Menopause and depression: how to protect yourself?

Menopause is well known for its highly destabilizing, and sometimes even debilitating, symptoms. While we often talk about hot flashes (and rightfully so), they are not the only manifestations of this hormonal transition.

At Puissante, we believe that an informed woman is better equipped to make good decisions for her health. That is what self-care really is.

Driven by this conviction, we decided to delve deeper into key topics: anatomical knowledge, gynecological diseases, mental health, and, of course, menopause.

Today, we are focusing on the psychological consequences of menopause, and specifically on your vulnerability to depression during this period.

How do you recognize it? How can you manage it? We have the answers.

A few words on menopause

Before we dive into depression, a quick and essential reminder about menopause and how it shakes up your body.

Menopause refers to a period of hormonal transition experienced by 100% of women at some point in their lives. In practical terms, the level of sex hormones (estrogen and progesterone) gradually decreases during perimenopause until it reaches zero: that is menopause.

You are officially menopausal when you have not had your period for 12 consecutive months; your menstrual cycle has stopped. On average, menopause is diagnosed at age 51 (Inserm), but the first symptoms can appear as early as the late thirties in some women.

Among the most uncomfortable manifestations, we find, of course, climacteric disorders (hot flashes, night sweats), as well as vaginal dryness, chronic fatigue, and musculoskeletal pain.

In fact, your entire body is impacted by menopause.

Most of your organs are equipped with hormone receptors. When your hormone levels drop, your organs struggle to function normally; your body panics and tries to regain balance as best it can… But it often needs a little help.

We’ll explain how menopause impacts your mental health.

Are you more exposed to depression during menopause?

Menopause truly impacts your psychological balance. If you feel tired, stressed, or fragile during this period, it is not a whim; it is a biological reality.

Starting in perimenopause, you may, for example, observe:

• Greater emotional fragility: this is once again a matter of hormones, just like mood swings during the menstrual cycle (hello, PMS).

• Greater anxiety: you find it difficult to manage stressful situations or unexpected events.

• You feel tired: chronic fatigue is indeed a symptom of menopause, but it is also a consequence of other physical disorders. It is difficult to get restful nights if you suffer from urinary leakage, night sweats, or anxiety…

Ultimately, you feel more vulnerable and are exposed to intense emotional fluctuations. The environment is more than favorable for depression.

A 2024 British study that combines the results of several surveys shows the link between the different stages of (pre)menopause and exposure to depression.

This meta-analysis combines data from 7 international studies with over 9,000 women to measure the link between the stage of menopause and the risk of depression.

Women in perimenopause have approximately a 40% higher risk of developing depressive symptoms or being diagnosed with depression compared to premenopausal women.

In short, the further you progress into menopause, the more vulnerable you are to depression.

Even if depression (which, we remind you, is a disease) is not inevitable, it cannot be denied that hormonal fluctuations very significantly influence your mental health.

How do you recognize the first signs of depression during menopause?

Distinguishing between depression and the blues

Depression is not at all the same thing as feeling blue or having a temporary slump. During menopause, you may occasionally feel helpless, tired, or overwhelmed by all the changes. If this is fleeting and does not affect your quality of life in the long term, we call it "the blues" rather than depression.

Depression is a disease with concrete, long-term consequences. If you are going through a state of continuous sadness that lasts for more than 15 days, it should alert you to the possibility of depression.

The Paris Brain Institute (Institut du Cerveau) defines depression as:

“A behavioral disorder in which the mood is pathologically stuck in sadness or pain. The sadness of a depressed person is intense and is not diminished by external circumstances.”

This disease affects 5% to 15% of the adult population and impacts twice as many women as men. Like all diseases, it must be diagnosed by a healthcare professional: a psychiatrist or general practitioner.

Symptoms of depression during menopause

You are beginning to see the difference between a temporary slump and true depression. Now, let’s get into the specifics.

