Menopausal changes at 46 linked with more anxiety and depression symptoms

Researchers analyzed information from 2,632 women taking part in the Northern Finland Birth Cohort 1966 at its 46-year follow-up. The study was prospective, meaning the cohort had been followed over time, but the reported analysis compared women’s menopausal status and mental health symptoms at age 46.

A total of 356 participants, or 13%, were classified as climacteric. This refers to being in a more advanced menopausal stage, including the transition when menstrual cycles and hormone patterns change. The researchers compared them with women described as preclimacteric, who had not yet reached that stage.

Participants completed established symptom questionnaires. Anxiety symptoms were measured with the Hopkins Symptom Checklist-25, while depressive symptoms were assessed with the Beck Depression Inventory. Researchers also used a national registry to examine purchases of psychiatric medicines.

Significant anxiety symptoms were reported by 22.6% of women in the climacteric group and 16.0% of women in the preclimacteric group. Before adjustments, the odds of significant anxiety symptoms were 1.53 times higher in the climacteric group. After accounting for smoking, alcohol use, body mass index, and education, the association remained: the adjusted odds ratio was 1.44, with a 95% confidence interval of 1.04 to 2.00.

Depressive symptoms were also more common among women in the climacteric group, reported by 30.1% compared with 24.6% of preclimacteric women. That association remained after adjustment for the study’s covariates, with an adjusted odds ratio of 1.39 and a 95% confidence interval of 1.03 to 1.85.

A second depression measure, the Beck Depression Inventory-21, found higher rates of depression in the climacteric group: 17.7% versus 13.6%. But this difference was no longer independently associated with menopausal status after the researchers adjusted for other factors.

The study also found that antidepressant purchases and purchases of benzodiazepine derivatives were more common among climacteric women between ages 40 and 57. However, after adjustment in the multivariable analysis, menopausal status was not independently linked with those medication purchases.

These results are useful because they point to a group that may report more emotional symptoms during midlife. But they cannot show that entering the menopausal transition caused anxiety or depression. Other differences between the groups, including factors not measured or not fully accounted for, could help explain the findings.

The results also come from one Finnish birth cohort, all assessed at the same age. Further research would need to examine whether the pattern is seen in other populations, how symptoms change over time, and which biological, social, or health factors may contribute.