Fact check: What illnesses can menopause cause in women, and how many and what percentage of women experience mental illness caused by menopause?

1. Startling list: What illnesses are linked to menopause and the transition

Menopause is associated with a broad array of conditions spanning mental, cognitive, and somatic domains. The studies and reviews provided list mood swings, major depressive disorder, anxiety symptoms, cognitive complaints such as brain fog, and an elevated incidence of mania during perimenopause; some sources explicitly note no clear association with schizophrenia-spectrum disorders but do highlight first-onset psychiatric presentations in midlife ^{[1] [5] [4]}. Physical symptoms such as vasomotor disturbances (hot flashes, night sweats) are not listed uniformly among the provided analyses but are identified as contributors to mental health burden in several reports, underlining a multifactorial path from hormonal change to psychiatric and cognitive symptoms ^{[1] [6]}. The literature frames menopause less as a single illness and more as a biological transition that can precipitate or unmask varied psychiatric and cognitive conditions.

2. Conflicting headcounts: How many women experience mental illness during menopause

Prevalence figures diverge notably across sources, reflecting different study designs, populations, and measurement methods. One pair of reviews cites very high symptom rates — mood swings up to 70%, depression 45–60%, and cognitive complaints near 60% — while a global meta-analysis pooled a depression prevalence of about 35.6% across menopausal stages; separate clinic- or survey-based studies report depression symptoms in 65.2% and anxiety in 52.0% of respondents ^{[1] [7] [2] [8]}. This spread indicates no single definitive percentage; instead there is a plausible central tendency in the 30–40% range for depression, with higher proportions reported in some cohorts and lower pooled estimates in others, underscoring the need to interpret any single figure cautiously ^{[2] [8]}.

3. The perimenopause danger zone: New-onset psychiatric disorders and mania risk

Multiple analyses highlight the perimenopausal window as a time of increased risk for first-onset psychiatric disorders, not just recurrence of prior illness. A specific study found that rates of mania during perimenopause were more than double those in the late reproductive stage, and major depressive disorder incidence rose in this transition period; schizophrenia-spectrum disorders did not show a similar association in that dataset ^[5]. Another population-based analysis reported elevated incidence rate ratios for common mental health diagnoses among women aged 45–54, compared with men, reinforcing a sex- and age-specific pattern ^[4]. These findings point to hormonal fluctuation or interaction with midlife stressors as plausible mechanisms, and they emphasize the clinical importance of monitoring for first presentations, not only relapse.

4. Who is most at risk: Patterns and predictive factors reported

The studies identify repeatable risk patterns: a history of depression, prominent vasomotor symptoms, and earlier menopause onset are associated with higher risk of depressive episodes during transition, while sociodemographic factors like marital status and education showed protective effects in at least one sample (married and literate women were less likely to report depression and anxiety) ^{[6] [8]}. Reported prevalence differences between perimenopausal and postmenopausal phases vary, but perimenopause commonly emerges as the highest-risk interval, especially for first-onset depression and mania ^{[5] [2]}. These findings argue for targeted screening for women with prior mood history or severe vasomotor symptoms and for clinicians to consider menopause stage when assessing midlife psychiatric presentations.

5. What the evidence omits and what clinicians and patients should watch for

The supplied analyses reveal gaps: heterogeneity in measurement, reliance on cross-sectional and web-based surveys in some reports, and limited data linking specific hormonal profiles to symptom trajectories. A scoping review calls for more research and psychoeducation programs for women with serious mental illness, signaling a system-level shortfall in tailored care ^[3]. The mixed prevalence estimates imply potential sampling bias and cultural or healthcare-access influences; some studies use symptom-screening tools rather than diagnostic interviews, inflating apparent rates relative to clinician-diagnosed disorders ^{[8] [9]}. Clinicians should therefore combine symptom screening with functional assessment, and policymakers should fund longitudinal, diverse-cohort studies to clarify true incidence and causal pathways.

6. Bottom line: Translating the evidence for patients and policy

Menopause and its transition carry a credible, evidence-based risk of depression, anxiety, cognitive complaints, and even first-onset mania for a subset of women, with prevalence estimates commonly centered around one-third for depression but with higher figures in certain samples; perimenopause is the most consistently vulnerable interval ^{[2] [5] [8]}. The heterogeneity of estimates demands nuanced clinical screening, attention to individual risk factors, and improved longitudinal research and education programs to close gaps in care.