Menopause is nearly universal-but its mental health risks remain dangerously under-recognized across Europe and the US. A Royal College of Psychiatrists survey found only 28% of women knew menopause could trigger new psychiatric illness.
Perimenopause-beginning as early as the 30s-brings erratic oestrogen and progesterone shifts. These drive not just hot flushes and insomnia, but mood instability, anxiety, and first-time major depression-up 30% in perimenopause, per European research.
Sonja Rincón, founder of Menotracker, was misdiagnosed with depression at 35. She spent years on ineffective antidepressants before self-diagnosing perimenopause at 41-and demanding hormone replacement therapy.
A 2026 Liverpool John Moores University study found 16.6% of women experience untreated suicidal thoughts during perimenopause and menopause. Professor Pooja Saini warns clinical tools often ignore hormonal drivers-creating dangerous gaps in care.
Workplace impact is severe: Astellas Pharma’s 2025 study of 13,800 workers found 1 in 12 women faced menopause-related discrimination-and only 24% felt safe discussing it with managers.
Rincón attributes the crisis to decades of gender bias in medicine: women were excluded from U.S. clinical trials until 1993. The Royal College of Psychiatrists now urges mandatory menopause training for all clinicians-and national workplace policies.