Author: Pia Lustig, Psychology student and intern at FemiLab, Lausanne University Hospital, Switzerland | Editor: Romina Garcia de leon (blog coordinator)
Published: May 24th, 2024
There is a wide range of factors that contribue to depression during menopause; including genetic markers, previous depression history, and menopause symptoms. However, If we look beyond biology, could there be other reasons why women across the world experience menopause so differently? And how much of a factor does society, and the narratives around menopause affect lived experience of this transition?
The natural menopause transition normally starts around mid-forties and continues for 5-10 years. As the body prepares for the “post-fertility” phase, a woman can experience a spectrum of symptoms, including hot flashes and night sweats, insomnia, weight gain, and vaginal dryness. However, there are certain social factors that are also at play. As is the case in many cultures, women are more likely to be caretakers of elderly parents, the primary caretaker of children and household duties. Moreover, women carry out more than 2.5 times more unpaid care work and household duties than men. Balancing the many responsibilities between home, work, and relationships may lead to burn out. When menopause is added to the equation, this becomes further excacerbated. Suddenly, physiological changes come into play. Vasomotor symptoms such as sleeplessness combined with hormonal fluctuations might make everyday life feel like an emotional rollercoaster. Moreover, symptoms like vaginal dryness, hair growth in unwanted places and excessive weight which may lead to feelings of shame and insecurities.
Research shows that women´s self-perception influences overall moods during the menopause transition. If their perception of the transition is more positive, women are less likely to develop depression. The kind of messages women receive from their immediate circle – family and friends –are pivotal in shaping their perceptions and reducing the risk of depression. Can they openly discuss their experiences around menopause, and do they receive the support they need? Equally important is the workplace environment. Are they understanding and accommodating of the possible symptoms women may be facing during working hours? How is the media representing women in midlife? Are women represented in a way that emphasizes their worth beyond youth, or are they overlooked and deemed less relevant, less attractive? Is menopause even talked about publicly, or does it remain a topic shrouded in silence and shame?
The messages from the environment are closely linked to the broader culture that shapes women's experiences, including societal attitudes toward women’s health. Globally, the risk of depression is twice as high for women as for men, research shows that women in Western societies experience higher rates of depression during the menopause transition. Furthermore, when looking at self-reported menopausal symptoms, some groups of women in Asia and Latin America hardly report symptoms at all. To understand why women´s experiences are so different, we may need to focus on society´s perceptions about women during this time in their lives, and to what extent the external environment is providing support. In some cultures, status is elevated passing the childbearing years. For example, for Taiwanese women menopause is viewed in a positive and holistic light. If societal perceptions influence menopausal symptoms and depression risk - this is an important avenue to focus on.
Can we support women going through the menopause transition better as a society and as loved ones? Viewing menopause-related risk for depression from a broader perspective could help us better understand how to best support women in these transitional stages. We might discover that support networks and positive messages from the environment may be part of the key that solves the puzzle.