Why menopause can lead to mental health issues – and what we can do about it

Dr. Louise Newson explains why HRT is crucial in helping people have a happy menopause

Five years ago I started experiencing migraines, memory loss, irritability and found myself shouting at my husband. I felt completely out of balance and assumed it was because, as a busy GP, I was working too hard.

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It was only when one of my daughters asked if I was on my period that the penny dropped that I was probably perimenopausal – the perimenopause is the time directly before the menopause (when you haven't had a period for 12 months) where hormone levels start to fall and you can start to experience symptoms. When I asked for hormone replacement therapy (HRT), my own GP refused to prescribe it. Why? Because for years, women, healthcare professionals and the media were given incorrect information about the risks associated with HRT.

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Can HRT cause cancer?

HRT has been used as a treatment to replace hormones lost during the perimenopause and menopause for decades. However, 20 years ago the Women's Health Initiative study pointed to concerns about an increased risk of breast cancer and cardiovascular disease in women who took combined HRT.

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The study was halted early, and the news made headlines around the world. Overnight, women stopped taking their HRT and many healthcare professionals refused to prescribe it.

However, subsequent analysis of the study has shown that women who take oestrogen-only HRT have a lower risk of breast cancer and women taking any type of HRT have a lower risk of dying from breast cancer.

Menopause can be a distressing time f

Even after further studies showed that taking HRT carries a negligible risk of developing breast cancer and that it can be beneficial to women's health, the fear persists, with many medical professionals and women all over the world still reluctant to prescribe and use it.

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I don't think it's a coincidence that when HRT prescriptions dwindled, the use of anti-depressants increased.

Menopause and depression

A lack of training around menopause symptoms, particularly those related to mood, means there is a risk that menopause-related low mood and anxiety can be misdiagnosed as clinical depression.

While antidepressants can help with clinical depression, they won't change menopause-related low mood. I've treated or spoken to women who have even been sectioned because their clinicians haven't been trained to recognise menopausal symptoms, and didn't think to ask those women about their hormones.

Dr. Louise Newson wants to bust myths surrounding menopause

Back in Victorian times, the asylums were full of women suffering from so-called hysteria, but our medical knowledge should have moved on since then. If men had periods and experienced menopause the whole world would stop to find a solution to the misery.

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Women tend to put their families first and their own health last, and just try to get through each day. But even when they get that lightbulb moment – often when they're desperate for help with the menopause – they often still find it hard to receive the help and treatment they need.

Having suffered some of the symptoms myself, I want to help those less fortunate by educating healthcare professionals through a free menopause education programme and educating women through the free Balance app. Some of the stories I hear in my clinic are harrowing. As a result of the impact of their low hormone levels, many women are giving up their jobs and losing their relationships. In extreme cases, some are suicidal.

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One lady, who'd been previously prescribed anti-depressants, told me how she had to hide the knives in her home because she had no idea what was happening to her until she realised she was menopausal.

Others say that without HRT, they doubt that they would still be here. Many people underestimate the suffering caused by menopause and have no idea that it is the lack of hormones in the body that can lead to serious illness.

Health benefits of HRT

If women receive effective, individualised and evidence-based menopause treatment then they are less likely to be a drain to the NHS because feeling better leads to them needing fewer appointments (and fewer investigations for their symptoms).

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To help them further, the free Balance app can track and monitor their symptoms and create a health report which they can show to their GPs. We've reached a pivotal moment in women’s health and I will do everything I can to empower them.

My aim is always to educate and arm women across the country with as much information as possible so they can make informed decisions about their future health and it's great that HELLO! is helping people to do that.

Find out more about the menopause Balance app.

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