Menopause, grief and suicide bereavement: Understanding the intersection
By Nima Nair, Service Manager
October is World Menopause Month - a global opportunity to raise awareness of the menopause and its wide ranging impact on the lives of women. At Suicide&Co, we also work with people who are navigating menopause alongside suicide bereavement. This piece explores how menopause interacts with grief, with particular attention to those bereaved by suicide.
How menopause impacts hormones
Menopause typically involves a decline of oestrogen and progesterone levels.
Oestrogen plays a significant role in regulating mood, sleep, cognition and emotional processing. As levels decline, the brain's neurochemical landscape shifts. Production of serotonin, the neurotransmitter closely associated with mood stability, is reduced, and the brain's capacity to regulate emotional pain can be compromised. Dopamine and noradrenaline are also affected, which can impact motivation, concentration and resilience.
Cortisol, the body's primary stress hormone, can become dysregulated during perimenopause and the menopause, meaning that the stress response is heightened and recovery from stressful events takes longer. For someone who is also carrying the weight of suicide bereavement, this has significant implications.
Menopause and mental health: what the evidence says
Research using data from the 2014 Adult Psychiatric Morbidity Survey found evidence of an association between menopausal stage and depression, with clinicians advised to be aware of this link in order to best support women. A 2025 qualitative study published by Liverpool John Moores University explored the mental health challenges, including suicidality, experienced by women during perimenopause and menopause, finding that mental health struggles during this transition are significant and often overlooked.
Research from the University of Bristol, published in the British Journal of General Practice in October 2025, found that many women aged 45 to 55 who visit their GP with mental health concerns may not realise their symptoms could be linked to perimenopause, and that GPs often do not ask. Time pressures and a lack of menopause-specific training were cited as barriers to better support.
Common mental health presentations during menopause include depression, anxiety, irritability, low self-esteem, cognitive difficulties often described as brain fog, and disturbed sleep. These symptoms can be mistaken for clinical depression or anxiety disorders, and may be treated without the underlying hormonal context being recognised.
When menopause and suicide bereavement collide
For people who are bereaved by suicide during perimenopause or menopause, the two experiences can intensify one another in significant ways:
Emotional dysregulation: the hormonal changes of menopause reduce the brain's capacity for emotional regulation at precisely the time when grief is demanding the most of it. Feelings of guilt, shame, anger and despair, already heightened in suicide bereavement can feel more intense and harder to manage.
Sleep disruption: both grief and menopause significantly disrupt sleep, through night sweats, hot flushes, anxiety and intrusive thoughts. Sleep deprivation compounds every aspect of grief, impairing cognitive function, emotional resilience and the capacity to seek help.
Cognitive difficulties: brain fog during menopause can affect memory, concentration and executive function. When layered with the cognitive impact of traumatic loss, which research consistently shows impairs processing and decision-making, the effect can be profound.
Identity and meaning: suicide bereavement often ruptures a person's sense of identity and their assumptive world. Menopause can bring its own identity disruption. Together, they can leave a person feeling profoundly uncertain about who they are and where they belong.
Social isolation: both menopause and suicide bereavement carry stigma, and both can lead to withdrawal from social support at a time when connection is most needed.
Unprocessed earlier grief: the hormonal changes of menopause can cause earlier losses including losses that were never fully grieved to resurface. For someone bereaved by suicide, this can mean previous losses returning alongside the current one.
What helps
Seek support for both: menopause and grief are both deserving of professional attention. A GP can discuss hormonal treatment options, including Hormone Replacement Therapy (HRT), which could improve mood, sleep and cognitive function during the menopausal transition. At the same time, emotional support for grief is equally important. It is advisable not to wait while the other is attended to.
Name what you are carrying: speaking openly with a trusted person, a GP or a support service about the dual weight of menopause and grief can help both to be seen and addressed. Neither experience should be minimised in the presence of the other.
Prioritise sleep: given that both menopause and grief disrupt sleep, attending to sleep hygiene and seeking support for sleep disturbance is particularly important. This might include speaking to a GP about menopausal sleep symptoms alongside grief-related insomnia.
Attend to the body: menopause is a physical transition as much as an emotional one, and grief also lives in the body. Gentle movement, nutrition and rest matter, not as a way of pushing through grief, but as a way of supporting the physical system that carries it.
Allow the grief of menopause its own space: if you are noticing feelings of sadness or loss about your own body, your identity or the passing of time, these feelings are valid. They deserve acknowledgment alongside the grief of bereavement.
Connecting with others and support: communities of women navigating menopause, whether in person or online, can offer connection and normalisation at a time when both may be lacking. Menopause Matters and The Menopause Charity offer UK-based resources with accessible information and support.
A note for practitioners
For practitioners supporting clients who may be in perimenopause or menopause, it is worth gently exploring whether hormonal changes may be contributing to the emotional experience. Asking open questions about physical symptoms, sleep, energy, mood fluctuations, hot flushes can open a conversation that the client may not have felt able to raise. It is also valuable to signpost to resources or to a GP alongside ongoing bereavement support.
References
Adji, A. et al. (2023). Associations between common mental disorders and menopause: cross-sectional analysis of the 2014 Adult Psychiatric Morbidity Survey. BJPsych Open, 9(4).
Boss, P. (1999). Ambiguous Loss: Learning to Live with Unresolved Grief. Cambridge, MA: Harvard University Press.
Burgin, J. et al. (2025). Mental health consultations during the perimenopausal age range: a qualitative study of GP and patient experiences. British Journal of General Practice.
Hendriks, O. et al. (2025). The mental health challenges, especially suicidality, experienced by women during perimenopause and menopause: a qualitative study. Liverpool John Moores University.
Newson Health (n.d.). How do I cope with grief during menopause? Available at: https://www.drlouisenewson.co.uk/knowledge/how-do-i-cope-with-grief-during-menopause
Samuel, J. (2017). Grief Works: Stories of Life, Death and Surviving. London: Penguin.
Stroebe, M. and Schut, H. (1999). The dual process model of coping with bereavement. Death Studies, 23(3), pp.197–224.