Misdiagnosed and Mismedicated: Why So Many Women Are Prescribed Antidepressants Instead of Menopause Care
Sep 26, 2025
by: Dr. Beverly Huang ND, MSCP
It’s one of the most common patterns we see in clinic: a woman in her 40s or 50s shows up exhausted, anxious, moody, and unable to sleep. She’s told it’s depression or stress. She’s handed a prescription for antidepressants.
But here’s the thing—what if those symptoms aren’t primarily depression? What if they’re the result of hormone fluctuations during perimenopause and menopause?
This is a story we hear again and again. And the statistics back it up.
The Overlap That Leads to Confusion
Perimenopause (the years leading up to menopause) is a time of hormonal chaos. Estrogen and progesterone levels rise and fall unpredictably, leaving women with:
-
Mood swings
-
Irritability
-
Heightened anxiety
-
Brain fog and memory slips
-
Insomnia or early waking
Sound familiar? They also happen to be textbook symptoms of depression and anxiety disorders. This overlap is exactly why so many women are misdiagnosed and treated as though they have a primary psychiatric condition—when in fact, hormones are at the root.
Antidepressants as the Default
Across Canada, the U.S., and the U.K., the numbers are striking:
-
In Canada, 1 in 4 women aged 45–64 is prescribed an antidepressant in a given year.
-
In England, 1 in 6 women over 50 has been on antidepressants for five years or longer.
-
In the U.S., nearly 1 in 5 women aged 40–59 is currently using antidepressants.
Not all of these women meet diagnostic criteria for major depression. Which means many are being medicated for hormone-driven symptoms without ever being offered menopause-informed care.
Why It Matters
This isn’t just a numbers game. Misdiagnosis has real consequences:
-
Incomplete relief: Antidepressants may take the edge off mood symptoms, but they don’t touch hot flashes, night sweats, low libido, or vaginal dryness—all part of estrogen decline.
-
Long-term use: Many women stay on these medications for years without re-evaluation.
-
Missed opportunities: Estrogen therapy has been shown in clinical trials to prevent or reduce depressive symptoms in perimenopausal women, yet it remains underused.
In other words, women are often left managing only part of the picture—while the bigger story of hormone health goes unaddressed.
What Better Care Looks Like
It’s time to reframe how we care for women in their 40s and 50s. Here’s what helps:
-
Menopause-informed screening: When women present with mood symptoms, their hormonal stage should be part of the conversation.
-
Integrated treatment: Hormone therapy (when safe and appropriate), cognitive behavioural therapy, nutrition, exercise, and—when truly needed—antidepressants.
-
Regular medication reviews: Prescriptions shouldn’t be a lifetime sentence without re-checking whether hormone support could be the missing piece.
The Heart of It
Antidepressants can be life-saving and absolutely have a place in women’s health. But the staggering rates of use among women in their 40s, 50s, and 60s point to something bigger: a health system that still too often overlooks menopause.
Women deserve care that sees the whole picture. They deserve answers, options, and treatments that help them thrive through this transition.
That’s why we created menoPowered—to break the silence, challenge the defaults, and give women the knowledge they need to reclaim their power.
We are happy you are here.
If this story resonates with you, you’re not alone—and you don’t have to keep guessing.
Join us for Inside Thrive: A Mini Session — a one-hour live class with a menopause-certified naturopathic doctor.
You’ll learn:
-
What’s really happening with your hormones in perimenopause + menopause
-
Why symptoms like mood swings, brain fog, and poor sleep are so often misdiagnosed
-
How hormones connect to your long-term health (bones, heart, metabolism)
-
A preview of the Thrive Method framework that’s helping women stop surviving and start thriving
Spots are limited — save yours today for just $25.
