University of Edinburgh

3

OFHS240155

This study's main aim is to find out whether women* are at increased risk of needing to stay in a mental health (psychiatric) hospital, when they are going through perimenopause. Perimenopause is the time when a woman’s body is getting ready to stop having periods (known as ‘menopause’). In perimenopause, the periods have not stopped yet, but women have other menopause symptoms like hot flushes, anxiety, or insomnia. Scientists already know that perimenopause or early postmenopause (the years shortly after periods stop) is a time of worse mental health for many. The risk of having to spend a night or more as a patient in a hospital specialising in mental health (psychiatric hospital) has never been researched. This is what this study is hoping to investigate. The study will also ask what factors make it more likely that a woman spends a night in a mental health hospital around her menopause. For example, previous mental health difficulties. It will also look at patterns in men of a similar age, for comparison. * It is important to note that some people don’t feel they are women but were born female, and so still go through menopausal changes. The association of the years around the menopause with mental health (psychiatric) hospital admission has never been studied. This is the major knowledge gap addressed by this study. The years around the menopause are associated with an increase in clinically significant symptoms of depression and anxiety. These symptoms are experienced by about a fifth of women with no previous mental health problems and around half of women with previous mental health problems. This time is also associated with a doubling of the risk of recurrence of depressive disorder, and an increased risk of first onset depression and bipolar disorder. However, the association of the years around the menopause with mental health (psychiatric) hospital admission has never been investigated, and there is very little data on diagnoses such as anxiety and psychosis. Describing the association between menopausal stage and hospital admission, whether it is different for different mental health diagnoses, and whether any risk factors can be identified will be important in informing decision making by patients and clinicians and in planning services.

Around 50% of the population will experience the menopause. The link between menopause and mental health is gaining increasing public awareness but more scientific evidence is needed. The years before and after the menopausal transition are a time when many women experience new or worsening mental health symptoms, including developing severe mental illnesses. However, the degree to which mental health symptoms around the time of menopause result in important real world outcomes such as hospital admission is unknown. Any risk factors are also unknown. This information would be useful to the public by allowing more informed choices and better anticipation in the form of relapse prevention plans. For example, if someone has had a previous mental health disorder related to reproductive factors (e.g. postnatal depression), does this increase their risk of requiring admission during menopause? If someone has previously required hospital admission, is an admission during menopause likely to be of longer duration?

Public Health Research

09/03/2025

09/03/2025

TRE