An Analysis of Mental Health in Menopause

Menopause is a major life transition and is frequently accompanied by significant symptoms. While many complaints are often addressed by healthcare providers, many others are frequently left out of the discussion. While these symptoms are significantly detrimental to quality of life and effective treatments are available, many symptoms of menopause remain under-addressed. Mental health symptomatology such as depression, cognitive changes, and decline in libido are common and frequently distressing in the menopause transition and are well worth focused attention. Depression in menopause is well treated by selective serotonin reuptake inhibitors (SSRIs) but may also benefit from treatment with menopausal hormone replacement therapy (HRT) in some cases. Cognitive changes can be treated with HRT in some cases but reassurance regarding dementia risk is also warranted. Loss of libido is well treated by HRT but openness of providers in introducing this topic is of particular importance here due to frequent reticence on the part of patients to do so. In the absence of contraindications, HRT is an effective course of treatment for many menopausal symptoms but common misconceptions regarding risks have corresponded with a reduction in treatment. Proactive initiation of screening and discussion by providers is of great importance.