MHM Magazine

Issue 4 | 2023 | MENTAL HEALTH MATTERS | 27 MHM Menopause is a natural phase of life which comes with many challenges, including mental health issues. Menopause, when a woman stops menstruating for a year at least and experiences a drop in oestrogen, often has symptoms such as hot flushes, night sweats, painful sexual contact, vaginal dryness, and a decreased libido. Menopause can be accompanied by cardiovascular complications and even psychiatric symptoms. This can be challenging for the individual. Because oestrogen decreases during menopause, common mental health issues in those facing menopause are mood instability and conditions such as depression and anxiety. Women are twice as vulnerable to mental illness due to the fluctuating hormones involved with pregnancy and the menstrual cycle. Most women start menopause from their late 40s into their 50s and the mood changes may be quite distressing for those experiencing it. The emotional impact can carry through to external factors such as relationships, especially seeing as intimacy is impacted during this period. Even the way in which food is metabolised during this period, often leading to weight gain, can have implications on mental and relational health. Oestrogen has also been researched in its implication in neurocognitive disorders such as dementia, as it is protective in terms of memory. Due to the decrease in oestrogen, there is research indicating that a higher risk of dementia is possible. Every medical condition has ways for preparation, and menopause is no different. This might entail a woman taking calcium for bone brittleness and vitamin D as well as regular exercise and good nutrition as preventative steps. Perimenopause is often accompanied by the biggest mood swings and symptoms such as hot flushes and night sweats. During the postmenopausal era, the risk of all symptoms, including osteoporosis, is greatest, and can be treated with hormone replacement therapy. Women with preexisting mental health conditions often see an exacerbation during menopause if they are not on medication or are not already stable. Although mild mood swings are to expected during menopause, many women describe a feeling of their emotions being “out of control” or “going crazy”, feeling irritable and angry, and experiencing symptoms that impact their functioning. Even in those on medication, there can be a mild exacerbation in symptoms. This makes ongoing psychiatric care relevant to make necessary adjustments to their psychiatric medication. Women with undiagnosed or untreated mental SADAG’s Ask the Expert with: Dr Lavinia Lumu, Psychiatrist Dr Rethabile Khalema, Obstetrician & Gynaecologist NAVIGATING MENOPAUSAL TRANSITION & MENTAL HEALTH