Lang XL, Huang CC, Cui HY, Zhong HX, Shen MY, Zhao F. From physiology to psychology: An integrative review of menopausal syndrome. World J Psychiatry 2025; 15(11): 108713 [DOI: 10.5498/wjp.v15.i11.108713]
Corresponding Author of This Article
Fen Zhao, Department of Gynecology, First People’s Hospital of Linping District, No. 369 Yingbin Road, Linping District, Hangzhou 310000, Zhejiang Province, China. zhaofen0508@126.com
Research Domain of This Article
Psychology
Article-Type of This Article
Review
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Nov 19, 2025 (publication date) through Nov 3, 2025
Times Cited of This Article
Times Cited (0)
Journal Information of This Article
Publication Name
World Journal of Psychiatry
ISSN
2220-3206
Publisher of This Article
Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA
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Lang XL, Huang CC, Cui HY, Zhong HX, Shen MY, Zhao F. From physiology to psychology: An integrative review of menopausal syndrome. World J Psychiatry 2025; 15(11): 108713 [DOI: 10.5498/wjp.v15.i11.108713]
Xiao-Lin Lang, Chang-Chang Huang, Hong-Yin Cui, Huan-Xin Zhong, Min-Yan Shen, Fen Zhao, Department of Gynecology, First People’s Hospital of Linping District, Hangzhou 310000, Zhejiang Province, China
Author contributions: Lang XL and Huang CC conducted literature search and wrote the original draft; Cui HY, Zhong HX, and Shen MY contributed to data analysis and manuscript revision; Zhao F conceived the study, supervised the project, and provided critical review. All authors approved the final manuscript.
Supported by Zhejiang Provincial Medical and Health Science and Technology Program, No. 2025KY196.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Fen Zhao, Department of Gynecology, First People’s Hospital of Linping District, No. 369 Yingbin Road, Linping District, Hangzhou 310000, Zhejiang Province, China. zhaofen0508@126.com
Received: May 23, 2025 Revised: June 29, 2025 Accepted: September 10, 2025 Published online: November 19, 2025 Processing time: 163 Days and 22.3 Hours
Abstract
This review examines the mechanisms of anxiety and depression in menopausal syndrome from an integrated physiological to psychological perspective. Fluctuations in estrogen and progesterone levels during menopause affect neurotransmitter systems (including serotonin, norepinephrine, and dopamine), hypothalamic-pituitary-adrenal axis function, inflammatory processes, and neurotrophic factor expression, collectively diminishing the resilience of emotional regulation neural circuits. Simultaneously, vasomotor symptoms (such as hot flashes and night sweats), sleep disruption, genetic susceptibility, and epigenetic modifications interact with mood disorders, while psychosocial factors (such as midlife stressors and role transitions) and cognitive factors (including negative schemas about aging, attentional bias toward threats, and difficulties in emotional regulation) further shape women’s experiences of menopausal changes. Clinical practice should adopt a biopsychosocial model, employing personalized multimodal approaches through hormone therapy, antidepressants, psychotherapy, and lifestyle adjustments, while future research should focus on developing biomarkers, utilizing advanced technologies, and developing targeted interventions to support women’s psychological wellbeing during menopause.
Core Tip: This integrative review explores how hormonal fluctuations during menopause contribute to anxiety and depression through neuroendocrine, neuroinflammatory, genetic, psychosocial, and cognitive mechanisms. By bridging physiology and psychology, the paper highlights the complexity of menopausal mental health and advocates for a biopsychosocial framework in clinical care. Understanding these interconnected pathways can inform personalized interventions - ranging from hormone therapy to psychotherapy and lifestyle adjustments - and guide future research on biomarkers and targeted treatments to support emotional wellbeing in midlife women.
