Perimenopausal women are more likely to experience mania and major depressive disorders, according to new research by Cardiff University.
In a study of 128 294 women across the UK, a team from the University’s School of Medicine and Bipolar UK investigated whether perimenopause – the years surrounding the final menstrual period - is associated with an increased risk of developing psychiatric disorders.
The study emerged from the first-hand experiences of women lead academic Professor Arianna Di Florio was seeing in her mental health clinic.
'During perimenopause - the years around the final menstrual period - approximately 80% of people develop symptoms, including hot flushes, cognitive dysfunction, sleep disturbances and mood-related symptoms. But the extent of the impact on the onset of severe mental illness was unknown,' said Professor Di Florio who was awarded an ERC Starting Grant in 2020.
'In my clinic, I found that some women, previously living lives without any experience of severe mental health issues, developed severe mental illness around the time of the menopause.'
'I feel a duty towards the women I work with. I wanted to provide them and other women with the answers to why they were feeling this way,' she added. The study is the first known investigation into the link between first-onset psychiatric disorders in the years around menopause.
The team focused on the four years surrounding the final menstrual period and found that incidence rates of psychiatric disorders significantly increased compared to the 6 to 10 years prior. An 112% increase in incidence of mania was observed at perimenopause. Onsets of major depressive disorder were found to increase by 30%.
There was no association found between perimenopause and the onset of schizophrenia spectrum disorders.
The increased risk of mania and major depressive disorder was linked with the narrow four-year perimenopausal timeframe, and the risk decreased significantly once women entered the post-menopausal stages.
Professor Di Florio said: 'Research like this is vital, as women experience these profound changes in their lives and bodies and are currently let down by the lack of detailed understandings of these changes.'
'We have been able to expand our knowledge of the mental health changes associated with perimenopause, which can help provide explanations, diagnoses and support for women who have previously been left in the dark about what is happening to them.'
Clare Dolman, Ambassador for Bipolar UK and Patient and Public Involvement Lead on the project, said: 'This study is extremely important as it demonstrates for the first time in a very large sample that the menopausal transition has a measurable impact on women’s mental health.
'For me, this confirms what we have observed and heard from women with bipolar themselves; that hormonal change is a very important factor in mood disorders and one that deserves to be researched thoroughly.'
'As a woman with bipolar myself who has gone through menopause, I am looking forward to the research community recognising the importance of this funding. The studies will allow us to predict an individual woman’s risk of becoming unexpectedly ill at this time of life. That knowledge could be life-saving.'
The study focussed on first-onset experiences of psychiatric disorders during perimenopause but didn’t investigate links with the recurrence of pre-existing psychiatric disorders in perimenopause. Further research focussing on people with a previous history of mental illness is needed.
The research, Exploration of first onsets of mania, schizophrenia spectrum disorders, and major depressive disorder in the perimenopause, was published in Nature Mental Health, and was funded by the European Research Council.
About Cardiff University
Cardiff University is recognised in independent government assessments as one of Britain’s leading teaching and research universities and is a member of the Russell Group of the UK’s most research intensive universities. The 2021 Research Excellence Framework found 90% of the University’s research to be word-leading or internationally excellent. Among its academic staff are two Nobel Laureates, including the winner of the 2007 Nobel Prize for Medicine, Professor Sir Martin Evans. Founded by Royal Charter in 1883, today the University combines impressive modern facilities and a dynamic approach to teaching and research. The University’s breadth of expertise encompasses: the College of Arts, Humanities and Social Sciences; the College of Biomedical and Life Sciences; and the College of Physical Sciences and Engineering. Its University institutes bring together academics from a range of disciplines to tackle some of the challenges facing society, the economy, and the environment.
