Abstract / Summary
Abstract Background: The menopause transition is associated with hormonal, physical, and psychosocial changes that may contribute to increased mental health challenges among women. This study examined the relationship between menopause status, menopause symptom burden, mental health outcomes, perceived burdensomeness, thwarted belongingness, and unmet mental health treatment needs among adult women. Methods: This cross-sectional survey study included 368 adults who identify as female in the United States recruited between February and May 2026, with recruitment primarily focused in Wisconsin. Participants were categorized as other/pre-menopause (n = 124), likely perimenopause (n 112), or post-menopause (n – 132). Linear and logistic regression models were used to examine associations with menopause status and menopause symptom count. Adjusted models controlled for age, race, annual household income, and education. Results: Greater menopause symptom burden was consistently associated with poorer mental health and psychosocial outcomes. Each additional menopause symptom was associated with higher depression, anxiety, perceived stress, perceived burdensomeness, and thwarted belongingness scores and a 35% increase in the odds of unmet mental health treatment need (OR = 1.35, 95% CI 1.18–1.57, p < .001). Compared with women in the other/pre-menopause group, women classified as likely perimenopausal had significantly higher scores for depression (β = 3.8, p < .001), anxiety (β = 3.2, p < .001), and perceived stress (β = 3.4, p = .001). Postmenopausal women also had significantly higher depression (β = 4.2, p < .001), anxiety (β = 3.4, p < .001), and perceived stress scores (β = 2.4, p = .025). Menopause status was not significantly associated with perceived burdensomeness or thwarted belongingness. Postmenopausal women had greater odds of reporting an unmet mental health treatment need compared with women in the other/pre-menopause group (OR = 2.77, 95% CI 1.26–6.28, p = .013). Conclusions: Menopause status and symptom burden were associated with poorer mental health outcomes, with symptom burden showing associations across broader range of outcomes. Routine assessments of menopause symptoms and mental health concerns may help identify women who could benefit from additional mental health support during these phases of life.