Many women sense something is wrong during midlife, yet walk away from GP appointments with labels that never quite fit.
New research from leading psychiatrists suggests those mislabelled struggles are often linked to menopause, which can quietly trigger serious mental health conditions that go undiagnosed for years.
Polling reveals a major knowledge gap
A nationwide YouGov survey for the Royal College of Psychiatrists (RCPsych) has found that almost three in four women in the UK do not realise menopause can be linked to a brand-new mental illness.
Only 28% of women surveyed knew that going through menopause or perimenopause could increase the risk of conditions such as clinical depression, bipolar disorder or eating disorders.
By contrast, the classic physical symptoms of menopause are widely recognised. In the same poll, 93% of women associated menopause with hot flushes, and 76% linked it with a reduced sex drive.
Psychiatrists warn that millions of women are well-versed in hot flushes, but almost completely in the dark about the mental fallout.
The college, which represents more than 20,000 psychiatrists, says this gap means many women are not getting the help they urgently need.
Psychiatrists issue first-ever menopause and mental health warning
Alarmed by the findings, the Royal College of Psychiatrists has released its first dedicated position statement on menopause and mental health, calling the issue a matter of public concern rather than a private problem.
RCPsych president Dr Lade Smith described menopause as a “societal issue”, stressing that every woman will encounter it in some form, and the emotional and psychiatric risks can no longer be brushed aside.
The college wants menopause-linked mental health to be treated with the same seriousness as postnatal depression or premenstrual mood disorders, both of which are now widely recognised and researched.
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Perimenopause: a high-risk window for mental illness
The report lays out stark statistics about the perimenopause – the transition phase leading up to menopause, when hormones fluctuate sharply.
- Perimenopausal women are more than twice as likely to develop bipolar disorder.
- They are about 30% more likely to develop clinical depression.
- Hormonal shifts may trigger new or relapsing eating disorders.
- Suicide rates are higher among women around menopausal age.
Dr Cath Durkin, a joint presidential lead for women and mental health at RCPsych, warns that perimenopause may be a “period of particular clinical danger” for women with, or at risk of, bipolar disorder.
The report notes that women with bipolar disorder who previously experienced postnatal depression, or severe premenstrual mood symptoms, face especially high risk of mood relapse during the menopausal years.
For some women, midlife hormonal change acts like a match dropped into dry grass, igniting an illness that was never there before.
Misdiagnosis and dismissal at the GP surgery
Many women say they are being told they are “just anxious” or “just depressed”, with menopause barely mentioned in consultations.
A separate study from University College London, published in the journal Post Reproductive Health, found that 58% of Black women in the UK felt completely uninformed about menopause. More than half reported anxiety, yet many said their doctors treated those symptoms as stand-alone mental health issues rather than part of a hormonal picture.
Only 23% of women in that study went on to use hormone replacement therapy (HRT), often because menopause was never clearly identified as the root cause.
One woman’s seven-year search for answers
The consequences of this diagnostic blind spot are vividly illustrated in the story of 43-year-old Sonja Rincón, who began feeling “crushing fatigue and low mood” at 35.
With no background of mental illness, she sensed something in her body had fundamentally shifted. Yet each GP visit ended the same way: another prescription, a higher dose, or a different type of antidepressant.
She had never heard of perimenopause. No one mentioned it to her. She kept working, caring for her daughter and juggling everyday tasks, but described daily life as moving through thick fog. Laundry and basic chores felt overwhelming. She slept whenever she could and became skilled at pretending she was fine.
For seven years, she was treated for depression while the hormonal cause sat undetected. Her confidence in both her body and her judgment eroded. Only when friends her age began talking about hot flushes did she connect the dots.
Rincón started researching menopause, insisted on being heard, and pushed for proper assessment. She was finally diagnosed with perimenopause and offered HRT. The change, she says, felt like getting her old self back. She has since come off antidepressants completely.
Rincón now argues that women in their 30s should not be brushed off as “too young” for perimenopause when they present with fatigue, brain fog and persistent low mood.
Her experience led her to create Menotracker, an app designed to help women log symptoms and patterns, arming them with data before they step into a consultation.
