Perimenopause Mental Health: Why Workplaces Must Act Now to Support Midlife Women

For years, the dominant narrative around perimenopause focused on hot flushes and irregular periods. But the data are becoming undeniable: this transition is often a mental health tipping point for midlife women, particularly those balancing high-pressure careers, family life, and societal expectations.

Escalating Impact on Mental Health

Emerging research continues to spotlight the psychological effects of perimenopause. A 2024 meta-analysis in The Lancet Psychiatry concluded that women in perimenopause are two to four times more likely to experience depressive symptoms than premenopausal women¹. Notably, the presence of these symptoms is independent of a prior mental health diagnosis.

Brain fog, irritability, and insomnia — once dismissed as "normal ageing", now appear linked to neuroendocrine changes that disrupt serotonin, dopamine, and GABA pathways². A lack of awareness about these mechanisms can result in misdiagnosis or inappropriate treatment, often with antidepressants instead of hormone therapy.

Suicide Risk: The Hidden Toll

Suicidal ideation during perimenopause is no longer anecdotal. In 2023, a UK-wide health study revealed that 20% of perimenopausal women aged 45–55 had experienced recent suicidal thoughts, compared to 6% of their male peers³. The disparity is not purely hormonal — it's structural.

In Australia, the suicide rate for women aged 50–54 rose to 9.1 per 100,000 in 2022, compared to 5.5 just a decade earlier⁴. Suicide Prevention Australia attributes this spike to “compounded midlife stressors worsened by hormonal transitions and social stigma”⁵.

The Price of Inaction in the Workplace

These mental health impacts have real organisational consequences. Deloitte’s 2023 She Leads report estimated that nearly 25% of women in mid-to-senior roles consider leaving their jobs due to unmanaged perimenopausal symptoms, citing loss of confidence, impaired cognition, and anxiety as major factors⁶.

Despite the growing awareness, only 11% of Australian workplaces have formal menopause policies or training for managers⁷. This leaves many high-performing women unsupported, leading to preventable burnout, absenteeism, and premature exits from the workforce.

Rethinking HRT and Workplace Health

Hormone Replacement Therapy (HRT) remains one of the most effective interventions — yet it’s still widely underused. According to the 2024 Global Menopause Health Report, only 13% of eligible Australian women are prescribed HRT⁸.

This underutilisation stems partly from persistent myths stemming from the original 2002 WHI study. However, long-term follow-ups and updated clinical reviews continue to show that, for most women under 60, HRT is not only safe — it’s often life-changing.

Dr Sarah White, a menopause GP based in Melbourne, notes:

“We’re not just treating symptoms, we’re treating the loss of identity, purpose, and confidence that creeps in when mental health deteriorates during midlife transitions.”

Leadership Needs to Lead

Perimenopause affects women at their career peak — and current systems are not keeping pace. Leaders and HR teams must move from silence to strategy by:

• Embedding menopause awareness into corporate health and wellbeing policies

• Providing access to mental health support tailored to hormonal shifts

• Offering flexible work arrangements for symptom management

• Normalising discussions of midlife transitions in leadership development programmes

A proactive stance not only improves retention and wellbeing, it signals a culture that values experience, equity, and long-term leadership sustainability.

More Than a Women’s Issue

Addressing perimenopause is not just about health — it's about human capital. When organisations fail to support midlife women, they risk losing some of their most capable, creative, and emotionally intelligent leaders.

The conversation must shift from coping to capability — recognising that with the right support, midlife is not a career setback, but a time of profound resilience and transformation.

Resources

If you or someone you know is struggling with perimenopausal mental health challenges, contact:

• Lifeline Australia: 13 11 14

• Beyond Blue: 1300 224 636

• Jean Hailes for Women’s Health: www.jeanhailes.org.au

• Your GP or accredited menopause specialist

Footnotes

1. The Lancet Psychiatry, “Hormonal Transitions and Risk of Depression in Midlife Women”, 2024.

2. Harvard Health Publishing, “How Hormones Affect the Brain During Menopause”, 2023.

3. UK Women’s Mental Health Consortium, “Midlife Mood Survey”, 2023.

4. Australian Bureau of Statistics, “Suicide Data by Age and Sex”, 2022.

5. Suicide Prevention Australia, “Women’s Mental Health in Midlife”, Trends Report, 2023.

6. Deloitte, She Leads: Women in Corporate Leadership, 2023.

7. Workplace Gender Equality Agency (WGEA), “Menopause and the Modern Workplace”, 2023.

8. Global Menopause Health Report, 2024 – Australasian Chapter.