Menopause is a significant life transition in itself so it’s quite common to experience mood swings and anxiety at times. Depression, on the other hand, is a more serious condition.
Unlike temporary mood changes or the worry associated with anxiety, depression is a more persistent condition. It affects your emotions, behaviour, and daily performance, with symptoms that persist over time and can significantly disrupt daily life1.
Symptoms of depression may include low self-esteem, frequent crying, feelings of hopelessness, emotional numbness, or a loss of interest in activities you once enjoyed. Menopause doesn’t necessarily mean you will experience depression. Studies show that around 30% of women do face depression during this time. That being said, even mild emotional or psychological challenges during menopause are valid reasons to consult a doctor.
Depressive symptoms are most likely to happen during perimenopause2,3, the transitional phase leading to menopause. This is when hormones fluctuate even more, making it a particular ‘window of vulnerability.’ This makes it especially important to monitor changes in your mood and well-being during the years surrounding menopause.
Though statistically less common, depression can still happen at a later stage of menopause — the why and how are still questions that need more research. One thing is for sure, depression is not a personal failing. If you’re experiencing symptoms that disrupt your daily life, remember that support and treatment are available to help you feel better.
Can menopause cause depression?
Yes, there is an increased risk of depression during menopause. This is often due to hormonal changes and the complex interplay of emotional, physical, and life circumstances that many women face during this time. It’s easy to confuse depression for anxiety or mood swings. However, depression is distinct. It’s shown as a range of symptoms that persist daily over time and that significantly affect your ability to function in everyday life.
Alongside common signs of depression—such as sadness, feelings of unworthiness, or fatigue—menopause may also bring symptoms like anger, irritability, forgetfulness, and poor concentration.
Physical symptoms like headaches4, hot flushes or night sweats are often correlated with depression but they are not necessarily predictive of it. Speaking with a specialist is a great first step in understanding your symptoms and finding a path forward. Our medical experts are here to help you identify your menopause symptoms and provide support tailored to your needs.
How long does depression last during menopause?
For many women, depressive symptoms tend to improve two to four years after their final menstrual period. This is particularly true for those who experienced depression only during perimenopause, as this phase represents the most sensitive period of vulnerability5,3.
Is it menopause or depression?
It’s not always easy to distinguish menopause-related symptoms from anxiety or depression, as the emotional and physical symptoms often overlap. If you need clarity on your symptoms or personalised support, reach out to our menopause experts for guidance.
What causes depression during menopause?
As for why depression happens, we now know that it is multifaceted. Research suggests that depression during menopause stems from a complex interplay of biological, hormonal and social factors. While researchers don’t fully agree on all the causes, several theories have emerged to explain why this increased risk occurs.
A decline in oestrogen
One of the primary factors is the decline in oestrogen levels during menopause6. Oestrogen plays a crucial role in regulating the production of neurotransmitters like dopamine and serotonin, both of which are vital for our emotional well-being. When oestrogen levels drop, these chemical processes can be disrupted, potentially contributing to depressive symptoms7. Interestingly, studies suggest that women with longer exposure to oestrogen during their reproductive years—such as those who experienced later menopause—may have a lower risk of depression during menopause8.
The impact of other menopause symptoms
Another explanation focuses on hormonal changes as a "domino effect" on mental health. Some studies suggest that declining oestrogen levels may intensify other menopause-related symptoms such as hot flushes, night sweats or insomnia. These symptoms then disrupt sleep, interfere with daily routines, diminish overall quality of life and potentially contribute to depression. However, evidence for this chain reaction remains conflicting, with some studies showing depression happens even when these kinds of symptoms improve over time9.
Life events
One major contributor is that important life transitions often coincide with menopausal years. For some women, this can be the time when they navigate challenges such as caring for ageing parents, coping with children leaving home, managing shifts in relationships, or big career milestones. These stressors can amplify emotional strain, and some researchers even put these societal pressures surrounding menopause as a potential trigger for depressive symptoms.
Medical history
A history of depression is another significant factor. Women who have experienced postpartum depression or prior depressive episodes are at a higher risk of facing depression during menopause. This history of vulnerability can make more people sensitive to hormonal and life changes during this time, potentially leading to another episode.
