Menopause and suicide: A systematic review.

Background: The menopausal transition is a critical phase in a woman's life marked by hormonal fluctuations that can result in a wide variety of physical and psychological symptoms. These symptoms vary in strength and their negative impacts on women's health and well-being. One of the most severe impacts of (peri)menopause is increased vulnerability to suicidality in some women, yet no systematic review has examined the holistic relationship regarding this potential link.

Objectives: To examine the relationship between the menopausal transition and suicidality, and identify menopause-related factors contributing to increased suicide risk.

Design: A systematic review was conducted in accordance with PRISMA guidelines.

Data sources: MedLine, CINAHL, PsychINFO, Web of Science and Cochrane Library were searched for studies addressing both menopause and suicidality. Studies were screened independently by two reviewers. Data extraction focused on suicidal ideation, attempts, and completed suicide among menopausal women. The quality of included studies was assessed using the Mixed Methods Appraisal Tool.

Results: Nineteen studies published between 1987 and 2025 met the inclusion criteria. Of the 19 studies, 16 (84%) reported an association between the menopausal transition and increased suicidality, with 7 studies specifically noting this association in perimenopausal women. Hormonal changes, pre-existing mental health conditions, physical symptoms, and limited social support emerged as key factors associated with increased suicide risk. Three studies did not find a significant link.

Conclusion: There is some evidence of an association between the menopausal transition and suicidality, particularly during perimenopause, though conclusions are limited by study design and heterogeneity. The review highlights the importance of integrating mental health support within menopause care and suggests further research to clarify the mechanisms underpinning suicide risk during the menopausal transition. Enhanced screening and supportive interventions may benefit menopausal women experiencing suicidality.