According to World Health Organisation (WHO), natural menopause occurs between the age of 45 and 55. Menopause is a natural biological process that marks the end of a woman’s menstrual cycles. Perimenopause is a transition phase before menopause, typically lasting a few years in women’s 40s. In India, menopause typically occurs between 45-50 years . Recent trends suggest an increase in premature menopause before the age of 40 years (PUB)
1.2 billion women globally will be menopausal or postmenopausal by 2030, highlighting the importance of addressing mental health concern related to this stage of life. (PMC)
It is important to understand the physical and psychological effects of menopause, given that women today live longer than previous generations, many will spend one-third or more of their lives after menopause.
During perimenopause a woman’s body starts producing less estrogen, that influence not only the reproductive system but also the brain and nervous system, symptoms like irregular periods, hot flashes, or mood changes. (PMC)
Historically, menopause discussions have focused on physical symptoms such as hot flashes, night sweats, joint pain, and sleep disturbances. These symptoms are easier to observe and measure clinically, which is why they have dominated medical consultations and public health conversations. For example, research indicates that menopausal symptoms such as joint and muscular discomfort affect a large proportion of women globally. (Springer).
Mental health is an equally vital part that is frequently ignored. As awareness about women’s health grows globally, it is essential to recognize that menopause can influence emotional well-being, mood, and psychological health in profound ways.
In contrast, emotional and psychological symptoms such as anxiety, irritability, or low mood are sometimes neglected as normal stress or aging. This narrow focus can prevent women from recognizing that their mental health challenges may also be linked to hormonal changes.
Menopause and Mental Health
Many research highlights a strong link between menopause and mental health. Hormonal fluctuations during perimenopause can affect neurotransmitters such as serotonin and dopamine, which regulate mood, sleep, and emotional stability. Studies show that depressive symptoms are common during the menopausal transition, with research estimating that 20–40% of women experience depression during perimenopause. (WMH)
In addition to this, mood symptoms are also widespread. According to the American College of Obstetricians and Gynaecologists (ACOG), about 4 in 10 women experience mood-related symptoms such as irritability, low energy, or difficulty concentrating during perimenopause.
Research further suggests that menopause is associated with higher rates of anxiety, sleep disturbances, and emotional distress, highlighting the need for greater attention to mental health during this period. (PMC)
Cultural Silence and Stigma Around Menopause
In parts of India, the onset of Menarche (i.e. beginning of the first menstrual period) is celebrated for adolescent girls by communities. There are elaborate customs, rituals and celebrations for pregnancy and childbirth. This is in sharp contrast to the cultural of silence and social stigma surrounding menopause which often stems from negative connotations around aging and loss of fertility functions of women. Women transitioning into menopause face fatigue, anxiety, and cognitive challenges without adequate medical information as the health practitioners often tend to minimise the concerns/ gaslight the conversations. This is observed in both private and public health care settings across the country. This further acts as a barrier to the health care seeking behaviour for physical and mental health symptoms of women in India.
Breaking this silence is a critical step towards empowering women that recognizes menopause as both a biological and psychological milestone. Increased awareness helps women reframe their emotional experiences not as mere “mood swings,” but as valid mental health challenges. Pragmana Foundation offers a 5-week structured online safe space programme on Empowering your Menopause Journey with Nutrition, Movement and Gut Wisdom improving their long-term quality of life and ensuring they feel supported throughout this transition.