Calls for mandatory training and workplace policies
The RCPsych report urges health systems and governments across the UK to act quickly. Its recommendations include:
- Mandatory training on menopause and mental health for all medical and psychiatric trainees.
- Joined-up care between GPs, gynaecologists and mental health teams.
- Workplace menopause policies that explicitly address mental health impacts.
- More research funding for menopause-related psychiatric conditions.
Charities echo the message. Janet Lindsay, chief executive of Wellbeing of Women, says women’s symptoms have been “dismissed or misunderstood” for too long and argues for better awareness, workplace support and research.
TV presenter Davina McCall, who has spoken publicly about her own menopause journey, supports the college’s statement. She points to lingering stigma and silence that keep women from talking openly with doctors, colleagues and even close friends.
Government response and changing health checks
The Department of Health and Social Care says it recognises the problem. A spokesperson called current barriers to care “unacceptable” and pointed to several measures underway.
| Current action | What it aims to change |
|---|---|
| Adding a menopause question to NHS health checks | Helps GPs spot symptoms earlier, including mental health changes |
| Renewing the women’s health strategy | Places female-specific conditions, including menopause, higher on the policy agenda |
| Extra £688m for mental health services | Expands access to support, including for midlife women |
| Recruiting 8,500 more mental health workers | Boosts capacity for assessment, therapy and follow-up care |
Ministers say women now have access to a broader range of treatments and that new doctors are receiving improved training on menopause and mental health.
What menopause-related mental illness can look like
Menopause does not affect every woman in the same way. Some feel only mild mood swings; others face symptoms that mirror severe psychiatric conditions.
Common mental health changes linked to perimenopause and menopause include:
- Persistent low mood or loss of interest in daily life.
- Racing thoughts, agitation or severe mood swings.
- Sleep disruption that makes coping during the day much harder.
- Intense anxiety, often with no clear trigger.
- Obsessive thoughts about weight, eating or body image.
- Brain fog and memory lapses that fuel fear of “losing it”.
On their own, each symptom can be written off as stress, overwork or ageing. Together, especially in a woman in her 40s or even late 30s, they may signal a hormone-driven mood disorder that needs specialist input.
Practical steps women can take
Women who suspect menopause might be affecting their mental health can take some concrete steps before and after visiting a GP.
- Keep a simple symptom diary for at least a month, noting mood changes, sleep, periods, hot flushes and energy levels.
- Bring a written list of questions to appointments, including whether perimenopause could be a factor.
- Ask directly about HRT, antidepressants, talking therapies and how these might work together.
- Consider asking for a referral to a menopause clinic or psychiatrist if symptoms are severe or long-lasting.
- Share information with trusted friends or family, so they can support appointments and follow-up.
Workplaces can also make a difference by allowing flexible working hours, private spaces for rest, and open conversations about midlife health without stigma or jokes.
Terms and risks worth understanding
Perimenopause refers to the period when oestrogen and progesterone levels start fluctuating, often several years before periods finally stop. Many of the sharpest mood changes occur in this phase rather than after menopause itself.
Clinical depression is more than feeling low. It involves at least two weeks of symptoms such as deep sadness, loss of pleasure, disrupted sleep, appetite changes, concentration problems or thoughts of self-harm.
Bipolar disorder involves swings between depressive episodes and periods of elevated or irritable mood. Hormonal shifts can destabilise a condition that was previously well controlled.
One key risk is that menopause-related mental illness can go untreated because women blame themselves, or assume they simply lack resilience. Another is that clinicians may focus only on psychological treatments, without considering hormone-based options that could target the underlying trigger.
Combining approaches often works best. For some women, HRT eases hot flushes and sleep disruption so that therapy and, where needed, antidepressants or mood stabilisers have a better chance of working. For others, psychological support helps them cope with relationship changes, caring responsibilities and workplace stress that intersect with hormonal change.
Taken together, the emerging research points to a clear message: when a woman in midlife says, “I don’t feel like myself any more,” both she and her doctor should consider menopause as a serious part of the conversation, not an afterthought.
Originally posted 2026-03-06 06:52:46.