Irritability and menopause
Remember those mood swings about a week before your period? They were caused by hormonal fluctuations. The same applies to menopause. Hormonal imbalances during menopause can make you more emotional or irritable than before. All of a sudden, life can feel like an emotional roller coaster. Maybe you don't even recognise the person in the mirror anymore. How do you deal with this jumble of emotions?
My daughter is going through puberty and I'm a menopausal mother. Not the best combination. - Iris (age 51)
Hormones can make or break your mood. Especially during menopause. If you are irritable or find it difficult to control your emotions, know that you're not alone. About 70 percent of women have mood symptoms during perimenopause – sometimes even before any physical symptoms, such menstrual changes, show up.
While you might not think of perimenopause and your mood swings as being linked, they can be. One reason why perimenopause is often misdiagnosed is that many women are not aware of the condition or the symptoms associated with it. So be sure to bring it up when you talk to your GP so that you get the right treatment.
The good news is that after you hit menopause and hormone levels stabilise, chances are that the symptoms will disappear. Once reduced oestrogen and progesterone levels have rebalanced, your mood will gradually stabilise.
What is happening in your body?
Irritability in perimenopause is thought to be triggered or exacerbated by extreme hormonal changes. Oestrogen and progesterone are important hormones that regulate your body – and your mood.
For women, research suggests that oestrogen, or lack thereof, is strongly implicated in the regulation of mood and behaviour. Apparently, oestrogen has an effect on serotonin and dopamine (aka happiness hormones). When oestrogen levels begin to fluctuate in the period leading up to menopause, so do our happiness hormones.
Also, declining levels of progesterone can put you in an emotional roller coaster ride. Progesterone has a calming effect on your body. Therefore, when progesterone decreases during this stage of life, you are more likely to feel restless or tense.
Other causes
Other menopausal symptoms can also affect how you feel. We probably don't need to tell you that hot flashes, night sweats and lack of sleep can affect your mood. You are also more sensitive to stress in your menopausal years, which can cause you to be extremely irritable and snap at little things, even if you don't mean to.
What's more, most women suffer from multiple symptoms of menopause. So it's not unusual for irritability to go hand in hand with weight gain, muscle pain or low energy. Medication use or an underlying health condition can also impact your mental health.
How does menopause affect mood?
Hormone fluctuations can be overwhelming. Do you find your mood can change at the drop of a hat? Do you sometimes feel like you don’t recognise yourself, or know how you’re going to be from one day to the next? Do any of the following apply to you:
- You are grumpy
- You are irritable and snappy
- You get upset over little things
- You are filled with rage
- You feel tense or nervous
- You feel unhappy
- You feel insecure
- You have crying spells
- Your mood can change at the drop of a hat. If you experience that, you have what we call mood swings.
Feeling low or depressed
Constantly feeling intense and tumultuous emotions can make you feel anxious or depressed. Several studies have shown that menopause increases vulnerability to depression and anxiety. If you've never suffered from gloominess before, chances are that your hormones (or rather, lack thereof) are the culprit. Sometimes antidepressants may not produce the desired results, for example, if hormonal imbalances are related to menopause or caused by an underactive thyroid. Read more about a low mood.
What can you do?
Irritability can be exhausting. These tips will help you cope better:
- Do relaxation exercises. Whether it's mindfulness, a breathing exercise or a more active form of relaxation such as walking, yoga or reading, do whatever you find relaxing. Incorporate more restful moments into your day to reduce stress and tension.
- Nourish your microbiome and stabilise your blood sugar. A healthy intestinal flora and stable blood sugar levels will do your mood a world of good. Try to eat less carbohydrates and plenty of fibre. Make sure you eat smaller portions to prevent sugar spikes and eat regularly to avoid sugar crashes. Eat lots of fruit and vegetables (at least 500 grams a day) so that you get enough vitamins and minerals, and don’t forget to include omega-3 in your diet (if necessary, take a supplement). Low blood sugar can make you feel hungry, dizzy, sweaty, nervous and irritable.
- Talk about your feelings. Don't keep your feelings bottled up inside. It can be a relief to share what it’s like for you with a friend or partner, or women with similar experiences. This will also help people understand you better. If they know what you're going through, it'll be easier for them to support you.
Medication for irritability
A healthy diet, regular exercise and relaxation are all essential to keep your mind and mood in optimal shape. If dietary and lifestyle adjustments do not provide sufficient relief, hormone replacement therapy (HRT) may be a solution.
What treatments can help?
Sometimes more support is needed to get your mental health to a stable place. Hormone replacement therapy (HRT) can help with mood and improve mental resilience.
Since I've been on HRT, I feel much calmer. My emotions still get the better of me sometimes, but that's part of life. - Ellen (age 46)
Hormone therapy for irritability
Hormone replacement therapy (HRT) is widely used as a treatment for relieving all kinds of menopausal symptoms, including mental health issues. If you struggle with increased irritability, anger or rage, Trisequens or Progynova may be effective HRT options. Trisequens and Progynova are bioidentical hormone therapies using oestradiol and progesterone. Researchers and doctors agree that hormone therapy can be used safely and without risk by most women.
Sources
- Wharton W, Gleason CE, Olson SR, Carlsson CM, Asthana S. (2012). Neurobiological Underpinnings of the Estrogen - Mood Relationship. PMID: 23990808.
- Born L, Koren G, Lin E, Steiner M. (2008). A new, female-specific irritability rating scale. PMID: 18592028.
- Banskota S, Ghia JE, Khan WI. (2019). Serotonin in the gut: Blessing or a curse. PMID: 29909048.
Your path to a smooth menopause starts here
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Tips and advice
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FAQ
I suffer from menopausal mood swings. What can I do?
Acknowledging and accepting your emotions is the first step. Realise that your hormones are causing you to feel this way. It can also be helpful to talk with a friend, your partner or other women with similar experiences. Also, make sure you get at least 30 minutes of physical activity a day. Exercising has a positive impact on mood, is relaxing and can improve your sleep. More about mood swings.
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