Why do I get mood changes during menopause?

In this guest blog, Dr Louise Newson discusses how your wellbeing may be affected during perimenopause and menopause.

If you’re perimenopausal or menopausal, you may sometimes notice a dip in your mood.

In a Newson Health survey of 5,800 women, an overwhelming 95% of respondents said they’d experienced a negative change in their mood and emotions since the start of perimenopause, with stress and anxiety, feeling more easily overwhelmed, feeling low or tearful and feeling angry or irritable all being frequently cited.

Why can mood changes happen during perimenopause and menopause?

The three key hormones – oestrogen, progesterone and testosterone – that fluctuate and fall during perimenopause and menopause all play a part in regulating your mood.

Oestrogen helps to regulate several hormones with mood-boosting properties, including serotonin, which helps with your mood, energy, motivation and sleep. When levels of the oestrogen fall, levels of serotonin fall, too, while cortisol (the primary stress hormone) rises. Oestrogen also can help with cognition, so reduced levels can lead to brain fog and forgetfulness, which can also lower your mood.

Oestrogen, progesterone and testosterone work in many different areas of your brain, including the hypothalamus, amygdala and hippocampus, which are all important areas to regulate mood. Progesterone has a mild sedative effect and can help you to feel calm and relaxed. So when this hormone falls, you may feel more irritable or quicker to anger. Plus, a lack of testosterone can negatively affect memory and mood.

Don’t forget about the impact of physical symptoms, too

The knock-on effects of physical symptoms can also affect your mental health during perimenopause and menopause: if you’re struggling with genitourinary symptoms like vaginal dryness, or hot flushes, aching joints or a lack of sleep, your mood will likely be affected too.

And don’t forget that perimenopause and menopause can also come at a tricky stage of life – you might be coping with a busy career and caring responsibilities, such as caring for elderly relatives or or children still at home.

I know when I think back to when I was perimenopausal and before I started treatment and juggling a career with raising three daughters, my moods could be unpredictable: I’d often feel tearful one minute and irritated the next.

What can I do to improve my mood?

If you are experiencing mood changes during perimenopause and menopause, then the first step is to talk to a healthcare professional. Hormone replacement therapy (HRT) is the first line treatment for the management of perimenopause and menopause symptoms, including menopause-related low mood.

Cognitive behavioural therapy can also help, and it’s really important to take a holistic approach to managing any menopause symptoms too by prioritising sleep and trying to reduce stress where possible.

And don’t forget about the benefits a balanced diet and regular exercise can bring: activities that involve a mind-body connection, such as yoga or tai chi, can be particularly beneficial during menopause. These practices not only provide physical benefits but also help in managing stress, improving mental wellbeing and focus.

For me personally, yoga is a key part of my mental health toolkit. I know I can flick out my yoga mat and practice it anywhere anytime, whether it’s first thing in the morning at home, or even in a hotel room if I’m away at a speaking event.

Why communication matters

It’s important to remember that if you are experiencing low mood, you aren’t alone. It sounds like a cliché but a problem shared really is a problem halved. Try and be open with friends and loved ones about how you are feeling, and accept any offers of support to try and lighten the mental load.

Dr Louise Newson is a GP and Menopause Specialist and founder of Newson Health, the balance menopause support app and author of the Sunday Times bestseller The Definitive Guide to the Perimenopause and Menopause. Tickets for her UK theatre tour, Hormones and Menopause: The Great Debate, are on sale now and her new online course, Dr Louise Newson Menopause Masterclass, is available now.