Professor Jayashri Kulkarni’s career in psychiatry began with a simple but powerful phrase from one of her patients: “It’s my hormones, Doc. No one believes me.” That moment shaped her lifelong dedication to understanding women’s mental health, particularly how hormonal changes influence wellbeing.
Listening to Women’s Voices
From her earliest days working in psychiatric wards, Professor Kulkarni recognised a pattern: women experiencing profound mental health shifts during postnatal periods and menopause. What struck her most was not only the symptoms themselves but the sense of invalidation women felt. Their voices often went unheard, yet their observations held the keys to better research and treatment.
Her approach centres on collaboration—listening to patients, drawing on research, and feeding results back into care. As she explains, “It’s not about a checklist. It’s about what this individual woman is experiencing and why.”
The Role of Hormones in Mental Health
Midlife mental health is deeply intertwined with hormonal changes. Estrogen, progesterone, and testosterone are not just reproductive hormones—they are powerful brain steroids that influence mood, cognition, and behaviour.
During perimenopause (a transition that can span up to 10 years, often starting in the early 40s), fluctuating hormones can trigger anxiety, depression, brain fog, irritability, fatigue, and changes in sleep and libido. These symptoms often appear before the more widely recognised hot flushes. For many women, the unpredictability of these fluctuations is the hardest part.
Importantly, women with histories of trauma may be more vulnerable to these hormonal shifts, underlining the need for sensitive, personalised care.
Treatment Options and Advocacy
Current treatment pathways include:
Professor Kulkarni encourages women to trust their instincts. “Back yourself. You know what’s normal for you—and when it isn’t.” If a GP is dismissive, she advises seeking another practitioner, ideally one with menopause training (the Australian Menopause Society provides a directory).
A Call for Change
Despite the scale of the issue, women’s mental health—especially in relation to menopause—remains underfunded and under-researched. Professor Kulkarni is passionate about changing this, through her leadership of the HER Centre Australia and the Monash Alfred Psychiatry Research Centre (MAPrc), both dedicated to inclusive, holistic research and treatment. She leaves us with a reminder: menopause is not a disease, but for women experiencing severe symptoms, it can be profoundly life-altering. Listening, research, and advocacy are key to ensuring women receive the care they deserve.
Source: Mind Your Being Podcast – Ep #2 Midlife, Menopause and Mental Health: A Real Conversation with Professor Jayashri Kulkarni