Women who had entered the menopausal transition by the age of 46 were 44% more likely to report clinically significant anxiety, a Finnish study of more than 2,600 women shows. Menopause guidance in England already asks clinicians to address mood, and women can ask for it.
NICE first issued its menopause guideline for England in November 2015. Nine years later, in November 2024, it revised the guideline to add recommendations on cognitive behavioural therapy (CBT), a structured talking therapy. The update also clarified how clinicians should address the possible effects of menopause on mental health.
Researchers in Finland have now measured how common those effects are at one age. A University of Oulu team studied more than 2,600 women aged 46 from the Northern Finland Birth Cohort 1966. Women already in the menopausal transition reported more anxiety and depression than those who had not started it.
Anxiety and low mood at 46
About 13% of the women had begun the transition, the stage when menstrual cycles and hormone function change. The team classified each woman using hormone levels, menstrual cycle information and records of medication purchases. Finnish women reach menopause at around 51 on average.
Clinically significant anxiety symptoms affected about 23% of women in the transition, compared with 16% of the comparison group. Women in transition were 44% more likely to have these symptoms. That link held after adjustment for smoking, alcohol use, body mass index and education.
Just over 30% of women in transition had clinically significant depressive symptoms. The figure for their peers was just under 25%, and this association also held after adjustment.
The study appeared in September in Acta Obstetricia et Gynecologica Scandinavica. It is observational, so it shows an association and can’t prove that hormonal change caused the symptoms. All participants came from one region of Finland and were the same age.
Perimenopause and depression in a 2024 review
A 2024 meta-analysis led by University College London pooled seven studies covering 9,141 women. They lived in countries including Australia, the US, China, the Netherlands and Switzerland. Perimenopausal women had roughly a 40% higher risk of depressive symptoms and depression diagnoses than premenopausal women.
Postmenopausal women in that review showed no significant increase in risk. Read together, the two studies point to the transition itself as the period when mood symptoms become more common.
Raising mood at a menopause appointment
Tiia Saarinen, a medical doctor and doctoral researcher at the University of Oulu, led the Finnish work. “Recognising psychological symptoms can help ensure that women receive timely treatment and support during menopause,” she said.
The World Health Organization’s menopause fact sheet lists mood changes, depression and anxiety among common symptoms. It says most women reach menopause between 45 and 55. WHO also reports that menopause gets limited attention in the training of many health workers.
England’s NHS guidance on menopause symptoms says hot flushes may be “replaced by other symptoms such as low mood and anxiety”. It encourages women to see a GP to discuss their options. “Early advice can help reduce the effects of menopause and perimenopause on your health, relationships and work,” the NHS page states.
Women in their 40s can raise low mood or anxiety in the same appointment as changes to their periods. In England, they can also ask whether CBT is available for menopause symptoms, as the 2024 NICE update recommends. Australia now funds a GP menopause check that covers mood, as our analysis of perimenopause mental health care explains.
This article is for information only and does not replace advice from a qualified health professional.
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