You go to your GP feeling low. Anxious. Tearful. Not yourself. You come away with a prescription for antidepressants — and for a while, maybe they take the edge off. But something still doesn’t feel right.
It’s only later — sometimes years later — that someone finally asks about your hormones. And suddenly, so much starts to make sense.
This is not a rare story. We hear versions of it regularly at Cardiff Menopause Clinic. And now, for the first time, the Royal College of Psychiatrists (RCPsych) has formally acknowledged it — publishing a position statement in March 2026 that puts the spotlight on a pattern that has been letting women down for far too long.
What the Royal College of Psychiatrists found?
The RCPsych statement is the first time the College has formally addressed the intersection of menopause and mental health — and the findings are hard to ignore.
A YouGov survey carried out for the College found that only around one in four women knew that menopause could trigger a new mental health condition. By contrast, 93% associated menopause with hot flushes. That awareness gap — among women and, crucially, among healthcare professionals — is at the heart of the misdiagnosis problem.
The College raised specific concerns that GPs and mental health professionals are not routinely asking women in their late 30s, 40s, and early 50s about their hormonal status when they present with mood or psychological symptoms. Without that question being asked, the hormonal dimension simply doesn’t enter the picture — and women end up being treated for conditions they may not have, while the actual cause goes unaddressed.
It’s also worth noting that perimenopause doesn’t wait until your late 40s. For some women, hormonal changes begin in their late 30s — an age at which almost no one thinks to raise menopause as a possibility.
Why this misdiagnosis happens — and why it matters
The psychological symptoms of perimenopause — low mood, anxiety, panic attacks, irritability, loss of confidence, emotional numbness — overlap significantly with clinical depression and generalised anxiety disorder. Without a hormonal assessment, there is often no obvious reason to look beyond a mental health diagnosis.
(If you’d like to understand more about why hormonal changes affect mood and mental health, our blog on menopause and mood goes into more detail on the science behind it.)
When the hormonal piece is missed, women can spend years on antidepressants that provide only partial relief — or none at all — without anyone addressing the underlying cause. That’s not a criticism of antidepressants, which have an important role and may sometimes be needed alongside hormonal treatment. But prescribing them without first considering whether perimenopause is a factor means the assessment is incomplete.
What needs to change?
The RCPsych statement calls for better education among healthcare professionals and greater integration between mental health and menopause care. It recommends that clinicians routinely consider a woman’s menopausal status when she presents with mood or psychological symptoms — not as an afterthought, but as a standard part of the assessment.
That’s a standard we’ve always worked to meet at Cardiff Menopause Clinic. Every consultation takes in the full picture — not just physical symptoms, but mood, sleep, energy, cognitive function, and how a woman is feeling in herself. For many of the women we see, it’s the psychological symptoms that are the most disruptive, and they deserve just as much attention as anything else.
What’s left, too often, is a woman who feels unheard, partially treated, and quietly wondering what’s wrong with her. Nothing is wrong with her. The system just hasn’t asked the right questions.
Could this be you?
If you’re in your late 30s, 40s, or early 50s and struggling with your mental health, it’s worth asking whether perimenopause could be part of the picture. Particularly if:
- Your mood symptoms are new, or have worsened without a clear reason
- You’re also noticing changes to your cycle, sleep, or energy levels
- Antidepressants haven’t helped as much as expected
- You’ve felt dismissed or not properly listened to when raising these concerns
A specialist menopause consultation can help untangle what’s hormonal, what’s psychological, and what the right treatment path looks like for you.
You deserve to be heard.
The Royal College of Psychiatrists’ statement is a real step forward. But a position statement doesn’t help the woman sitting in a GP’s office right now, feeling anxious and low and not sure why.
That’s where we come in. If you’re struggling and wondering whether your hormones could be playing a role, please don’t wait. Book a consultation with our team — we’re here to give you answers, and to help you feel well again.
Ready to take the next step?
Book a consultation with Cardiff Menopause Clinic today.