Daily stress and lifestyle factors
Chronic stressors can also contribute to depression risk. Ongoing stress, daily hassles, limited social support, and a lack of resources often create an environment where emotional health is difficult to maintain. These factors not only add to the mental burden but can also diminish resilience against the effects of hormonal changes.
Stopping HRT
Finally, research has linked depression to discontinuing hormone replacement therapy (HRT), during perimenopause. Women who had depressive episodes and who stop HRT during this transitional phase have an increased risk of depression due to the abrupt loss of hormonal support10. This shows how important it is to have a professional by your side to guide you through your HRT journey.
It’s clear that depression during menopause arises from a multifaceted interplay of influences; one that is unique to each individual’s experience.
How to deal with menopause depression
There are a few effective strategies and treatments you can start looking into to help manage symptoms and support your well-being, including lifestyle changes, therapies, and medical options.
Lifestyle changes
Small but consistent adjustments to your daily habits can significantly improve mood and overall health. These include:
- Quit smoking and reduce or remove alcohol consumption
- Adopt a nutrient-dense and balanced diet
- Incorporate regular exercise, even if it’s just a short walk - physical activity, even for five to ten minutes a day, can boost mood and energy levels11
- Try to maintain a healthy sleep routine: create a relaxing bedtime ritual and avoid screens before bed
- Track your emotions in a journal to identify patterns and triggers
- Consider complementary therapies like mindfulness meditation, acupuncture, or yoga
Self-care and professional support
Prioritising self-care and managing stress can have a profound impact on your well-being. This could look like: engaging in activities that bring you joy, connecting with trusted friends or family members, or carving out time for relaxation.
If lifestyle changes and self-care aren’t enough, reaching out to a healthcare professional is an important step, especially if your symptoms have been there for a while. Your doctor may use a combination of self-assessment tests and interviews to evaluate your symptoms and establish a follow-up plan.
- Cognitive Behavioral Therapy (CBT): CBT is a proven therapy that helps reframe negative thoughts and develop healthier coping strategies.
- Hormone Replacement Therapy (HRT): There is evidence that HRT is particularly beneficial during a "window of opportunity" in perimenopause and early postmenopause12. Oestrogen therapy has shown to be most effective for women having depressive symptoms in perimenopause13. Some other studies suggest that adding progesterone periodically can also help prevent depressive symptoms14.
- Antidepressants: If a clear diagnosis of depression is made, your doctor may prescribe antidepressants. Research suggests that combining HRT with antidepressants could offer quicker and more effective relief15. The specific combination of medication—whether HRT with oestrogen alone, HRT combined with progesterone, or HRT alongside antidepressants— that combination depends on your unique situation. That's why we recommend getting in touch with a medical professional so that you get prescriptions based on your unique needs.
If you’re facing menopause-related symptoms, remember that you��re not alone—help is available. You don’t have to cope on your own. Get in touch with our menopause care team for expert advice and personalised support tailored to your journey.
¹Depression During and After the Perimenopause: Impact of Hormones, Genetics, and Environmental Determinants of Disease Bromberger et al. (December 2018)
²The prevalence of depression and anxiety in premenopausal and menopausal women: A cross-sectional study Vaziri-Harami et al. (July 2024)
³Longitudinal Pattern of Depressive Symptoms Around Natural Menopause Freeman et al. (January 2014)
⁴Associations among depression, anxiety and somatic symptoms in peri- and postmenopausal women Terauchi et al. (May 2013)
⁵Major depression during and after the menopausal transition: Study of Women’s Health Across the Nation (SWAN) Bromberger et al. (September 2011)
⁶A prospective study of the association between endogenous hormones and depressive symptoms in postmenopausal women. Ryan et al. (May-June 2009)
⁷Perimenopausal Mental Disorders: Epidemiology and Phenomenology Rasgon et al. (June 2005)
⁸⁹The risk of depression in the menopausal stages: A systematic review and meta-analysis. Badawy et al. (July 2024)
¹⁰¹¹Prospective study of physical activity and depressive symptoms in middle-aged women Brown et al. (November 2005)
¹²Menopausal transition, mood, and cognition: an integrated view to close the gaps Soares & Maki (July 2010)
¹³¹⁴¹⁵Depression and the menopause: why antidepressants are not enough? Graziottin & Serafini (June 2009)
