Maria Sophocles, MD: Treating Mental Health in Menopausal Women

The symptoms and progression of menopause can be often be enough to consume the interaction between a gynecologist and patient during a routine visit. Maria Sophocles, MD, implores care providers to avoid this, though: they also have to check on the patient’s mental and behavioral health.

In an interview with MD Magazine®, Sophocles, medical director of Women’s Healthcare of Princeton, said that numerous outside factors beyond menopause or other health issues may be putting strain on a middle-aged women’s mental health at any given time. It’s critical that physicians and gynecologist’s follow up with just a simple question: “How are you doing?”

MD Mag: How should a physician address depression in patients entering or progressing through menopause?

Sophocles: In patient entering and progressing through menopause, physicians should also be looking out for her behavioral health needs. She's not just coming into your office, getting a pap smear and an order for a mammogram. She knows she needs those, and you know you need to offer that, but you need to make sure she is healthy from a behavioral health standpoint.

Menopausal-age women incur particularly high levels of stress because they are sandwiched between becoming caregivers for their aging parents, learning how to afford that, and how to logistically handle that, and still caring for a family at home. Especially adolescents and young adults need their own set of support systems. We're seeing a rise in suicides among teens and young adults, and parents have a lot of stress about this.

So, whether it's marital issues, financial issues, caring for the generation above or below, or others. So many more women are in the labor force today, and they're also trying to juggle the demands of family and home. And I think these present a uniquely difficult and complex set of circumstances for menopausal women. So they have to be able to share that with the caregiver and sometimes, they're trying to be everything for everyone.

And it's the clinician that can say, “How are you doing?” It's 1 simple question, really: “How are you doing? How are you holding up?” And sometimes, that's the only time that patient's going to feel that they're listened to and that they can say, “Actually, I'm barely holding it together.”