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The Emotional Roller Coaster of Menopause

Medically Reviewed by Traci C. Johnson, MD on August 09, 2021

Declining estrogen levels associated with menopause can cause more than those pesky hot flashes. They can also make women feel like they are in a constant state of PMS (premenstrual syndrome). Unfortunately, these emotional changes are a normal part of menopause.

Some of the emotional changes experienced by women undergoing perimenopause or menopause can include:

  • Irritability
  • Feelings of sadness
  • Lack of motivation
  • Anxiety
  • Aggressiveness
  • Difficulty concentrating
  • Fatigue
  • Mood changes
  • Tension

If you’re feeling irritable and sad, there’s a good chance it could be related to menopause. But many things can make you feel downright irritable. 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 increasingly unable to cope, see your doctor. They may be able to recommend medicine, such as antidepressants, or therapy that can get you through this rough time.

How Can I Cope With the Emotional Changes of Menopause?

Irritability 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 fosters a sense of achievement.
  • Stay connected with your family and community.
  • Nurture your friendships.

For a lot of women, 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. For instance, don’t mourn the loss of childbearing years. Embrace the freedom that lies ahead.
  • Get the focus off your crow’s feet and body changes and onto 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 other women. 

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.

Can Hormone Replacement Therapy Help During Menopause?

While there is 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.

I Have a Hard Time Concentrating and I'm Forgetful. Is This a Normal Part of Menopause?

Unfortunately, difficulty with concentration and minor memory problems can often be a normal part of perimenopause, the time leading up to menopause (defined as not having a period for a year). The good news is that it is 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.

What Can I Do About My Changing Body Image?

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:

  • Get the focus off your flaws and onto what you like about yourself. 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.

Show Sources

SOURCES:

North American Menopause Society: "Menopause FAQs: Understanding the Symptoms,” “The 2017 Hormone Therapy Position Statement of the North American Menopause Society,” “Get Positive About Body Image.”

National Institutes of Health.

Rakel: Integrative Medicine, 3rd ed. Greendale, GA.

Neurology, May 26, 2009.

CDC: “Women’s Reproductive Health.”

Indian Journal of Psychiatry: “Postmenopausal Syndrome.”

Hormone Health Network from the Endocrine Society: “Mood Swings.”

Cleveland Clinic: “Menopause: Emotional Aspects (Including Depression),” “Management and Treatment,” “Outlook / Prognosis.”

Jean Hailes, For Women’s Health: “Menopause: Mental Health & Emotions.”

Mayo Clinic: “Menopause.”

National Center for Complementary and Integrative Health: “Yoga: In Depth,” “Menopausal Symptoms: In Depth.”

JMI Database of Systematic Reviews and Implementation Reports: “Women's Experience of Menopause: A Systematic Review of Qualitative Evidence.”

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