Anxiety, depression, and their co-occurrence among menopausal women aged 30 to 49 years in Bangladesh: Evidence from the 2022 Bangladesh Demographic and Health Survey

Abstract Anxiety and depression are important contributors to women’s mental health burden, and the menopausal transition may increase vulnerability to both conditions. Evidence on menopausal mental health in South Asia, especially in Bangladesh remains limited. Thereby, this study aimed to estimate the prevalence of anxiety, depression, and their co-occurrence among menopausal women aged 30–49 years in Bangladesh and to identify socio-demographic factors independently associated with these outcomes. Data were obtained from the nationally representative 2022 Bangladesh Demographic and Health Survey. The analysis included 2,182 menopausal women aged 30–49 years. Anxiety and depression were assessed using the GAD-7 (cutoff ≥ 6) and PHQ-9 (cutoff ≥ 10), respectively. Survey-weighted bivariate analyses and multivariable logistic regression were performed. Associations were reported as adjusted odds ratios (AORs) with 95% confidence intervals. The weighted prevalence of anxiety, depression, and co-occurring anxiety and depression was approximately 26%, 7%, and 6%, respectively. Being widowed, divorced, or separated was associated with higher odds of anxiety (AOR = 1.63), depression (AOR = 1.78), and co-occurrence (AOR = 1.77). Anxiety was also associated with healthcare access problems (AOR = 1.52) and household decision-making participation (AOR = 1.57). Depression and co-occurrence were associated with administrative division and internet use, while depression was additionally associated with religion and age at first marriage. Anxiety was more prevalent than depression among menopausal women in Bangladesh. Marital dissolution was consistently associated with all three outcomes. These findings highlight the need to strengthen mental health screening and support for menopausal women, particularly those experiencing marital loss or barriers to healthcare access.