Mood Swings During Menopause? You're Not Alone

Most women who go through menopause won’t develop a major mood disorder. But many will experience some mood problems before, during, and after menopause when hormone levels fluctuate. These hormonal shifts can begin as early as perimenopause (the period right before menopause).

There are several ways that your mood can be affected by the hormone changes and other events around menopause. Understanding why this happens can help you cope. This article reviews what causes mood swings during menopause and ways to help relieve them.

Causes

If you're one of the women suffering from mood shifts, there may be an underlying clinical reason for it, and there are treatments and solutions that can help. Pay attention to the nature of your mood problems, and see whether one of the following could be at the root of your emotional symptoms.

Hormone Sensitivity

Some women are more sensitive to hormone changes than others. Only about 8% to 10% of women fall into this “super sensitive” category, but it can be unnerving to be easily affected by small hormone changes.

You might be in this category if you have:

• Suffered from premenstrual symptoms in the past
• Noticed you were emotionally up and down during a pregnancy
• Had postpartum depression

Any of these signs can warn that a change in estrogen levels may have a greater effect on you than on other women your age.

Estrogen plays a major role in how neurotransmitters (chemicals that affect brain and nerve function) operate. This can affect your mood and behavior. If you fall into this category, discuss hormone treatment options with your healthcare provider and see whether a short course of hormone therapy would help.

Hormonal Treatments

Women who have had a hysterectomy (removal of their ovaries) or whose ovaries have stopped functioning due to medical treatments may notice the impact of low estrogen.

Because the shift is rapid—from normal levels of estrogen to very low levels—the effect on neurotransmitters can be quite dramatic. This can cause serious mood problems or emotional instability.

Treatment for the sudden loss of estrogen depends on the cause. There are hormone therapies and selective estrogen receptor modulator (SERM) medications that may be useful during this time. If you'll be having surgical removal of your ovaries or medical treatment that affects them (such as chemotherapy), talk to your healthcare provider to plan ways to minimize symptoms.

Sleep Deprivation

Women who have vasomotor symptoms (like hot flashes and night sweats) or have trouble sleeping may have mood changes caused by sleep deprivation. After the age of 40, your chances of sleep disturbances rise.

If any of the following are true for you, you might be suffering from sleep deprivation:

• You wake up at night with night sweats. Even if your night sweats are mild, they can keep you from getting deep, restorative sleep. You might think you are getting eight hours of sleep per night, but if you never get into a deep sleep, you could still be sleep deprived.
• You regularly get less than seven hours of sleep a night. People are less productive and will have problems with memory and concentration if they ignore the need for sleep.
• You wake up thinking about problems. Stress is a major reason for sleep loss, so learning stress management techniques and ways to fall back asleep can give you more emotional stability to cope with life’s challenges.
• You snore. Snoring could be a symptom of sleep apnea. Weight gain and age can contribute to sleep apnea. Like night sweats, sleep apnea can prevent restorative sleep. If you snore and are tired during the day, you may want to consider a sleep study to see if you need treatment.

Sleep deprivation or a sleep disorder can cause irritability, anxiety, and depression if it goes on for long.

History of Depression

If you have a history of depression, you're more likely to suffer mood problems during menopause. If you have been on antidepressants in the past, or have been diagnosed with a depressive disorder, menopause may bring back depression. If you notice that your mood is suffering again, get help as soon as you notice.

Life Circumstances

So many life events can happen during the years after 40 that contribute to mood swings. Change can be a source of anxiety even when the changes themselves are positive. But add to that any hormone fluctuations, health concerns, and major life events, and you may feel especially overwhelmed.

Some common changes and challenges a woman faces during menopause can include:

• Children becoming teenagers
• Aging parents
• Changes in marital status or marriage instability
• Work stress
• Children getting married or having their own children
• Relocating to a new home
• Health issues

Changes to your normal routine can shorten your fuse and make you more likely to be anxious, irritable, or sad.

Treatment

If your mood is affected by your menopause transition, there are things you can do. Depending on what is causing them, you may want to consider:

• Hormone therapy
• Treatment for a sleep disorder
• Lifestyle changes that get you less stress and more sleep
• More exercise
• Stress management techniques
• Treatments for hot flashes and night sweats
• Anti-anxiety medications
• Antidepressant medications

Coping

Mood changes during menopause can be unnerving. They affect your relationships and your ability to manage your life. Follow these four steps to a better mood:

• Figure out why you're having mood swings. Whether it's hormones or life stress, look at what the causes might be before you try to treat it.
• Make lifestyle changes that make sense. Some simple changes can help your mood, including exercise, an earlier bedtime, talking about it, or eliminating stimulants like caffeine.
• Get treatment. Mood problems are common during this time of life. The earlier you address them, the sooner you can lessen their impact on your life. Don’t be afraid to discuss this with your healthcare provider.
• Be patient. Mood changes tend to happen in early perimenopause. As your body adjusts to the new levels of estrogen and other changes, you'll likely see an improvement in your mood.

Summary

Menopause can bring about many changes to your life. In response to fluctuating hormones, you may start to experience mood swings. First, understand that this is normal. Find out what may be causing your mood shifts and then take action to see what can help fix it. Talk to your healthcare provider if you need more guidance on improving your mood.