Substance Use and Menopausal Symptoms: A Scoping Review of Psychological Dimensions.

Abstract:

Menopause is a significant biological transition marked by physical and psychological symptoms, including hot flashes, insomnia, mood disturbances, and cognitive difficulties. While many women employ adaptive coping strategies, some resort to substance use—such as alcohol, tobacco, sedatives, or illicit drugs—as a maladaptive means of managing distress. This scoping review examined the psychological dimensions of substance use during menopause, synthesizing evidence from 2011 to 2025 across multiple databases. Findings reveal that 65% of menopausal women use alcohol, followed by tobacco (45%), sedatives (30%), and cannabis (15%), primarily for self-medication of anxiety, depression, and sleep disturbances. Psychological motivations include trauma reactivation, identity loss, and social isolation, with substance use often exacerbating cognitive decline and emotional instability. Sociocultural factors, including stigma and inadequate healthcare access, further compound these risks. Effective interventions identified include cognitive-behavioral therapy (CBT), mindfulness-based stress reduction, and peer support groups, though gaps remain in culturally tailored and low-resource settings. The review emphasized the need for integrated care models that address substance use within the biopsychosocial context of menopause, alongside improved screening and trauma-informed approaches. Recommendations emphasize routine substance use assessments in menopause care, expanded mental health services, and targeted research on underrepresented populations.