Low mood and menopause
Menopause can turn your life upside down. Feelings of depression, sadness or grief can literally unravel you. What is causing you to feel this way? What can you do to balance your moods? And can supplements help?
I used to be a happy go lucky kind of person. Then menopause struck. Now I have to drag myself out of bed and my social life is non-existent. - Suzanne (age 55)
Research shows that about 40 percent of women struggle with low mood or depression during menopause. 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.
What is happening in your body?
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. Fluctuating and declining levels of oestrogen during menopause decrease serotonin production in the brain. This can cause you to feel low, sad or depressed, or may trigger crying spells or feelings of grief.
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.
Why do I feel so sad?
Here’s something you may want to know. Menopause can trigger or exacerbate mental health symptoms, such as low mood or feelings of sadness, depression or grief, especially in people who struggled with depressive feelings in the past. That said, there is no evidence that menopause causes depression. You might also simply feel sad for no apparent reason from time to time. However, in many menopausal women, feelings of sadness are intensified by major life changes during this time: the loss of loved ones, caring for elderly parents, children leaving home or changes the body undergoes due to ageing.
Grief or sadness can manifest itself as feelings of hopelessness or worthlessness, a loss of interest in daily activities or a general feeling of indifference. Remember, you're not alone. There are solutions out there.
What can you do?
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 mood. 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 increase your serotonin levels and improve your mood. Spend at least 30 minutes outside every day. 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.
Medication for low mood
Not feeling your normal self? Hormone therapy can lift your mood and ease depressive symptoms, gloominess and mental fatigue. Discover the options with our convenient decision aid.
What treatments can help?
Hormone replacement therapy (HRT) can help stabilise mood by balancing hormone levels. If low mood or depression is not caused by a hormonal imbalance, then talk to your doctor about other treatment options.
Hormone therapy for low mood
Oestrogel, Kliovance (Activelle) and Evorel Conti are types of HRT medications that may help with low mood associated with menopause. Which treatment is right for you depends on your symptoms and needs. HRT is available in various forms – tablets, sprays, patches or gels – each offering different doses and combinations of hormones. Read all about the available options here.
Since menopause, negative thoughts I couldn't control kept popping up out of nowhere. Thanks to HRT, I feel like myself again. – Nina (age 46)
Sources
- 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/.
- Timur S, Sahin NH. (2010). The prevalence of depression symptoms and influencing factors among perimenopausal and postmenopausal women. PMID: 20400922.
- Dr. Nazanin E. Silver. American College of Obstetricians and Gynecologists, (2023). Mood Changes During Perimenopause Are Real. Here’s What to Know. https://www.acog.org/womens-health/experts-and-stories/the-latest/mood-changes-during-perimenopause-are-real-heres-what-to-know.
- Graziottin A, Serafini A. (2009). Depression and the menopause: why antidepressants are not enough? PMID: 19465674.
- Bromberger JT, Epperson CN. (2018). Depression During and After the Perimenopause: Impact of Hormones, Genetics, and Environmental Determinants of Disease. PMID: 30401549.
- Division of Sleep Medicine at Harvard Medical School. (2021). Sleep and Mood. https://sleep.hms.harvard.edu/education-training/public-education/sleep-and-health-education-program/sleep-health-education-87.
National Center for Complementary and Integrative Healt, NCCIH. (2022). Meditation and Mindfulness: What You Need To Know. https://www.nccih.nih.gov/health/meditation-and-mindfulness-effectiveness-and-safety
- Young SN. (2007). How to increase serotonin in the human brain without drugs. PMID: 18043762.
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FAQ
Why do I feel so sad?
Adjusting to all the changes your body goes through during menopause can be challenging. This alone can wreak havoc on your emotions. The production of progesterone and oestrogen also declines during this time. Oestrogen plays an important role in the production of serotonin, the so-called happiness hormone. When oestrogen levels drop it can profoundly impact your mood and sense of well-being. Progesterone has a calming effect on the brain. Low levels of progesterone can provoke feelings of sadness and restlessness.
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