Early menopause raises depression risk, calls for mental health screening

Women with premature ovarian insufficiency face significantly higher risks of depression and anxiety, prompting experts to call for routine mental health screening

For some women, the symptoms of menopause arrive far earlier than expected - not in their late 40s or 50s, but sometimes as early as their 30s or even 20s. This condition, known as premature ovarian insufficiency (POI), occurs when the ovaries stop functioning before the age of 40. It leads to reduced fertility and a sharp drop in reproductive hormones, triggering a cascade of physical and emotional changes.

 

While the physical effects of POI — such as irregular periods, hot flashes, and infertility — are well known, a growing body of research is shedding light on its psychological impact. A new study has found that women with POI face a significantly higher risk of depression and anxiety, prompting experts to call for better mental health support and integrated care.

 

 

  According to the Cleveland Clinic, POI differs from natural menopause in both timing and cause. It may strike much earlier than expected, especially in women over 30, though it can sometimes begin in the teens or twenties.  A 2024 study published in Nature found that five per cent  of  Indian women in rural areas and three per cent in urban areas experience premature menopause — with rates varying across states.

 

Some common symptoms for POI include:

• Irregular or missed periods
• Decreased sex drive
• Difficulty concentrating
• Irritability
• Dry eyes
• Hot flashes and night sweats
• Infertility
• Painful sex due to vaginal dryness

But what’s less commonly discussed is its impact on mental health.

 

How POI increases the risk of depression and anxiety

 

A new study published in The Menopause Society journal has found that women with POI report significantly higher levels of depressive symptoms. The study found that nearly one-third (29.9 per cent) of the women with POI, participating in the study, suffered from depressive symptoms. They were also about three times more likely to have depression and about five times more likely to have anxiety.

 

These results highlight the importance of comprehensive care, addressing both physical and psychological aspects of menopause at an early age.

 

According to researchers, several factors may contribute to this:

 

Hormonal disruption: The sharp decline in oestrogen can affect brain function and mood regulation.

 

Early loss of fertility: For many, this comes as a shock, leading to feelings of grief, loss, and lowered self-worth.

 

Lack of awareness and late diagnosis: Many women are misdiagnosed or left untreated, compounding distress.

 

The researchers additionally found that a younger age at POI diagnosis, severe menopause symptoms, fertility-related grief, and lack of emotional support were some of the risk factors.

 

Why experts are calling for mental health screening in POI care

 

Dr Monica Christmas, associate medical director at The Menopause Society, highlighted the importance of routine mental health screening in women with POI, noting that the high rates of depressive symptoms make this a vulnerable group.

 

She added, “Although hormone therapy is recognised as the standard of care for those with POI for management of some menopause-related symptoms and preventive care, it is not first-line treatment for mood disorders. This was evident in this study in which there was no difference in depressive symptoms between those using hormones and those not using hormone therapy. Addressing behavioural-health concerns with evidence-based interventions should be part of any comprehensive POI care plan.” 

 

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This report is for informational purposes only and is not a substitute for professional medical advice.