Perimenopause and Mental Health: Breaking the Silence

This week, Bossa Health’s Founder, Yasmin Bou Karim, spoke with A.R., a woman who navigated perimenopause five years ago. Her experience reveals the often-overlooked mental health impacts of perimenopause and menopause, highlighting the need for greater awareness and support.

What is Perimenopause?

Perimenopause is the transitional phase leading up to menopause when a person’s hormone levels, particularly oestrogen and progesterone, fluctuate. This period can last anywhere from a few months to several years and often begins in the mid-to-late 40s, though it can start earlier. The well-known symptoms include hot flushes, irregular periods, and night sweats, but many people also experience significant mental health challenges like mood swings, irritability, anxiety, and even depression.

The Prevalence of Perimenopause in the UK

In the UK, there are approximately 13 million individuals currently experiencing perimenopause or menopause. Data from the British Menopause Society indicates that up to 75% report symptoms that interfere with their daily lives, with over 40% experiencing mental health impacts, including anxiety and depression (British Menopause Society, 2023). Despite its prevalence, the mental health impact of perimenopause remains largely unaddressed, leaving many individuals without adequate support during a challenging time.

Perimenopause and Mental Health: Beyond Physical Symptoms

While the physical symptoms of perimenopause are widely discussed, the impact on mental health is often overlooked. Hormonal changes during this time significantly affect neurotransmitters like serotonin, closely linked to mood regulation, which can lead to a range of mental health challenges:

• Depression and Low Mood: Individuals going through perimenopause are two to three times more likely to experience depression than those in their reproductive years, even if they have no prior history of depression (National Institute for Health and Care Excellence, NICE, 2022).

• Anxiety and Panic Attacks: Fluctuating hormone levels can heighten anxiety, sometimes leading to panic attacks that feel overwhelming and hard to control. Studies show that nearly 50% of women in perimenopause experience increased anxiety (Mind, 2023).

• Irritability and Anger: Many report heightened irritability and anger during perimenopause, often impacting relationships at home and in the workplace.

• Brain Fog and Memory Lapses: Cognitive symptoms, including brain fog and forgetfulness, are common in perimenopause and can impact focus, productivity, and self-confidence (NHS, 2023).

The stigma surrounding mental health, combined with a focus on physical symptoms, can leave many individuals feeling isolated. Without adequate support and open discussions, individuals may struggle to seek help, impacting their overall well-being and quality of life.

A Conversation with A.R.

Yasmin: Could you tell me a little bit about your experience with perimenopause?

A.R.: Perimenopause was an incredibly difficult period for me. I was already managing a stressful job and going through a divorce. I found myself frequently clashing with colleagues, which they saw as inappropriate behaviour. My irritability grew, and it felt like the situation was snowballing out of control. I was constantly at odds with people around me, and my workplace began to threaten me with termination. This cycle fed into itself, and alongside my personal struggles, I felt I was falling apart.

At the time, there was no one to talk to or even suggest that what I was going through could be symptoms of perimenopause. What surprised me most was how the situation was approached at work. I had been with the company for over a decade and had never exhibited such behaviour before. Rather than exploring what might be contributing to these changes, the main response was to consider my departure.

This left me feeling completely alone and misunderstood. Eventually, the strain became overwhelming, and I reached a breaking point, leading to a suicide attempt. I spent two nights in hospital and was off work for ten weeks.

Yasmin: What did your journey after that experience look like?

A.R.: After my hospitalisation, someone in occupational health finally suggested that I might be experiencing perimenopause. This was the first time I began to consider a link between my symptoms and perimenopause. I started researching and realised how much it had been impacting my mental health. I began hormone replacement therapy (HRT), which helped stabilise my mood, and I attended counselling to help me process what had happened.

Since then, I’ve changed jobs, and my current workplace has mental health first aiders, though the support sometimes feels like a tick-box exercise. However, counselling was invaluable—I got six free sessions through work and continued seeing my counsellor afterwards. It helped me to understand that I wasn’t to blame for what happened.

I’m passionate about raising awareness around mental health and perimenopause and the profound impact it can have on one's mental health. I even wrote an internal blog about suicide ideation to raise awareness for Suicide Prevention Day and am open to conversing with anyone interested in learning more or sharing their own story.

The Importance of Support and Open Discussion

A.R.’s experience highlights the need for greater awareness and support for mental health challenges during perimenopause. Beyond HRT, accessible mental health resources and workplace accommodations can make a significant difference. Counselling, mental health first aiders, and open conversations about menopause can help individuals find the support and validation they need.

At Bossa Health, we’re committed to addressing the mental and emotional aspects of perimenopause. Through our integrated platform, we offer counselling, psychiatric support, and guidance to help people navigate this complex phase with compassion and expertise.

Resources and References

• British Menopause Society (2023): “Menopause & Mental Health,” available at thebms.org.uk

• NICE (2022): “Menopause: Diagnosis and Management,” National Institute for Health and Care Excellence.

• Mind (2023): “Menopause and Mental Health,” available at mind.org.uk

• NHS (2023): “Menopause Symptoms and Treatment,” available at nhs.uk

Note: This interview reflects the personal views and experiences of the author and does not represent the views of Bossa Health, nor is it intended to provide diagnoses or diagnostic tools.