Menopause and mood swings
Menopause can be a turbulent time, not least when it comes to your mood. One minute you feel like everything is under control, and then you are suddenly hit by a wave of anger, anxiety or tearfulness.
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MOOD SWINGS DEFINITION
Mood swings are sudden and noticeable changes in the way you feel. You may notice that you are increasingly irritable, frustrated, angry, tearful or sad, and that it can be difficult to predict when or why your mood will change.
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HOW LIKELY ARE MOOD SWINGS DURING MENOPAUSE?
Mood swings are a common part of menopause. Several studies have researched how common mood swings are in menopause, although the results have been highly variable.
One Chinese study of over 6,000 women found that 37.2% with menopausal symptoms reported mood swings. A Norwegian study found this figure to be 10% and another, smaller Chinese study looking at women with premature menopause found that 73.4% reported this symptom.
This demonstrates that mood swings can be difficult to understand and quantify. There is likely to be a reasonable amount of cultural and biological variation in the way we talk about (and tolerate) mood swings.
SIGNS OF MOOD SWINGS
Sudden or dramatic mood changes
Very irritable or snappy. PMS can worsen if you are having periods
Feeling easily tearful, overwhelming anxious, or experiencing panic attacks
Uncontrollable anger (rage)
TIPS TO HELP WITH MOOD SWINGS DURING MENOPAUSE
Check in with your doctor
Mood swings can be a normal (if difficult) part of menopause, but they can be part of a bigger mental health problem. Anxiety and depression can show themselves as panic attacks, irritability and tearfulness. Likewise, bipolar disorder can also be linked to dramatic shifts in mood. If mood swings are affecting you, check in with your doctor to be sure you have the right diagnosis.
Get some exercise
Exercise has many benefits for your general health. One study has also suggested that it could help reduce the mood swings related to menopause. Take a look at these blogs for the best exercise for menopause or to explore if exercise snacking is for you.
Think about triggers
Have you noticed anything which makes your mood swings worse? A stressful day at work, or feeling overwhelmed with chores at home? Consider keeping a log of your symptoms and think about ways you could avoid some of the worst flashpoints.
Try mindfulness
Mindfulness is helpful in a range of mental health conditions, and may help with menopausal mood swings. There is also some evidence that mind-body approaches (like yoga and tai chi) can help with menopausal symptoms.
Talk about it
Menopausal mood swings can cause friction between yourself and your family, friends and colleagues. If this is the case, try to find a quiet time to calmly discuss what is happening.
CAN HORMONE REPLACEMENT THERAPY (HRT) HELP?
Possibly.
HRT is thought to help with mood swings at menopause, and NICE recommend that it can be prescribed for low mood associated with menopause.
Likewise, HRT is a proven treatment for many other physical symptoms which may – if severe and untreated – have an understandable impact on your mood. For example, it is very difficult to keep a level head if your life is ruled by hot flushes and you’re struggling to sleep! HRT can effectively treat a number of symptoms associated with menopause including hot flushes and sleep disturbance among others.
While it can be very helpful, HRT is not suitable for everybody. Your doctor will be able to advise you about your own personal treatment options. Read more on the risks and benefits of HRT here.
It is also important to be aware that HRT is not suitable for everyone. Your doctor will be able to tell you more about the best approach for you personally.
MOOD SWINGS AND MENOPAUSE FAQs
Debate is ongoing as to whether this is because of hormonal changes or as a consequence of physical symptoms of menopause (because who doesn’t feel irritable or snappy when they are feeling rough physically?) It is likely to be a mixture of the two.
Oestrogen has effects on many different organs and tissues throughout the body. It also interacts with a number of different hormones which regulate mood and emotion, including serotonin.
When oestrogen levels plummet at the time of menopause, it is thought that serotonin function also suffers. This could be responsible for the common mood changes – including mood swings – that are seen at menopause.
Other hormones may also be affected. These include noradrenaline (which works in a similar way to serotonin) and cortisol (which is released in response to stress).
See your doctor if mood swings are becoming a struggle. You may notice that your mood swings are getting you down, or that you are finding it more difficult to get on with your normal life.
Seek urgent medical assistance if you have:
- Any thoughts about suicide
- Thoughts about hurting yourself or others
- Any symptoms of depression
- Any symptoms of a manic episode
- Any symptoms of psychosis
- Any other serious concerns
- Wang X, Wang L, Di J, Zhang X, Zhao G. Prevalence and risk factors for menopausal symptoms in middle-aged Chinese women: a community-based cross-sectional study. Menopause. 2021 Aug 30;28(11):1271-1278. doi: 10.1097/GME.0000000000001850. PMID: 34469934; PMCID: PMC8547757.
- A. Holte (1991) Prevalence of climacteric complaints in a representative sample of middle-aged women in Oslo, Norway, Journal of Psychosomatic Obstetrics & Gynecology, 12:4, 303-317, DOI: 10.3109/01674829109078010
- Huang, Yizhou MD1; Qi, Tongyun MD1; Ma, Linjuan MD1; Li, Die DPH2; Li, Chunming MD1; Lan, Yibing MD1; Chu, Ketan MD, PhD1; Chen, Peiqiong MM1; Xu, Wenxian MM1; Cao, Yina MB3; Ying, Qian MPH4; Xu, Ling MM5; Zhou, Jianhong MD, PhD1. Menopausal symptoms in women with premature ovarian insufficiency: prevalence, severity, and associated factors. Menopause: May 2021 – Volume 28 – Issue 5 – p 529-537 doi: 10.1097/GME.0000000000001733
- Moilanen JM, Mikkola TS, Raitanen JA, Heinonen RH, Tomas EI, Nygård CH, Luoto RM. Effect of aerobic training on menopausal symptoms–a randomized controlled trial. Menopause. 2012 Jun;19(6):691-6. doi: 10.1097/gme.0b013e31823cc5f7. PMID: 22334056.
- Molefi-Youri W. Is there a role for mindfulness-based interventions (here defined as MBCT and MBSR) in facilitating optimal psychological adjustment in the menopause? Post Reproductive Health. 2019;25(3):143-149. doi:10.1177/2053369119835964
- Innes, K. (2010) Mind-body therapies for menopausal symptoms: A systematic review. Maturitas. Volume 66 (2). P135-149.
- (2015) Menopause diagnosis and management, NICE guidelines [NG23]
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