According to the WHO, several symptoms should alert you if they persist over time:

• difficulty concentrating (reading the same email three times without understanding it),

• a sense of excessive guilt or plummeting self-esteem,

• a feeling that the future is bleak, blocked, with no perspective,

• sleep disturbances (waking up at night, insomnia, or conversely, wanting to sleep all the time),

• fluctuations in appetite or weight,

• intense, almost overwhelming fatigue,

• and, in the most serious cases, suicidal thoughts.

This last point is obviously an emergency signal. If you recognize yourself here, you must not stay alone.

What makes the menopause period particularly sensitive is that it compounds several vulnerabilities. Hormones are dropping, yes. But that’s not all.

A study conducted by Kantar for the Fondation des Femmes shows that more than one in three women struggles with aging. For one in four, menopause is synonymous with health problems and a weakened body. And one in ten says they feel as though "life is behind them."

This figure hurts.

Because it touches on something deep: the invisibilization of mature women. At work, in the media, sometimes even within a relationship. Some women describe a feeling of erasure: less watched, less listened to, less desired. As if their value had an expiration date.

Naturally, when the body changes, society sends messages that aren't exactly uplifting, and hormones play a rollercoaster ride, mental health can falter.

And this is not a question of a "weak mind." It is an accumulation of biological, psychological, and social factors. In other words: it is serious, and it deserves real care.

Managing depression during menopause

Can hormone replacement therapy for menopause help fight depression?

Honest answer: yes… and no.

Menopause Hormone Therapy (MHT) is currently the only treatment capable of acting globally on the symptoms related to hormonal decline. It provides synthetic hormones to compensate for the drop in estrogen and progesterone.

In practical terms, it can improve:

• hot flashes,

• sleep,

• vaginal dryness,

• certain pains,

• and sometimes emotional stability.

So yes, by rediscovering more peaceful nights, more comfortable intimacy, and a body in less pain, you can indirectly feel better psychologically.

If you are eligible, it is a first lever to discuss with a healthcare professional.

But, because there is a "but," MHT is not always enough.

First, it is not systematically prescribed during perimenopause. Second, depression is a multifactorial disease. Hormones play a role, but they are not the only ones responsible. Personal history, mental load, professional context, social perspective… everything comes into play.

This is why effective management is often comprehensive.

Lifestyle during menopause: a lever to fight depression

We know.

You may be tired of hearing that "exercise and nutrition are the foundation." Especially when you are already exhausted.

And yet… it is a biological reality.

A sedentary lifestyle and a completely unbalanced diet can accentuate fatigue, sleep disturbances, and mood swings. In an already unstable period, that doesn’t help.

Attention: this is not about adopting a military diet or embarking on a bootcamp at 6 a.m. (definitely not).

The idea is more about maintaining a reassuring and regular framework.

Regarding movement: find an activity that makes you feel good. Brisk walking, yoga, dancing, swimming, strength training… It doesn’t matter. What matters is that, when you finish, you feel a little more solid, a little prouder, a little more alive. And incidentally, you will have secreted endorphins, those famous hormones that support mood.

Regarding nutrition: nothing revolutionary. Ensure that your body is not lacking anything. Protein, healthy fats, fiber, vitamins, proper hydration. Sometimes, a small biological and hormonal check-up can be useful for adjustments (iron deficiency, vitamin D deficiency, thyroid disorders…).

You can also provide a little extra support to your body with food supplements specifically designed for menopause. They are not a treatment, but a natural boost to regain your balance.

These are not miracle solutions. But they are solid foundations.

What kind of support is available to fight depression during menopause?

If you feel that it is going beyond a "rough patch," your general practitioner can be the first point of entry. He or she will be able to assess the situation and guide you.

Then, several options exist:

• The psychiatrist: a medical doctor. They can diagnose depression, offer medication if necessary, and coordinate your care.

• The psychologist: a safe space to talk. You can unload absolutely everything here: fear of aging, complexes, bodily transformation, tension in your relationship, the feeling of invisibility…

The goal is not to label you, but to build a multidisciplinary care approach, adapted to you.

The most important thing? To feel confident, heard, and respected.

Because at menopause, you are not "at the end of the line." You are in a transition. And a transition is easier to cross when you are accompanied.