Menopause can bring on or worsen mental health conditions, which a psychiatrist is trained to diagnose and treat.
Seeing a psychiatrist during menopause may help if symptoms like depression or anxiety interfere with your daily life, and treating the underlying hormonal cause is ineffective or not possible.
The right psychiatrist can work with your other doctors to make sure you get the best possible care for your needs.
The menopausal transition is a big — and often uncomfortable — hormonal shift that affects people with ovaries. The physical and mental health symptoms associated with this transition often begin during perimenopause, which typically starts years before you have your last period.
Many treatments can help ease the symptoms of perimenopause and menopause, which might include everything from hot flashes and sleep issues to increased irritability or mood changes. Your gynecologist, and possibly your primary care physician, directly treat your menopausal symptoms.
Depending on your symptoms, a psychiatric provider can also support you during this time. A psychiatric provider doesn’t provide treatment that directly addresses the hormonal changes in menopause. But they can address any mental health symptoms that might come up.
Going through perimenopause and menopause can be a challenge, but you don’t have to do it alone.
When to see a psychiatrist during menopause
Every person with ovaries will go through menopause once they reach a certain age. Not all of them will need to see a psychiatrist. Although perimenopause and menopause is uncomfortable for many people, the mental health effects vary for each person.
Some people don’t need any treatment at all, while others benefit from treatments like hormone replacement therapy (HRT). HRT can ease mood swings and other hormonal symptoms. But not everyone finds relief from all symptoms with HRT or other treatments, and some people can’t take hormone therapy due to other health conditions. In these cases, you may benefit from seeing a psychiatric provider.
Psychiatrists and psychiatric nurse practitioners are medical providers who specialize in mental health. Typically, their main role is to diagnose mental health conditions and prescribe the appropriate medication and other interventions. They also sometimes offer therapy. These professionals don’t typically prescribe HRT or other hormonal treatments unless they have specialized expertise in this area.
Menopause is linked with an increased risk of several mental health conditions. Often, people who are in perimenopause or menopause first get treatment from their primary care physician, gynecologist, or endocrinologist. If these treatments don’t work to improve your mental health, seeing a psychiatrist might be a helpful next step.
Consider seeing a psychiatric provider during menopause if you:
Experience symptoms of depression, anxiety, or another mental health condition that impact your ability to function
Have received hormonal treatments for menopause, but your mental health doesn’t seem to be improving
Have thoughts about hurting yourself or ending your life
Already live with a mental health condition, and you want to prepare for how menopause could affect your symptoms
Have a hard time navigating life changes that may come up alongside hormonal symptoms
See, hear, or believe things that no one else can
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Common mental health conditions during menopause
Menopause can trigger new mental health conditions and worsen pre-existing ones. You might have had your mental health symptoms managed, only to find them flaring up during this time in life. This is normal and may be due to hormonal changes from menopause as well as life changes (like becoming an “empty nester”).
During menopause, you could be at higher risk for:
Depression
Psychotic episodes, including for the first time in your life
Alcohol use disorder, even if you weren’t an excessive drinker before
Worsening mood symptoms of bipolar disorder
You may also notice the symptoms of neurodevelopmental conditions, like attention-deficit hyperactivity disorder (ADHD), getting worse during menopause. These conditions, by definition, develop in early childhood. They don’t suddenly show up during menopause.
But for people who have ADHD already, symptoms can become significantly worse due to the impact of declining estrogen levels on dopamine levels in the brain. These worsened symptoms may be relieved with HRT. Your provider may also recommend starting or adjusting medication for your ADHD.
How a menopause psychiatrist can support your mental health
Seeing a psychiatric provider during menopause has several benefits. Even if you don’t live with a serious mental health condition, a psychiatric provider can help you take care of yourself while you go through this shift.
