Women In Perimenopause Report More Anxiety Than Other Menopausal Groups

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A systematic review of 21 studies covering 24,523 women found that anxiety symptoms were reported more often among perimenopausal and postmenopausal women than among premenopausal women. Perimenopause had the highest odds in the comparisons, but the observational findings do not show that menopause causes anxiety or that anxiety rises within individual women over time.

A systematic review and meta-analysis of 21 studies involving 24,523 women found that women in perimenopause had higher odds of reporting anxiety symptoms than premenopausal women, with postmenopausal women also showing higher odds. The findings, published in Scientific Reports, describe an association between menopausal stage and reported anxiety; they do not establish that menopause causes anxiety.

Researchers included observational studies from multiple countries and used data from 15 studies in the pooled meta-analysis. Compared with premenopausal women, perimenopausal women had 59% higher odds of reporting anxiety symptoms. Postmenopausal women had 63% higher odds than the premenopausal group.

In a direct comparison between the two later stages, postmenopausal women had 21% lower odds of reporting anxiety than perimenopausal women. That comparison suggests the highest odds were during perimenopause, but the results varied substantially across studies. Odds describe group-level comparisons; they do not mean that 59% more women in an individual population will necessarily experience anxiety.

The review considered cross-sectional and longitudinal observational research that assessed anxiety with standardized questionnaires, interviews or scales containing anxiety items. The meta-analysis used baseline observations from longitudinal studies alongside cross-sectional data. One study rated as low quality was excluded from the pooled analysis after the researchers assessed study quality.

Why Perimenopause Merits Attention

The findings may help clinicians and health services recognize that anxiety symptoms are reported across the menopause transition, particularly in the perimenopausal group in these comparisons. This matters because symptoms that affect mental health can be relevant to care during a period marked by changes in menstrual cycles and other physical experiences.

The review also points to a gap between evidence and guidance. The source report says the World Health Organization recognizes anxiety as a possible menopause-related symptom, while UK National Institute for Health and Care Excellence guidance does not explicitly list anxiety as a menopausal symptom, though it addresses other psychological symptoms. The study could inform future discussion of clinical guidance, but it does not itself establish a treatment recommendation or show which approach to care is effective.

For readers, the central message is an association, not a diagnosis: the group-level findings cannot determine why any one person feels anxious. Anxiety can have multiple contributing factors, and the review does not show that menopausal stage is the cause in a particular case.

How Researchers Compared Menopausal Stages

Menopause is defined as the permanent end of menstrual periods, identified retrospectively after 12 consecutive months without menstruation when no other cause explains the absence. Perimenopause precedes it and can involve irregular cycles. The review compared anxiety reports across premenopausal, perimenopausal and postmenopausal groups using defined staging criteria.

Researchers searched MEDLINE, PsycINFO, Embase and Web of Science for eligible studies from the databases’ inception through August 16, 2024. The review followed PRISMA reporting guidance and included studies using STRAW+10 criteria or equivalent definitions. Studies involving surgical menopause or co-occurring physical or psychiatric conditions were excluded, limiting the populations covered by the findings.

The report frames the work as addressing uncertainty left by earlier reviews, including a 2012 narrative review that could not pool quantitative estimates and did not use standardized staging criteria. The newer analysis provides pooled comparisons, but its evidence remains observational rather than experimental.

“Perimenopausal and postmenopausal women had significantly higher odds of anxiety symptoms compared with their premenopausal counterparts, with the highest odds observed during perimenopause.”

— The review authors, as summarized by News-Medical

What the Evidence Cannot Establish

The studies were observational, so the analysis cannot establish that menopause causes anxiety. It also does not show that anxiety symptoms increase within the same women as they move from one stage to another: the pooled comparisons are between groups, and the meta-analysis used only baseline observations from longitudinal cohorts.

Results varied substantially between studies, and the review excluded certain populations, including women experiencing surgical menopause and those with co-occurring physical or psychiatric conditions. The supplied report does not provide enough detail to determine how differences in participants, settings or measurement tools affected the variation. It also does not establish whether the findings apply equally across countries or to women with different health histories.

The authors proposed that hormonal fluctuations, sleep disruption and symptoms such as hot flashes could interact with mental health, but these are possible pathways discussed in the report, not mechanisms proven by this meta-analysis. The evidence does not identify a single explanation for the higher odds observed during perimenopause.

Questions for Future Menopause Research

The review may inform future research and discussion of mental-health guidance during menopause, but the supplied report does not identify a specific policy decision or follow-up study that has been announced. Further research could track women over time, use consistent definitions of menopausal stage and anxiety, and examine how symptoms and other health factors relate to changes in anxiety reports.

For now, the reported findings support awareness of anxiety across menopausal stages without resolving cause, individual risk or the best response to symptoms. Anyone concerned about anxiety or other mental-health symptoms should discuss them with a qualified health professional, who can consider the person’s circumstances and possible causes.

Key Questions

What did the review find about anxiety during perimenopause?

Compared with premenopausal women, women in perimenopause had 59% higher odds of reporting anxiety symptoms in the pooled analysis. This is a group comparison, not a prediction for any individual.

Did postmenopausal women also report higher anxiety?

Yes. The analysis found 63% higher odds of reported anxiety among postmenopausal women compared with premenopausal women. In the direct comparison, postmenopausal women had 21% lower odds than perimenopausal women.

Does the study prove menopause causes anxiety?

No. The review combined observational studies, which can identify associations but cannot establish that menopause causes anxiety or that symptoms rise within the same person over time.

How many women and studies were included?

The review covered 21 studies and 24,523 women. Fifteen studies contributed to the meta-analysis comparing anxiety reports across menopausal stages.

What should someone do if they have anxiety symptoms?

The study does not provide individual medical advice or recommend a specific treatment. People concerned about anxiety should speak with a qualified health professional about their symptoms and circumstances.

Source: rss