Prevalence and incidence of depressive, anxiety, and insomnia symptoms in perimenopausal and postmenopausal women: Systematic review and meta-analysis.

BACKGROUND

Menopausal transition represents a vulnerable stage for women's mental health. Yet, global epidemiological estimates of psychological morbidity across perimenopausal and postmenopausal periods remain limited.

OBJECTIVE

To systematically synthesise the pooled prevalence and incidence of depressive, anxiety, and insomnia symptoms in perimenopausal and postmenopausal women.

METHODS

We systematically searched MEDLINE, EMBASE, and SCOPUS until December 2024 for cross-sectional and cohort studies reporting point or period prevalence or incidence of depressive, anxiety, or insomnia symptoms. Random-effects models generated pooled estimates with 95% confidence intervals (CI). Subgroup analyses were performed by assessment type and duration of menopause. Risk of bias was evaluated using the Newcastle-Ottawa Scale.

RESULTS

A total of 102 studies (N = 1,141,955) were meta-analysed. The pooled point prevalence of depressive symptoms was 32% (95% CI, 26%-37%) in perimenopausal and 30% (95% CI, 27%-34%) in postmenopausal women; the period prevalence was 24% (95% CI, 20%-29%) and 19% (95% CI, 15%-23%), respectively. The corresponding incidence rates were 13% (95% CI, 7%-22%) and 5% (95% CI, 2%-10%), respectively. Anxiety point prevalence was 29% (95% CI, 15%-45%) in perimenopausal and 39% (95% CI, 22%-57%) in postmenopausal women. Point prevalence of insomnia was 42% (95% CI, 34%-50%) and 27% (95% CI, 19%-37%) among postmenopausal and perimenopausal women, respectively. Subgroup analyses revealed higher rates with screening instruments and during early menopause. Most studies had a low or moderate risk of bias.

CONCLUSIONS

Nearly one in three women experiences depressive, anxiety, and/or insomnia symptoms around menopausal transition, underscoring the need for routine mental health screening and integrated multidisciplinary care.