The mental health risks associated with perimenopause

A new study has explored whether perimenopause, the transition around the final menstrual period (FMP), increases the risk of developing psychiatric disorders in women compared to earlier reproductive stages

The UK Biobank analyzed 128,294 women’s data, which examined the psychiatric conditions during the different stages of reproductive ageing.

The analysis was taken between three stages, before perimenopause (6-10 years before FMP), during perimenopause (the 4 years surrounding FMP) and postmenopause (6-10 years after FMP).

Increase in psychiatric disorders during perimenopause

One of the main findings from the study was that women had a higher risk of developing psychiatric disorders for the first time during perimenopause. It was revealed that in. perimenopause were about 52% more likely to develop a psychiatric disorder than they were in earlier years. However, after perimenopause, the rates dropped back down to premenopause levels.

Links between certain psychiatric disorders and perimenopause

• MDD: The risk of developing major depressive disorder was 30% higher during perimenopause than in the premenopause stage (RR of 1.30). This matches previous findings that perimenopause can increase the risk of depressive episodes.
• Mania: The occurrence of mania was more than doubled during perimenopause (RR of 2.12) but returned to baseline levels after perimenopause. This shows a particularly strong link between perimenopause and the beginning of mania.
• Schizophrenia spectrum disorders: No link was found with schizophrenia spectrum disorders. The study found no increased risk of developing schizophrenia spectrum disorders during perimenopause, as the rate remained relatively unchanged from premenopause (RR of 0.95). Rates were actually lower in the postmenopausal period.
• Other psychiatric diagnoses: Both perimenopause and postmenopause showed increased rates of other psychiatric diagnoses not specifically detailed in the study, such as anxiety disorders or non-severe mental health issues (RR of 2.10 for perimenopause and RR of 2.08 for postmenopause).

The researchers confirmed that other factors (like socioeconomic status, BMI, alcohol intake, and smoking status) did not significantly alter the results. This means the findings are robust across various demographic and lifestyle categories.

Women’s hormonal changes during perimenopause

The research also examined male participants in ages similar to the female participant’s reproductive stage.

No significant increase in new psychiatric disorders was observed during men’s perimenopausal proxy stage.

This difference between men and women supports the idea that hormonal changes during perimenopause could play a role in mental health shifts.

The study concludes that perimenopause is associated with an increased risk of developing major depressive disorder and mania, but not schizophrenia spectrum disorders. It also highlights the idea that during the period of reproductive transition women should take the time to monitor and prioritise their mental health.