"There needs to be more research done so that treatments can be developed, and it is very important that women who have previously had PP are made aware of the risks. Forewarned is forearmed in my mind."

On this page

  • Mental health during the menopause.
  • Postpartum psychosis and the menopause.
  • Talking to health professionals.
  • Treatment during the menopause.
  • Hormone Replacement Therapy (HRT) and mental health medication.
  • Support from APP.

postpartum psychosis and the menopauseMental health during the menopause

Many women experience poor mental health during the menopause and perimenopause (the months or years before your periods stop).

If you have experienced PP and/or have a diagnosis of bipolar disorder and you are approaching menopause, you may be worried about:

  • whether you will experience further episodes of illness,
  • where to get the best advice,
  • what support is available if you do become unwell, and
  • how HRT interacts with any medications you are taking for your mental health.

This page has some more information on the research and support currently available.

Postpartum psychosis and the menopause

Some studies suggest women who have had PP and/or bipolar disorder are at higher risk of depression, anxiety, mania and (more rarely) psychosis during perimenopause and menopause. Much more research is needed.

This video has more information on the menopause and bipolar disorder.

Talking to health professionals

It is important to seek support from your GP, psychiatrist, or mental health team as early as possible if you notice changes in your mood alongside other symptoms of menopause.

Most health professionals do not receive training in the menopause. It is important to make them aware of your mental health history as well as your concerns. You might find it helpful to use these checklists to monitor your symptoms over time and start a conversation with your GP.

If you do not get the attention and answers you want from your GP, it is ok to ask for a second opinion from another doctor.

The Cardiff University Psychiatry service offers specialist advice on the menopause and mental health. The service is free and can be accessed via Zoom. You will need to ask your GP, psychiatrist or other health professional to refer you.

Treatment during the menopause

Hormone Replacement Therapy (HRT) is currently recommended to be the first option for treating symptoms of menopause, including mood symptoms. This is because it is the reduction or fluctuation of certain hormones that often lead to mood symptoms such as low mood and anxiety.

Some people need psychiatric medication such as anti-depressants or anti psychotics as well or instead of HRT. There is more information about anti-depressants and the menopause here.

Talking therapy is also offered to people who are struggling with anxiety or low mood. Working closely with your health professionals can help you find an approach to treatment that is right for you.

HRT and mental health medication

Some medications for mental health conditions are affected by HRT.  For example, HRT can lower the levels of the mood stabiliser Lamotrigine in your body.  You can check for interactions between HRT and other medications here and ask your health professional to discuss these with you.

Support from APP

APP is here for you throughout your life. You can connect with other women with experiences of worsening mental health during menopause in our peer support community. Find peer support here.