopause might make pre-existing phobias more severe.

A final set of reasons how menopause can impact anxiety is it can make people experience panic attacks, especially at night or at the same time as a hot flush, people might be bothered by things that they never used to worry about, and they might experience intrusive thoughts. These are distressing thoughts, urges or feelings that keep popping into someone’s mind and they don’t go away.

This is another important reminder about why it’s important to learn about menopause and mental health, because whenever you typically think about menopause, we always think about the hot flushes and not anxiety. As well as if we apply this information to clinical psychology, then at first, we might want to just treat this as we do with any other form of anxiety. We would offer the client individualised treatment, do some behavioural experiments and other cognitive interventions. Yet when it comes to anxiety that is rooted in a client’s menopause then we do need to adapt our approach because there is a critical factor that separates more “traditional” anxiety and menopause anxiety.

The menopause, the changes and the things that the people is typically anxious about is actually happening to the client.

This is different from more “traditional” anxiety because if you’re supporting someone with social anxiety, then the client will typically have anxious feelings about “what if” a person judges me and everyone will stare at me if I go to that party or social event. These are all anxious feelings that aren’t based in reality. They are concerns and fears about things that haven’t happened.

Anxiety that’s linked to the menopause is similar, but if a client is anxious about their work performance decreasing because of their feelings of overwhelm, their brain fog and the other cognitive difficulties associated with menopause, and they’ve already received a written warning because of their work decreasing. Then that is a little different. As well as our client can see the biological changes happening to them in real time and they’re experiencing them every day.

Therefore, whilst cognitive behavioural interventions can be effective for all forms of anxiety, I strongly believe when it comes to supporting someone with anxiety undergoing the menopause, we do need to take a step back, reflect on how the menopause is impacting our client and actually have an open and honest conversation about menopause. Try to understand the menopause for the client, especially if you’re male, because this will help the client feel listened to, supported and valued. This can have an immensely beneficial impact on the therapeutic alliance.

How Does Menopause Impact Depressive Feelings and Suicidal Thoughts?

The menopause can have an immense impact on a person’s mood because it can make them feel like they can’t cope with daily life, like life is slow or empty and like there’s a heavy weight or burden on their mind or body. As well as they might feel sad or unhappy more often than usual, they despair or have a feeling of dread about the world or future, they’re emotional or tearful a lot of the time and they’re hopeless about the future. Also, they can’t do the things they normally do and the techniques the client used to use to improve their mood no longer work.

In addition, it’s unfortunately common to have suicidal thoughts during menopause, and when this happens, these thoughts about ending their life can be very scary, overwhelming and confusing. Equally, a client might be feeling numb or empty whilst they think about taking their own life.

Moreover, a client undergoing menopause might feel very suicidal but then their mood changes quite quickly and they feel okay again. Whilst this is good in terms of it means the client no longer feels suicidal, these thoughts and feelings can be hard to understand and control, or a client might experience these thoughts all the time.

It’s important to remind a person going through the menopause that they aren’t alone and things can get better with support, treatment and over time. The same goes when it comes to suicidal thoughts.

Personally, whilst I’ll never go through the menopause, I do have a history with suicide so I want to take a few moments to stress that I know what it’s like. I know what it’s like to be in so much emotional pain and suffering that you just want a release, you just want all the hurt and pain to disappear and you want to be at peace. I know what it’s like to feel so numb that you just want to feel something, even the pain of death, and I understand how appealing suicide is because it really can seem like the only way out of the endless suffering that life can become.

Yet I promise you that it isn’t endless.

I tried to end my own life three times in late 2024, and I’m so glad that I wasn’t successful. Since my mental health and my life has improved so much and I’m so grateful for it. Your life can and will get better too with the right support, treatment and over time. If I had died two years ago then I wouldn’t get to interact with my amazing podcast listeners and readers, I won’t get to learn more about psychology or politics and I wouldn’t have gotten to meet all my friends and more.

And most importantly, I wouldn’t be able to enjoy all my boys’ love anime that I’m devouring at the moment.

Your life can get better, because I am living proof of it. So please, seek professional mental health support, look after yourself and please do not end your life.

You are so much more important and loved and valued than you realise.

Ultimately, if we apply this knowledge to clinical psychology then whilst suicide risk is always a part of our therapeutic work and we always ask about it. I think it’s important that we acknowledge that suicidal thoughts and feelings are a natural part of menopause and we need to manage the risk throughout therapy. As well as even within educational psychology, I think it’s important that we ask a member of staff experiencing mental health difficulties, whether it’s related to the menopause or not, if they’re experiencing any suicidal thoughts. Since if you ask them then you are not planting the thought in their head, you’re creating an opportunity for them to speak to you openly and you might be able to refer them or help them get support. This relates to educational psychology because helping a staff member get mental health support will have a great benefit for the children and their education compared to the immensely devastating effect that a suicide will have on the school community.

How Does Menopause Impact Existing Mental Health Difficulties?

