Review article

Women's Mental Health During the Menopausal Transition

Sandra Vuk Pisk

Abstract

A woman’s life is not linear—it is cyclical, and that cyclicality comes at a cost. The menopausal transition is increasingly recognized as a sensitive period of heightened psychological vulnerability resulting from sudden and intense hormonal fluctuations, particularly of estradiol, although the effects of progesterone and testosterone levels should not be overlooked. These hormonal fluctuations are responsible for vasomotor and somatic symptoms, which may in turn lead to cognitive and psychological symptoms such as difficulties in concentration, energy, sleep, memory, mood changes, anxiety, and reduced libido.
The more pronounced the symptoms of the menopausal transition, the greater the likelihood that women will develop a mental disorder, most commonly affective, anxiety, or sleep disorders. Insomnia is often the first symptom and may occur up to two years before the onset of menopause. During the menopausal transition, previously existing psychiatric disorders may worsen, while first-onset psychiatric disorders may also emerge.
It is precisely during this period that women experience the so-called “second peak” in schizophrenia incidence, a phenomenon not observed in men. The specificity of the therapeutic approach during the menopausal transition is determined by particular pharmacokinetic and pharmacodynamic changes characteristic of this period, together with the presence of somatic multimorbidity.
Therefore, it can be stated that an integrative multidisciplinary approach to the treatment of mental disorders during the menopausal transition is not merely an option, but an imperative. This includes a biopsychosocial approach: alongside psychopharmacological and psychotherapeutic interventions, equal attention must be paid to the treatment of somatic comorbidities. Social support is also essential, as well as work on core values aimed at fostering a more culturally positive acceptance of menopause as a life stage.

Keywords

menopausal transition, psychological disorders, somatic comorbidities, specificities of therapy, non-pharmacological approach

Hrčak ID:

349374

URI

https://hrcak.srce.hr/349374

Publication date:

10.7.2026.

Article data in other languages: croatian

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