For many women, midlife is a critical period biological, psychological and social changes. One of the biggest is menopause, and there is a growing understanding of how these hormonal changes can occur. Affect mood, sleep, cognitionand stress response.
An important but often overlooked factor is the connection between menopause and substance use. Emerging evidence suggests that going through the menopause transition may influence substance use patternsWhich includes an increase in a woman’s substance abuse and the risk of relapse after a period of recovery.
Recognizing menopause as part of the continuum of substance use Important for improving women’s health outcomes.
An overlooked window of risk
For most women, The menopause transition can last for years. This includes perimenopause, which usually lasts about four years on average but can extend longer, and menopause, which begins after 12 consecutive months without menstruation and continues for the rest of life.
Common symptoms include Anxiety, depression, insomnia and chronic pain. Sleep disturbances are particularly common and linked to widespread health risks In middle aged women. Hormonal changes can increase emotional distress, and many women experience other stressful life changes as well. caring responsibilities, Career change, and social isolation.
Women may use substances in an attempt to cope with all of these difficult changes. Some women may drink alcohol or use other substances to manage symptoms such as insomnia or mood changes. Others may increase existing use as symptoms worsen. Cannabis use is increasing In middle-aged women, often for relief of symptoms such as sleep disturbance, anxiety, or pain.
Effects on treatment and recovery
Lack of awareness about the connection between menopause symptoms And substance use may prevent women from seeking care. Additionally, substance abuse and menopause may have a two-way relationship, meaning they affect each other over time.
sleep disturbance And mood instability can make it difficult to stick to treatment, while co-occurring conditions can complicate diagnosis and care planning. If these symptoms are not addressed, the risk of returning to substance abuse may increase.
Recovering women may also face a greater risk of returning to substance use during the menopause transition, and co-occurring mental health conditions can make people more vulnerable, especially because symptoms may worsen during menopause.
Despite these challenges, menopause is not typically considered in substance abuse disorder prevention, screening, treatment, or recovery programs. This gap highlights the need for greater awareness, better guidance for providers, and care tailored for women in midlife.
Moving towards menopause-informed care
This May, SAMHSA is sponsoring its first symposium addressing how menopause symptoms fit into the substance use disorder prevention, treatment, and recovery continuum of care. The goal is to bring together physicians, researchers, and policy makers to collaborate, share information and evidence-based practices, and identify gaps in screening, treatment, and prevention.
Coordinated strategies are needed to address menopause within substance use disorder prevention, treatment, and recovery. This includes routine screening for substance use disorders in primary care, OB/GYN, and behavioral health settings as well as trauma-informed care approaches. It is also necessary to strengthen collaboration between behavioral health and women’s health providers.
Workforce training and expanding public awareness can help ensure that providers are better equipped to recognize and address menopause-related risks. Integrating menopause into prevention, treatment, and recovery efforts may help lead to earlier identification of risk, more tailored care, and better long-term outcomes for middle-aged women.
Resources for women experiencing midlife transition, substance use disorder, or both
If you or someone you know is experiencing challenges related to menopause or substance abuse, don’t wait to seek help. Learning how symptoms such as sleep disruption, mood changes, and stress can influence substance abuse may help reduce stigma and encourage earlier engagement with care. Sharing resources and supporting community efforts can also help advance a more coordinated, person-centered approach.
The U.S. Department of Health and Human Services (HHS) offers a range of resources for individuals, families, providers, and communities:
- Substance Use – A comprehensive resource on SAMHSA’s website where you can learn about substances, prevention, treatment, and recovery.
- SAMHSA: Substance Use Disorder Treatment – A comprehensive resource containing information about substance use, resources, and treatment and recovery options for substance use disorders and co-occurring disorders.
- Women’s Health Office: Menopause – A resource providing clear, reliable information on the stages of menopause, common symptoms, health effects, and options for symptom management and overall well-being.
- CDC: Menopause, Women’s Health and Work – A resource that provides an overview of menopause, including common symptoms such as sleep disturbances and mood changes, as well as guidance on managing symptoms and understanding their impact on daily life and workplace functioning.
- National Institute on Aging: What is menopause? – A resource explaining menopause as a natural phase of aging, including information on hormonal changes, common symptoms, and their impact on overall health and well-being.
- Agency for Healthcare Research and Quality: Menopause – A resource that provides an overview of menopause as a natural life stage and evidence-based approaches to managing symptoms and improving quality of life.
- HHS Office on Women’s Health: Advancing Women’s Health Through Collaboration – A resource highlighting federal partnerships to improve awareness, education, and evidence-based care for postmenopausal health conditions.
- FindTreatment.gov – A confidential and anonymous resource (run by SAMHSA) for individuals seeking treatment for mental health conditions and substance use disorders.
- 988 Suicide and Crisis Lifeline – A SAMHSA-run lifeline for individuals in need of help or in crisis. Call or text 988 or chat988lifeline.org.
