Irritability and menopause: what you need to know

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.  

Remember those mood swings about a week before your period? They were due to hormonal fluctuations. The same applies here. Around menopause, several hormones are thrown off balance. This can make you feel unhappy, irritable or angry. 

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. 

Many women experience a host of symptoms as they go through menopause, such as hot flashes, sleep problems and mood swings. 

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 the above, you have what we call mood swings. 

Constantly feeling intense and tumultuous emotions can make you feel anxious or depressed. Several studies have shown during the menopausal transition women have a higher risk of anxiety and depression. 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.

Hormones can make or break your mood. Especially during the menopausal transition. 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. 

Mood swings and rage can be exhausting, especially around menopause when you've got so many other things on your plate. Especially if it is getting in the way of family time or your performance at work. 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. 
• Hormone therapy can help with mental problems. Ask your doctor if HRT could be an option for you.