So far in this episode, we’ve focused on mental health difficulties that developed during or after menopause, but what happens during menopause if you already have mental health conditions or difficulties? If a person already has a mental health difficulty before menopause then they can find that menopause impacts the condition.

During menopause, the person might find it more difficult to manage their mental health, the things that used to help manage the condition don’t work as well as they used to and the client needs to make changes to their self-care or treatment during menopause. As well as the symptoms of their mental health condition might get worse or they notice new symptoms.

On the other hand, some people have reported that during menopause, they don’t find that their mental health condition gets worse, some people argue that the difficulty becomes easier to manage and their mental health doesn’t change too much during menopause.

As always, if you’re struggling with your mental health, then please talk to a mental health professional.

Building upon this, if we outright apply this section to clinical psychology then this is why I wanted to do this podcast episode. Since the impact of menopause isn’t spoken about and if we have a client who didn’t have menopause at the start of treatment, but let’s say, halfway through they start the menopause and their mental health symptoms change. Then as aspiring or qualified clinical psychologists, we will need to adapt to this knowledge and biological process. As well as we cannot adapt our therapeutic work in light of menopause if we don’t know about it, and that is why podcast episodes like this one are so important.

In addition, another thought that just popped into my head is the ending work seen in cognitive behavioural therapy. At the end of CBT, we’re focusing on consolidating and making sure that the client has all the tools and techniques they need in the future to deal with their mental health. If the client is going to experience the menopause, then maybe we should have a brief conversation about it with them, so they know that their mental health changing is okay, normal and it’s a part of the process. And most importantly, they won’t be alone in their struggles. Also, we could give them some links to online resources to help them manage their symptoms when the time comes.

Therapy is all about making sure that our clients can deal with whatever the world throws at them, and that includes menopause.

How Do You Know Whether Menopause is Causing Your Mental Health Difficulties?

Like I always say, your mental health will never have a single cause because mental health never happens in isolation. Neither does menopause, because whilst experiencing menopause, it’s like that people will be coping with other things and challenges too. They might be dealing with relationships, caring responsibilities, children or money worries. Also, the person might have experienced discrimination, trauma, abuse or bereavement and this all interacts with the menopause to further harm a person’s mental health.

As a result, it can be really difficult to understand if menopause is the cause, and this is why it’s important to realise that whilst our mental health is often impacted by a mixture of things. If a person gets treatment as well as support for menopause symptoms then they might help a person to feel better able to cope with everything, even if menopause treatment doesn’t help with everything in their life.

So please, if you’re going through the menopause and struggling with your mental health, seek professional support.

Clinical Psychology Conclusion

I always enjoy psychology podcast episodes that focus on topics no one really talks about, because topics like the menopause are so natural, normal and every female goes through it. Yet because of the systemic inequality and the patriarchal world we live in, women and others are typically shamed or silenced into thinking that they’re weird, “crazy” or weak for experiencing these difficulties and “allowing” the menopause to impact their mental health.

I really hope that this episode has highlighted how the menopause can negatively impact a person’s mental health, and I’ve given aspiring or qualified psychologists a lot of food for thought about how to use this knowledge to impact lives.

Therefore, as a small recap, here are the main ways how menopause can impact mental health:

·       Feeling anxious

·       Feeling depressed

·       Brain

·       Feeling empty or numb

·       Anger

·       Feeling self-critical

·       Sleep problems

·       Suicidal feelings.

And we also spoke about how menopause can impact existing mental health difficulties too

I hope you enjoyed today’s clinical psychology podcast episode.

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Clinical Psychology References and Further Reading

Brown, L., Hunter, M. S., Chen, R., Crandall, C. J., Gordon, J. L., Mishra, G. D., ... & Hickey, M. (2024). Promoting good mental health over the menopause transition. The Lancet, 403(10430), 969-983.

Dotlic, J., Radovanovic, S., Rancic, B., Milosevic, B., Nicevic, S., Kurtagic, I., ... & Gazibara, T. (2021). Mental health aspect of quality of life in the menopausal transition. Journal of Psychosomatic Obstetrics & Gynecology, 42(1), 40-49.

Garg, R., & Munshi, A. (2025). Menopause and mental health. Journal of Mid-life Health, 16(2), 119-123.

Hooper, S. C., Marshall, V. B., Becker, C. B., LaCroix, A. Z., Keel, P. K., & Kilpela, L. S. (2022). Mental health and quality of life in postmenopausal women as a function of retrospective menopause symptom severity. Menopause, 29(6), 707-713.

https://www.mind.org.uk/information-support/tips-for-everyday-living/menopause-and-mental-health/how-can-menopause-affect-mental-health

O'Reilly, K., McDermid, F., McInnes, S., & Peters, K. (2024). “I was just a shell”: Mental health concerns for women in perimenopause and menopause. International Journal of Mental Health Nursing, 33(3), 693-702.

Thurston, R. C., Thomas, H. N., Castle, A. J., & Gibson, C. J. (2025). Menopause as a biological and psychological transition. Nature Reviews Psychology, 4(8), 530-543.

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