The Emotional Roller Coaster of Menopause

Medically Reviewed by Jabeen Begum, MD on April 07, 2023
3 min read

Declining estrogen levels linked to menopause can cause more than those pesky hot flashes. They can also make you feel like you're in a constant state of PMS (premenstrual syndrome). That doesn't mean anything is wrong. For many people, emotional changes are part of menopause. 

Some of the emotional changes you might notice during perimenopause or menopause  include:

  • Crankiness and anger
  • Feelings of sadness
  • Loss of confidence or self-esteem
  • Anxiety
  • Forgetfulness and trouble concentrating
  • Fatigue
  • Mood swings

If you’re feeling cranky and sad, there’s a chance it could be related to menopause. But many things can make you feel this way. Tell your doctor how you’re feeling, so they can rule out other medical or psychiatric conditions.

Although depression isn’t caused by menopause, studies show that about 20% of women have symptoms of depression during this time. It’s more likely if you’ve had it at other times in your life. If you’re feeling more unable to cope, see your doctor. They may be able to recommend medicine, such as antidepressants, or therapy that can help.

Crankiness and feelings of sadness are the most common emotional symptoms of menopause. Often, they can be managed through lifestyle changes, such as learning ways to relax and reduce stress.

Here are some tips that may make it easier for you to handle your fluctuating emotions:

  • Exercise and eat healthy.
  • Find a self-calming skill to practice, such as yoga, meditation, or rhythmic breathing.
  • Avoid tranquilizers and alcohol.
  • Engage in a creative outlet that gives you a sense of achievement.
  • Stay connected with your family and community.
  • Nurture your friendships.

Sometimes, confronting the aging process triggers emotional issues around menopause. It might help to adjust your outlook.

  • Remember that menopause is a natural part of life.
  • Think about what you’ll gain with menopause. Embrace the freedom that lies ahead.
  • Focus on what you like about yourself. Cognitive behavioral therapy (CBT) can teach you to notice thoughts that make you feel bad, and replace them with positive ones.
  • Seek support from your doctor or health care system, community, and others going through these changes. 

Insomnia can be a cause-and-effect problem during menopause.  Symptoms like hot flashes can disrupt your sleep, making anxiety and depression worse. Meanwhile, mood problems themselves can cause sleep problems. Hormone replacement therapy may help. So can exercise, relaxation techniques like meditation, and avoiding caffeine and alcohol.

While there's growing evidence to suggest that hormone replacement therapy (HRT) can relieve emotional symptoms linked to menopause, HRT alone is not effective in treating more severe depression. Antidepressant drug therapy and/or psychotherapy may be necessary.



Difficulty with concentration and minor memory problems are often part of perimenopause, the time leading up to menopause (defined as not having a period for a year). But these issues are likely to be temporary.

Researchers aren’t sure why memory changes often come with perimenopause, and there are no treatments to relieve these symptoms. If you’re having memory problems, talk to your doctor. They can help manage memory problems or refer you to someone who can.

You might notice some weight gain now. It’s probably more related to your age and lifestyle changes. Menopause might change where your body stores fat, though. Your metabolism might dip.

Even though it’s normal, you can feel baffled and upset to see your body change. Try these tactics to build a healthy outlook:

  • Focus on  what you like about yourself rather than what you think of as flaws. When critical thoughts come up, it can help to jot down a few self-compliments you can come back to later.
  • Immerse yourself in positive pursuits that allow you to grow. Expand your social or spiritual life to replace inward, self-critical habits.
  • An exercise routine can boost your body image as well as your health and outlook, even if you don’t lose weight.