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Hormonal changes during menopause can drive suicidal thoughts – a crisis that healthcare services have failed to recognise or adequately address. The devastating link is laid bare in research my colleagues and I conducted recently. The study, which involved interviews with 42 women who experienced suicidal thoughts and behaviour during perimenopause or menopause, exposes a troubling pattern. Women in crisis are being prescribed antidepressants instead of hormone replacement therapy (HRT), despite clear menopause guidelines stating that antidepressants should not be a first-choice treatment for menopause-related low mood.