Abstract
OBJECTIVES: The study aimed to identify associations between menopause, alcohol use, and mental health. Particularly examining how menopause symptoms may relate to alcohol behaviours in midlife women. DESIGN: An online mixed methods cross-sectional survey study was conducted to gather data on menopause-related symptoms, alcohol use, mental health, and well-being among women. METHODS: A sample of 936 women aged 40-65 was recruited for the study. Quantitative measures assessed menopause symptoms, alcohol use and associated harm, mental health, and overall well-being. Qualitative data were collected through text responses to explore motives for drinking. RESULTS: Perimenopausal participants, compared to pre- or postmenopausal women, reported the highest levels of menopause symptoms, negative reinforcement drinking motives (e.g. drinking to cope), negative mood, and the lowest well-being scores. Additionally, negative reinforcement motives partially mediated the relationship between menopausal symptoms and hazardous drinking. Qualitative findings showed that women often drank as a coping mechanism, while some avoided alcohol due to its potential to worsen menopausal symptoms. CONCLUSIONS: This study provides new insights into the associations between menopausal symptoms, alcohol use, and mental health in midlife women. The findings highlight the complex factors driving alcohol use and avoidance, suggesting that tailored interventions are needed for women in midlife. This research underscores the importance of addressing alcohol-related risks in this under-researched group, given the potential for significant harm.