Crying spells and menopause
Are you going through menopause and find yourself suddenly crying over random things? Are you more emotional than before, or do you feel sad or gloomy for no apparent reason? You're not alone. Hormonal changes can have a big impact on your emotions and overall well-being. Thankfully, there are things you can you do to feel better. Why does menopause affect mood and what can you do to feel more balanced and resilient during this transformative phase of life?
I've always been emotional, especially before my period. But since perimenopause, tears seem to come from nowhere and I can't control it. I cry over the smallest things. - Tina (age 49)
Low mood, irritability and crying spells are common symptoms experienced by menopausal women. They can develop early on in perimenopause, even before your menstrual pattern changes. This is because the risk of developing depressive symptoms is especially high when levels of sex hormones fluctuate most – which is during perimenopause. If you suffered from depression and mood problems before perimenopause, you may be more susceptible.
Crying spells can be a symptom of mental health problems, such as depression. Studies do show that about twice as many women as men experience depression and that menopause may increase a woman's risk of depression. However, it is important to note that frequent crying spells do not automatically indicate depression.
What is happening in your body?
Women's ovaries gradually produce less oestrogen and progesterone in the years leading up to menopause. During perimenopause, the stage before menopause, hormones fluctuate dramatically, causing changes in the body. Both hormones play a crucial role in the regulation of mood and emotional stability.
Oestrogen, for example, stimulates the production of the happiness hormone serotonin. When oestrogen levels drop during perimenopause it can profoundly impact your sense of well-being. This can manifest as sadness or uncontrollable crying – sometimes with no identifiable trigger.
Progesterone stimulates the brain to produce a calming neurotransmitter. A decrease in progesterone levels can contribute to symptoms of stress, irritability or anxiety. In addition, progesterone can affect the conversion of thyroid hormones T4 to T3. Low T3 levels can affect thyroid function. Thyroid dysfunction may lead to mental health symptoms, such as mood swings, anxiety and low mood, or make existing symptoms worse.
Other causes
Menopause isn’t just a time of physiological and emotional challenges, it intersects with major life transitions as well. For instance, children moving out of the family home (empty nest syndrome) and caring for sick and/or elderly parents. These major life events can contribute to feelings of melancholy or depression. It's only natural that you might find yourself dealing with these feelings. Also, dealing with ageing and physical deterioration, and the lack or loss of (sexual) intimacy in relationships, can also negatively affect mood and bring about emotions such as sadness or irritability.
Hormonal changes can also trigger a variety of menopausal symptoms, such as hot flashes, sleep problems and mood swings.
What can you do?
The tips below can help to get you on the right track. Give it some time, and don't hesitate to reach out to a professional if you’re struggling.
- Support your intestinal flora by eating fibre-rich foods. Eat 500 grams of fruit and vegetables each day. Incorporate fibre-rich foods such as nuts, legumes and whole grain products into your diet. Eating fibre helps with digestion and will result in higher levels of ‘good bacteria’ in the gut. Gut microbiota can stimulate the production of neurotransmitters that regulate mood, such as serotonin. Having a healthy gut flora is incredibly important!
- Stabilise your blood sugar. Limit your intake of (fast) carbohydrates, sugar and processed foods to keep your blood sugar levels in check. Blood sugar fluctuations can negatively impact your mood and energy levels. A diet with plenty of vegetables, protein, healthy fats and whole grains will help keep blood sugar levels and mood stable.
- Eat foods high in omega-3 fatty acids. Studies show that omega-3 can increase the production of serotonin and dopamine, which has positive effects on mood. Try eating fatty fish twice a week. If this is a problem, you may want to take an omega-3 supplement.
- Boost your mood with high-quality dietary supplements. A Vitamin B complex, particularly B6 and B12, can help regulate mood and maintain healthy brain function. Low Vitamin D levels are associated with increased symptoms of depression (low mood and crying spells). Vitamin D can be obtained from sunlight exposure, but during autumn and winter a Vitamin D supplement is recommended.
- Make sleep your number one priority. During sleep your brain regenerates and processes emotional information.
- Go outside. Scientific studies show that exposure to sunlight increases the brain's release of a hormone called serotonin. Serotonin regulates your mood: more serotonin means better mood.
- Exercise regularly. Exercise stimulates production of endorphins and improves sleep quality. You’ll kill two birds with one stone.
- Get plenty of rest and reduce stress. Breathing exercises directly impact the nervous system to relieve stress. Practising mindfulness and yoga can help, too. It's also important to set priorities. Menopause enhances stress sensitivity, which makes it more difficult to juggle responsibilities.
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What treatments can help?
If the above tips do not provide sufficient relief, then you could consider hormone therapy.
Hormone therapy for crying spells
Hormone replacement therapy (HRT) treats symptoms of menopause by replacing lost hormones. One reason why menopause is often misdiagnosed is that many women – and GPs too – are not aware of the condition or the symptoms associated with it. Medication, such as antidepressants, may be prescribed for depression. However, an antidepressant will not help if a hormonal imbalance is the root cause of the problem.
I had mood swings and was insecure, tearful, gloomy, edgy and exhausted... HRT has given me my life back. - Iris (age 60)
Sources
- Bromberger JT, Epperson CN. (2018). Depression During and After the Perimenopause: Impact of Hormones, Genetics, and Environmental Determinants of Disease. PMID: 30401549.
- MGH Center for Women's Mental Health. (2021). Essential Reads: Who is at Risk for Depression During the Perimenopause? https://womensmentalhealth.org/posts/essential-reads-who-is-at-risk-for-depression-during-the-perimenopause/.
- Graziottin A, Serafini A. (2009). Depression and the menopause: why antidepressants are not enough? PMID: 19465674.
- Toffol, E., Heikinheimo, O., & Partonen, T. (2015). Hormone therapy and mood in perimenopausal and postmenopausal women: A narrative review. Menopause, 22(5), 564-578. https://journals.lww.com/menopausejournal/abstract/2015/05000/hormone_therapy_and_mood_in_perimenopausal_and.14.aspx
- Vivian-Taylor, J., & Hickey, M. (2014). Menopause and depression: Is there a link? Maturitas, 79(2), 142-146. https://www.maturitas.org/article/S0378-5122(14)00178-9/abstract
Tips and advice
Thyrza (age 50): “My menopausal symptoms improved once I prioritised sleep”
Thyrza suffered from hot flashes, weight gain and other symptoms. Her health proved to be strongly connected to sleep quality. “Sleep is my number one priority now.”
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FAQ
What is the difference between depression and mood swings?
Depression is a long period of feeling low, hopeless or lethargic. These feelings are crippling and affect daily life. A mood swing is a sudden change in mood from one extreme to another (for instance, from happy to sad). These feelings are typically short-lived and less intense than depressive feelings. Menopause can trigger or intensify mood swings and crying spells (especially if you are prone to depression). That said, there is no evidence that menopause causes depression.
Can antidepressants help reduce the frequency and severity of crying spells?
Menopause guidelines are clear that antidepressants should not be used as a treatment for low mood or crying spells caused by hormonal changes. If your mood changes are related to perimenopause or menopause, evidence suggests that hormone therapy may improve mood. Contact your GP or a doctor of your choice for more information.
What supplements can help with mood?
High-quality supplements can support your mood. MenoPrime is a hormone-free dietary supplement that provides support for symptoms such as mood swings, hot flashes and irritability*. This supplement has been specially developed for menopausal women, based on scientific research.
*Health claims pending approval by the European Commission.
