Low mood and menopause: what you need to know

Sex hormones play a role in many processes in the body, such as fertility, but they can also affect your emotions. This applies to both oestrogen and progesterone. 

Oestrogen stimulates the production of the feel-good hormone serotonin. When oestrogen levels begin to fluctuate and fall around menopause, serotonin levels in the brain drop, too. This can cause you to have crying spells or feel low, gloomy or depressed.  

Progesterone has a calming effect on the brain. Deficiency of this hormone can lead to stress and anxiety, even with no apparent reason. Progesterone also speeds up the conversion of thyroxine (T4) to triiodothyronine (T3). Decreased progesterone can reduce thyroid function which, in turn, can unsettle your emotions. This can make mood swings, gloominess, and feelings of restlessness or agitation more likely to occur. 

Other factors, such as hot flashes, lack of sleep and sensitivity to stress, can also impact mood. Understanding what is happening in your body and why you feel the way you do can help you appreciate your body more and take better care of it. It’s important to be kind to your body during this time and to listen to what it wants. 

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

During the menopausal transition, many women experience a roller coaster of emotions. Some women feel gloomy, others restless and irritable, and some have mood swings that leave them seething with rage one minute and sobbing the next.  

Menopause can indeed trigger crying spells or intensify low mood (especially if you are prone to depression). That said, there is no evidence that menopause causes depression. If you find yourself crying a lot, feeling hopeless or useless, uninterested in your usual activities, or indifferent in general, you are not alone. Many women have these same struggles on their journey through menopause. 

Research shows that about 40 percent of menopausal women experience low mood or feelings of depression. This risk of mood problems increases in the years leading up to menopause and the first few years after the last menstrual period. If you've had bouts of mood problems before menopause, you may be more susceptible.

Good health starts with a healthy lifestyle and a healthy diet. This also applies to menopausal health. Studies have shown that proper nutrition and a balanced lifestyle can decrease the risk of menopausal symptoms, including mental problems. 

• Make sleep your number one priority. There's a close relationship between sleep and mental health. People who suffer from, for example, night sweats, report being more stressed, gloomy, angry and tired after one week of sleep deprivation. Conversely, your mood can significantly impact the quality of your sleep. Be sure to practise good sleep hygiene and consider taking supplements that promote sleep. 
• Practise mindfulness. The scientific evidence on mindfulness speaks for itself. Mindfulness and meditation help you relax, reduce stress and feelings of gloominess, and improve sleep quality. 
• Pack your diet with vegetables and fruit to keep your blood sugar stable. Studies show that what you eat affects how you feel. Increased fibre intake encourages a healthy gut flora, which can help to improve mood. Blood sugar fluctuations can also impact how you feel. Cutting down on sugars and fast carbohydrates has a positive effect on your blood sugar levels. 
• Make sure you get enough omega 3. The human brain is nearly 60 percent fat. Omega 3 is critical to brain health as well as mental health. Therefore, you should eat fatty fish twice a week. Or include more omega 3 in your diet through a supplement. 
• Expose yourself to bright light. Scientific studies have shown that exposing yourself to light is a mood booster. It’s a good way to naturally boost your serotonin levels and overall mood. Spend at least 30 minutes outside every day. Alternatively, a light therapy lamp can also be helpful. 
• Get at least 30 minutes of physical activity a day in addition to your normal activities. Exercise stimulates the production of the happiness hormones serotonin, dopamine and endorphin. Choose a sport or activity that you enjoy. This makes it easier to stay motivated. 
• Talk about your feelings. It can help to talk about what you're feeling or thinking with someone you trust or a therapist. A therapist can help you understand your emotions and develop healthy coping mechanisms.  

Although these tips are helpful, they might not be enough for those with severe symptoms. Talk to a doctor about hormone therapy if you are experiencing new or worsening anxiety and depression. You should also be aware that mental health problems can develop early on in perimenopause, even before your menstrual pattern changes. One reason why perimenopause 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 to improve the symptoms of depression. However, an antidepressant will not help if a hormonal imbalance is the root cause of the problem.