Hormonal fluctuations during perimenopause and menopause can significantly impact mental health, triggering mood swings, insomnia, anxiety, and depression. General practitioner Dr Louisa Albertyn highlights that progesterone decline drives insomnia and anxiety, while estrogen fluctuations cause hot flushes, pointing to hormone replacement therapy as a primary first-line treatment option.
When a woman navigates perimenopause and menopause, the accompanying hormonal shifts deliver far more than physical changes like hot flushes. They frequently alter mental well-being, introducing mood swings, sleep disturbances, anxiety, and depression. General practitioner Dr Louisa Albertyn explains that menopause simply marks the point when monthly periods stop once a woman’s lifetime supply of eggs is exhausted.
Perimenopause serves as the transitional phase preceding this milestone, which can last anywhere between four and 10 years. Women entering menopause in their 30s experience what medical professionals call premature ovarian insufficiency. According to insights shared by Dr Louisa Albertyn during a Q&A session hosted by the SA Depression and Anxiety Group, every menopause symptom can manifest during this prolonged transition.
Tracking the Hormonal Shift: Estrogen and Progesterone Decline
During perimenopause, hormonal levels fluctuate wildly before eventually flatlining in menopause when the ovaries stop producing them entirely. Estrogen levels surge and drop unpredictably, while progesterone steadily declines. Albertyn points out that the decline in progesterone causes, most commonly, insomnia and anxiety. Insomnia subsequently disrupts how both the body and brain function the following day.
While estrogen fluctuation drives hot flushes and mood changes, the hormone also plays a vital role in protecting the brain and cardiovascular system. Furthermore, estrogen helps prevent osteoporosis, a medical condition that leaves bones weak and fragile. Women also maintain small amounts of testosterone, which influences sexual health. Issues with testosterone can lead to hypoactive desire disorder, marked by a low or absent interest in sex, alongside difficulties with arousal, orgasms, and vaginal dryness.
Physical Activity, Eco-Anxiety, and Well-Being in Climate Disasters
Beyond internal hormonal transitions, external environmental factors like climate-driven natural disasters present distinct psychological challenges. Natural disasters such as floods serve as major sources of eco-anxiety for young people, posing serious threats to overall human well-being. A study examining these dynamics found that adolescents’ well-being shares a low negative significant correlation with eco-anxiety and a low positive significant correlation with physical activity frequency.
However, researchers discovered non-significant correlations between eco-anxiety and both flood disaster experiences and physical activity frequency when analyzing total participant scores. Despite this, moderated moderation analyses revealed that physical activity frequency significantly moderates the role of flood disaster experiences on the relationship between eco-anxiety and adolescent well-being. Simple slope analysis revealed that the effect of eco-anxiety on well-being is significantly moderated by flood experience disaster in adolescents with low levels of PA frequency, whereas moderate or high physical activity participation buffers this effect.
First-Line Medical Interventions for Hormonal Transitions
Addressing the wide-ranging symptoms of hormonal decline requires careful medical management. Albertyn notes that health practitioners should always remain mindful of fluctuating hormones in women. To stabilize hormones, clinicians may prescribe a low-dose contraceptive pill or hormone replacement therapy, which allows women to maintain regular monthly periods until they reach a full year without menstruating.
Hormone replacement therapy is administered through patches, gels, and tablets. Safety guidelines require specific adjustments based on patient medical history. If you’ve had breast cancer, then you can’t have HRT, according to Albertyn. For patients who smoke or have experienced blood clots, oral hormone replacement is avoided in favor of transdermal applications through gels or patches to minimize risks while protecting bone density, brain function, and cardiovascular health.
