Three in four women unaware menopause can trigger new mental illness, poll finds | Menopause

Nearly three-quarters of UK women do not know menopause can trigger a new mental illness, polling shows.

This lack of understanding is so acute that the Royal College of Psychiatrists has launched its first targeted “position statement” to raise awareness about menopause and mental health.

A YouGov poll, commissioned by the college, which represents more than 20,000 psychiatrists, found that only 28% of women know a new mental illness can be associated with menopause. In contrast, 93% of women associate menopause with hot flushes and 76% with reduced sex drive.

As a result, many women are not seeking or receiving vital help, the RCPsych’s report says.

Dr Lade Smith, the president of the college, said: “Menopause can have a significant yet often overlooked impact on women’s mental health and wellbeing. Women account for 51% of the population and all will experience menopause at some point. This is a societal issue for everyone. Simply put, we must do better.”

The report lays bare the mental health impact during perimenopause, and the numbers are striking. Anxiety and low mood are relatively common side-effects of hormonal changes during menopause, but for some women menopause significantly increases the chance of developing serious mental illness.

Perimenopausal women are more than twice as likely to develop bipolar disorder and 30% more likely to develop clinical depression, while hormonal and physical changes associated with menopause may lead to the relapse or trigger the development of eating disorders. Suicide rates are also higher among women of menopausal age.

Dr Cath Durkin, a joint presidential lead for women and mental health at the RCPsych, said: “For women with or at risk of bipolar disorder, perimenopause may represent a period of particular clinical danger that has historically gone unrecognised.”

Bipolar women who experienced postnatal depression or had premenstrual mood symptoms were also at higher risk of relapse of depression during menopause, the report highlighted.

The report calls for health services and governments in all UK nations to take urgent action to improve care, mandatory teaching of menopause and mental health in all medical and psychiatric training and menopause policies in all workplaces that address its relationship with mental health.

It comes as a study from University College London published in the Post Reproductive Health journal found that 58% of black women in the UK said they felt completely uninformed about menopause, while many found it “psychologically damaging”. More than half (53%) reported anxiety, yet many women said they were misdiagnosed with anxiety or depression, not menopause, when they spoke to their GP. As a result, barely one in five (23%) took hormone replacement therapy (HRT) to manage menopausal symptoms, the study found.

The TV presenter and Menopausing author, Davina McCall, said she supported the RCPsych’s position statement. She said: “Lack of knowledge and ingrained stigma still prevent open conversations between doctors and patients, in the workplace and among friends and family, leaving women without the crucial support they need at an incredibly vulnerable time in their lives. And it’s just not acceptable. Why are women still fighting to be heard?”

Janet Lindsay, the chief executive of Wellbeing of Women, said: “For too long, women’s symptoms have been dismissed or misunderstood. We fully support the call for better awareness, joined‑up care, better workplace support and policies, and more research that will help ensure women are listened to and supported through menopause.”

A Department of Health and Social Care spokesperson said: “It’s unacceptable women are facing barriers to the care and support they need. We’re taking action, bringing a menopause question into NHS health checks, renewing the women’s health strategy, and investing an extra £688m in mental health services while recruiting 8,500 more mental health workers.

“Women now have access to a wider range of treatments alongside improved training for new doctors to help ensure faster diagnosis and support.”

‘Nobody knew how bad things really were’

Sonja Rincón, 43

Sonja Rincón: ‘People like me shouldn’t continue to be medically dismissed because they’re “too young” for perimenopause.’ Photograph: Supplied

“I was 35 when I first went to my doctor with symptoms I couldn’t explain, like crushing fatigue and low mood. I had a feeling that something had fundamentally changed in how I was functioning. The doctor’s answer was antidepressants, then a higher dosage, then different antidepressants.

“At the time, I had no idea that perimenopause even existed. I certainly had no idea it could cause depression. I was a single parent and while I could still care for my daughter, it was exhausting in a way that’s hard to describe. Even picking up a newspaper or doing a load of laundry felt like an enormous effort. I was outwardly functioning, but I didn’t feel anything and slept whenever I could. I was still going to work, but I did the bare minimum so that I could keep my job.

“Nobody around me knew how bad things really were, because I’d become so good at faking it. I had no prior experience of mental health difficulties, so this came out of nowhere. For seven years, I was treated for depression while the real cause – perimenopause – went unidentified.

“When you have to keep going back to the doctor to have the same conversation, something’s wrong. It exacerbated the low feelings I was experiencing. I lost confidence in my own body, and even in my own judgment.

“I eventually realised I might be menopausal when friends my age started getting hot flashes, which I was also getting. So I educated myself about the menopause, demanded to be taken seriously, and pushed for treatment. I finally received a formal perimenopause diagnosis last year and started HRT. It was like rediscovering myself after so many years of antidepressants. Now I feel so well, I have been able to come off antidepressants completely.

“GP training has to change. When a woman in her mid-30s presents with fatigue, low mood and brain fog, perimenopause needs to be on the list of possibilities.

“People like me shouldn’t continue to be medically dismissed because they’re ‘too young’ for perimenopause, as I was. Women are losing years of their lives to a diagnostic gap that, with better training, is entirely preventable. It’s why I set up the Menotracker app, to help other women so they feel less alone and more in control of their symptoms.”