Menopause is a significant life transition that affects both the body and the mind. While many women anticipate physical symptoms like hot flushes and irregular periods, fewer expect the emotional toll it can take. Mood swings, anxiety, brain fog and even depression are common, often leaving women feeling unlike themselves.

The hormonal fluctuations during menopause, particularly the decline in oestrogen and progesterone, can impact neurotransmitters like serotonin, which regulate mood and energy levels. These changes can lead to increased anxiety, panic attacks, low mood, irritability, mood swings, and difficulty concentrating — often referred to as “brain fog.”

In addition to biological shifts, menopause often coincides with other major life transitions, such as children leaving home, ageing parents and career shifts, all of which can add extra stress. Changes in body shape, such as weight gain, despite maintaining healthy eating habits and staying active, can also contribute to emotional distress. Many women describe feeling as though their bodies have betrayed them, which can be particularly difficult. These challenges can leave women feeling overwhelmed, with low motivation and difficulty concentrating.

As a clinical psychologist specialising in body image, I often see women who struggle with these unexpected changes and the emotional strain they cause. Managing mental health during menopause begins with acknowledging these changes, seeking support, and implementing strategies that promote emotional wellbeing.

Here are five key, research-backed, strategies I use with my clients to help them manage mental health during this time:

1. Acknowledge the changes without judgement
   Menopause is a natural process, not a sign of weakness or failure. Many women feel frustrated by emotional ups and downs, but practising self-compassion is essential. Recognising that your feelings are valid — and often temporary — can help ease distress.
2. Prioritise sleep and rest
   Sleep disruptions are common during menopause, and poor sleep can significantly affect mood and cognitive function. Establishing good sleep hygiene — such as limiting screen time before bed, reducing caffeine, creating a relaxing bedtime routine and maintaining a consistent sleep schedule — can improve sleep quality and overall mental wellbeing.
3. Stay physically active
   Exercise is one of the most effective ways to support mental health during menopause. It helps regulate mood, reduce stress and improve sleep.
4. Manage body image with compassion
   Changes in body shape, such as weight gain, can be difficult to accept during menopause, especially when they feel out of your control. It’s important to practise self-compassion and challenge negative thoughts about your body. Focus on what your body can do rather than how it looks. Embrace a positive relationship with food, exercise, and self-care. Remember that your worth is not defined by your appearance and be gentle with yourself as you adjust to these changes.
5. Seek support — You’re not alone
   Many women suffer in silence, but talking about menopause can be incredibly validating. Connecting with a trusted friend, joining a support group, or consulting a healthcare professional can reduce feelings of isolation and provide practical strategies for managing symptoms.

If low mood, anxiety or brain fog significantly affects your daily life, reaching out to a GP, psychologist or menopause specialist can be helpful. Various treatment options — including therapy, lifestyle adjustments and hormone therapy — can make a meaningful difference in managing symptoms.