A psychiatrist or PMHNP can support you during menopause by:
Assessing for and diagnosing specific mental health conditions
Talking to you about treatment options, including medication
Adjusting medications for pre-existing mental health conditions
Providing therapy or referring you to someone who does
Working with your other healthcare providers to offer well-rounded support
Recommending lifestyle changes to support your overall well-being
Helping you work through grief, stress, or identity changes that may come up during this life stage
Offering crisis support if you experience severe symptoms like suicidal thoughts* or psychosis
Supporting you in developing coping skills that improve your quality of life
*If you or a loved one is experiencing suicidal thoughts or thoughts about harming themself or others, please call or text 988 on any phone for the Suicide & Crisis lifeline, contact a local crisis line, or head to the emergency room immediately. Any of these resources will ensure that the person in crisis receives support right away. For more information on getting help, go to 988lifeline.org
If experiencing a life-threatening emergency or you need immediate help, please call 911.
Finding the right psychiatric care during menopause
The “right” psychiatric provider to support you during menopause is unique to you and your needs and preferences. It might be helpful to find a professional who has experience with menopause. But some people may value other things, like personality fit or identity, over this expertise.
You can connect with a psychiatrist by:
Asking your gynecologist or primary care physician for a referral
Reaching out to a psychiatrist you worked with previously
Looking through your insurance panel
Doing an online search for providers who specialize in menopausal mental health
Some people feel brushed off when they seek psychiatric care for menopause. For example, your gynecologist might tell you that what you’re experiencing is normal and that HRT is enough. Alternatively, your perimenopausal or menopausal symptoms may be misidentified as “just” a mental health problem. But just because something is normal doesn’t mean that it isn’t painful, and it’s essential to find providers who carefully treat both your physical and mental health concerns in the menopause transition. You know yourself best, and you deserve qualified support.
You don’t need a referral to access psychiatric care. If you believe that you need it or could benefit from it, you can reach out to a psychiatric provider directly.
Perimenopause and menopause can impact your mental health, and it’s important to treat these challenges holistically. I coordinate with my patient’s other providers because it often makes sense to address the possible hormonal cause of symptoms first. Then, we consider whether psychiatric medication might be helpful.
Halee Fullerton, PMHNP-BC
Clinical reviewer
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Menopause can bring physical and emotional challenges, and it’s perfectly OK to ask for support. A psychiatrist can help you manage any mental health concerns that come up and also make sure your care is coordinated with other healthcare providers. You deserve compassionate support during this stage of life — and finding the right psychiatrist can make a big difference.
At Rula, we’re committed to delivering a comprehensive behavioral health experience that helps people feel seen and understood so they can get back to feeling their best.
Rula makes it easier to find a licensed therapist or psychiatric provider who accepts your insurance so you don’t have to choose between affordable care and excellent care. With a diverse network of more than 15,000 providers, 24/7 crisis support, and appointments available as soon as tomorrow, we're here to help you make progress — wherever you are on your mental health journey.
Saya Des Marais
Saya graduated with her Master in Social Work (MSW) with a concentration in mental health from the University of Southern California in 2010. She formerly worked as a therapist and motivational interviewing trainer in community clinics, public schools, mental health startups, and more.
Her writing has been featured in FORTUNE, GoodRX, PsychCentral, and dozens of mental health apps and therapy websites. Through both her clinical work and her personal OCD diagnosis, she’s learned the importance of making empathetic and accurate mental health content available online.
She lives in Portland, Oregon but you can find her almost just as often in Mexico or in her birthplace, Tokyo.
Halee Fullerton, PMHNP-BC
Halee is a psychiatric nurse practitioner with experience treating children, adolescents, and adults. She has worked in outpatient community health with children/adolescents as well as inpatient substance use disorder treatment. She currently sees patients via outpatient telehealth. Before becoming a psychiatric nurse practitioner, she worked in emergency rooms, medical-surgical units, long-term care facilities (including Alzheimer/dementia units) and the intensive care unit.
She chose a career in mental health because she wanted to help people and to contribute to breaking down stigma around mental health. She is especially passionate about working with people who are navigating substance use disorders, depressive disorders, and anxiety/trauma-related disorders. She has three labradoodles that she adores.
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