How to Handle Menopausal Mood Swings

During perimenopause, the period leading up to the end of a woman’s reproductive ability, lower levels of estrogen, one of the primary sex hormones, may lead to irritability, fatigue, anxiety, sleep problems, and other difficulties that can affect mood.

Hormonal changes may also affect levels of the neurotransmitters serotonin and norepinephrine, which may lead to anxiety and depression.

In addition, according to the American College of Obstetricians and Gynecologists, about 4 in 10 women have mood fluctuations during perimenopause similar to those that occur PMS, or premenstrual syndrome. You might be irritable, have low energy, be tearful and moody, or have difficulty concentrating.

Unlike PMS, however, these symptoms may appear seemingly randomly, with no association with your normal cycle. There’s a name for it — perimenopausal mood instability.

At Revive Health Clinic in Lady Lake, Florida, our expert team of women’s health specialists understands the roller coaster ride that is perimenopause. That’s why we provide treatments that can help reduce the problematic mood swings. If you’re struggling to make it from one day to the next, or one hour to the next if you cycle frequently, here’s what you can do to handle the problem.

The relationship among hormones, brain chemicals, and mood

During the years leading up to menopause, estrogen levels drop, causing far-reaching changes throughout the body, many of which have direct connections to menopausal mood swings.

For example, estrogen depletion may affect how the body manages serotonin and norepinephrine, which, as we mentioned, may have links to depression. However, research into this connection is inconclusive.

Lower levels of estrogen, though, are known to have links to irritability, fatigue, stress, forgetfulness, anxiety, and difficulty focusing on tasks, all of which can intensify feelings of anger, depression, and anxiety.

Also, researchers have discovered higher levels of the brain protein monoamine oxidase A (MAO-A) in women entering perimenopause, a protein that has links to depressive symptoms.

Sometimes, a mood response can build from other menopausal symptoms, such as with night sweats. These hot flashes are triggered by lower estrogen levels and occur when someone is asleep. They can be so intense, though, that you wake during the night.

Several nights of such disrupted sleep can result in trouble concentrating, irritability, and other symptoms associated with menopausal mood swings.

In addition, your 40s and 50s, when you’re experiencing perimenopause, are a time when the stress of kids, aging parents, and work responsibilities can be greatest. This level of stress can add to your mental health challenges.

How to handle menopausal mood swings

There's growing evidence to suggest that hormone replacement therapy (HRT) can relieve emotional symptoms linked to menopause, but HRT alone can’t treat more severe depression. As a result, antidepressant drug therapy and/or psychotherapy may be necessary.

Since mood changes during perimenopause and menopause are caused by altered hormone levels, the most effective treatment is to stabilize those levels by using HRT with estrogen (and for some women, testosterone as well). The right dose and form can help improve low mood and other psychological symptoms related to menopause.

Many women say they feel calmer, have renewed motivation and interest in things, a greater sense of energy, and are generally happier after just a few months on HRT. They usually see an improvement in other perimenopausal symptoms as well, such as hot flashes and night sweats, insomnia, and vaginal dryness.

Research has shown that women given HRT when they’re perimenopausal have reduced  incidences of clinical depression. Many women who start HRT and have been on antidepressants in the past find that their depressive symptoms improve to the extent that they can reduce or even stop taking their antidepressants.

For most women experiencing low mood, anxiety, irritability, or mood swings, it’s a combination of approaches that works best. Lifestyle factors such as eating a healthy diet, getting enough good quality sleep, exercising regularly, and reducing stress together help you feel better and on a more even keel.

Psychotherapy, such as cognitive behavioral therapy (CBT), has been shown to help with menopausal-related low mood and anxiety, and even with physical symptoms such as hot flashes. These alternative treatments are even more important for women who don’t wish to, or can’t take, HRT.

Take the next step

If you’re struggling with the inevitable mood swings of perimenopause, Revive Health Clinic can help. To schedule a consultation, call our office at 352-290-0896, or book online with us today.