Researchers lead $3.7M study to shed light on perimenopause and psychosis

For decades, women’s midlife experiences have been largely overlooked by medical research. Despite previous assumptions about midlife mental health risks, relatively little research has systematically investigated the connections between hormonal fluctuations and psychological symptoms.

Now, researchers from Michigan State University’s Department of Psychology are examining the understudied period of perimenopause and its potential impacts on mental health thanks to a $3.7 million grant from the National Institute of Mental Health.

MSU Research Foundation Professor Kelly Klump, Associate Professor Katharine Thakkar and Research Specialist Kristen Culbert are conducting the study — the first to comprehensively examine how hormonal changes during midlife might influence psychosis as well as other mental health outcomes like bipolar disorder.

“There’s been a noticeable absence of research in this area,” said Culbert, the study’s co-principal investigator. “We have known there is a midlife spike in psychosis in women that is not observed in men, but we haven’t known why. Our study is the first to examine perimenopausal shifts in hormones in an intensive daily study to see if hormones, not age, predict increased risk for psychosis in women.”

Study background

The study will follow 750 women aged 40–60 as they collect daily saliva samples and complete detailed questionnaires to help researchers track hormone levels and psychological symptoms. Uniquely, this research captures daily hormone variations, something never before accomplished in previous studies.

Another unique aspect of this study is that the researchers are looking at both estradiol — an estrogenic hormone — and progesterone, instead of focusing on estradiol alone.

Klump has shown through previous research that the interplay between estradiol and progesterone has been important in understanding mental health outcomes, like binge eating, that emerge during other developmental phases of life.

“All women go through this period of life, just like with puberty, but only a subset is vulnerable to experiencing outcomes like psychosis, mood disorders and other mental health concerns,” said Klump, also a co-principal investigator. “It’s important to do this research to better identify which women may be at risk. From a public health point of view, being able to identify these women could have a dramatic impact on their health care.”

Looking forward

The researchers hope their work will lead to better health care approaches, more personalized treatments and increased awareness about women’s midlife experiences.

“Our goal is to help women thrive during this transition,” said Klump. “By understanding these biological changes, we can develop better support systems and treatments.”

The team of researchers has been excited by the number of women eager to contribute to this work.

“Because it is such an understudied period of life, and women often feel unheard or forgotten at this phase of life, we’ve seen remarkable interest from women wanting to join the study,” said Culbert. “The feedback has been overwhelmingly positive, with participants expressing excitement about being a part of this important research and eagerness to learn what it will reveal.”

Culbert and Klump said that the study’s continuation depends on ongoing research funding, citing a critical need for sustained investment in women’s health research. Their research is expected to conclude in early 2027.