Many of the physical changes women experience during the transition into menopause can come as a shock to the system.
The hot flushes, the vaginal dryness, the sleep problems – none of them are pleasant but at least none are fatal.
But there are potentially deadly symptoms associated with perimenopause – which typically starts in women aged 40 to 44 and ends when they have gone 12 months without a period – that are rarely spoken about.
Brain fog, bursts of rage, anxiety and – most concerning of all – clinical depression can all be caused by fluctuating hormones associated with the end of a woman’s reproductive years.
These symptoms can impact any woman – but they are typically experienced by those who have never suffered from mental health conditions in the past.
Perimenopause expert Dr Ginni Mansberg told FEMAIL that women can wake up, burst into tears and feel like staying inside forever – all because of the spiking hormones experienced during the transitional life stage.
When they go to their GP to find a cure for the sudden decline in their mental health, they are pumped full of antidepressants which ‘don’t work’.
‘They are still just as depressed or anxious. In fact, perimenopause is the time a woman is most likely to die by suicide,’ Dr Mansberg said.
Dr Ginni Mansberg reveals the deadly side-effect of perimenopause
The anxiety and depression can be debilitating, leading women to quit their careers, withdraw from friends and family, and develop something similar to agoraphobia within a matter of weeks.
‘A lot of these women have had a terrible time with the pill, which is another thing some doctors try. But the women know that going on the pill would be a disaster,’ she said.
Dr Mansberg said researchers are looking into perimenopausal mental health conditions to see if they are linked to genes that cause premenstrual dysphoria, a severe form of PMS characterised by more intense mood swings.
She said these women are likely more sensitive to the hormonal fluctuations of perimenopause, which causes the more severe feelings of anxiety and depression.
‘Antidepressants don’t work – but 76 per cent of women do feel better when they are treated for perimenopause,’ she said.
‘If you understand what’s going on, then the prognosis is excellent. But you need treatment or it will continue to be awful.’
One of the main treatments for perimenopause symptoms is hormone replacement therapy (HRT). This is medication that replaces the female hormones estrogen and progesterone, which decrease during menopause.
HRT takes the form of pills, patches, gels, creams and more.
Women are most likely to take their own lives during perimenopause
Some women fear treatment, but Dr Mansberg said there is no way around it for the those who have severe symptoms.
‘Get treatment so you can get past it and get back to being you,’ she said.
One in three women suffer from anxiety or depression when they go through perimenopause.
‘These women are burst into tears in the middle of the supermarket. They say they don’t feel like themselves anymore. They are a bit overwhelmed by anything and they feel paranoid. They are losing their s**t at everyone,’ she said.
Dr Mansberg said it breaks her heart to see so many women suffering so profoundly with their mental health during perimenopause despite treatments being readily available.
Women are more than twice as likely to develop bipolar disorder in the years leading up to the menopause, study reveals
By Shaun Wooller, Health Editor
Women are more than twice as likely to develop bipolar disorder in the years leading up to the menopause, a recent study found.
Researchers examined data on 128,294 women in the four years around their final period.
Analysis revealed there was a 112 per cent increase in bipolar during perimenopause, while the onset of major depressive disorder increased by 30 per cent.
Perimenopause happens when a woman has symptoms of menopause, such as anxiety, mood swings and brain fog, but still has a period.
Study leader Professor Arianna Di Florio, of Cardiff University, said: ‘During perimenopause approximately 80 per cent of people develop symptoms, but the impact on the onset of severe mental illness was unknown.
Women are more than twice as likely to develop bipolar disorder in the years leading up to the menopause , a recent study found (stock image)
‘In my clinic, I found that some women, previously living lives without any experience of severe mental health issues, developed severe mental illness around the time of the menopause.
‘I feel a duty towards the women I work with.
‘I wanted to provide them and other women with the answers to why this terrible thing happened to them.’
Professor Di Florio said the findings could help provide additional support for women who have ‘previously been left in the dark’.
‘Research like this is vital, as women experience these profound changes in their lives and bodies and are currently let down by the lack of detailed understanding of these changes,’ she added.
‘We have been able to expand our knowledge of the mental health changes associated with perimenopause, which can help provide explanations, diagnoses and support for women who have previously been left in the dark about what is happening to them.’
The study, published in the journal Nature Mental Health, was conducted in collaboration with the charity Bipolar UK and the UK Biobank.
Clare Dolman, an ambassador for Bipolar UK and patient and public involvement lead on the project, said the findings could be ‘life-saving’.
She added: ‘This study is extremely important as it demonstrates for the first time in a very large sample that the menopausal transition has a measurable impact on women’s mental health.
Bipolar disorder is a mental health condition that affects your moods, which can swing from one extreme to another (stock image)
‘For me, this confirms what we have observed and heard from women with bipolar themselves; that hormonal change is a very important factor in mood disorders and one that deserves to be researched thoroughly.
‘As a woman with bipolar myself who has gone through menopause, I am looking forward to the research community recognising the importance of this funding.
‘The studies will allow us to predict an individual woman’s risk of becoming unexpectedly ill at this time of life. That knowledge could be life-saving.’
The study focused on first-onset experiences of psychiatric disorders during perimenopause and did not investigate links with the recurrence of pre-existing psychiatric disorders.
Bipolar UK said further research focusing on people with a previous history of mental illness is needed.