How Does Menopause Affect Your Emotions?

Medically Reviewed by Traci C. Johnson, MD on November 09, 2020

You snap at the friendly cashier. A good night’s sleep seems like a distant dream. You feel happy one moment, then burst into tears the next.

What’s going on? If you’re between 45 and 55, on average, it might not be you. It could be menopause, which happens when your ovaries stop making estrogen and progesterone. This natural part of life sets in when you’ve missed 12 monthly periods in a row.

Emotional Symptoms

Hot flashes may get the most press, but you might have other symptoms you don’t hear as much about. These can include mood swings, bursts of anger, and other emotions you may not know what to do with. You may go through times of sleeplessness.

The good news is these symptoms will pass. Here are some that might come up, and ways to keep them under control through this time.

Depression: You likely know about premenstrual syndrome (PMS) and other times when hormonal shifts can affect your frame of mind. This happens with menopause, too. Estrogen and progesterone affect serotonin and other neurotransmitters linked to mood. Big changes with these hormones can set your emotions awry.

Studies show that about 20% of women feel depressed at some time during menopause. You’re more likely to have depression now if you’ve had it at other times in your life. You might notice signs like:

  • Crying jags
  • Dark thoughts
  • Feeling worthless
  • Loss of hope
  • Low energy
  • Not enjoying what you used to
  • Sadness
  • Trouble making decisions

Anxiety: Depression and anxiety symptoms can overlap. One often will trigger the other. You may have anxiety if you:

  • Find it hard to relax
  • Feel fearful, panicky, or sense you’re in danger
  • Are moody or testy
  • Get impatient
  • Have nagging worry
  • Get restless

How to Treat Emotional Symptoms

Antidepressants: If you have major depression, especially at the start of menopause, your doctor might prescribe a standard antidepressant. It can take 4-6 weeks for effects to set in. Be aware, though, that they can sometimes cause edginess and insomnia. You might need to weigh the benefits against side effects.

Hormone replacement therapy (HRT): Some studies show that taking estrogen can help ease mild depression in early menopause. It can also boost the effects of an antidepressant. Your doctor might want you to try it if other treatments don’t help. As with all medications, there are risks and benefits, so be sure to talk with your doctor to make sure this is right for you.

Complementary and integrative treatments: There’s a wide range of relaxation methods you can learn online, in a class, or with a book, CD, or DVD. You can tap into:

Lifestyle changes that can help

  • Eat a well-balanced diet with lots of veggies, fruits, and grains. Meanwhile, limit alcohol, caffeine, and spicy foods, which can make symptoms worse.
  • Get creative. Tap into a fun new -- or former -- activity or hobby that gives you a sense of accomplishment.
  • Keep up with your friends and community life.

Sort out your feelings

  • Have a candid talk with yourself about why you feel this way. Try to trace the emotion to its root.
  • Challenge inner voices that can bring you down. Cognitive behavioral therapy (CBT) can help you learn to nail thoughts that make you feel bad, and replace them with positive ones.
  • Think about whether you’re covering up feelings that need to come out. If so, it’s time to deal with them in a healthy way. Your doctor might suggest counseling or psychotherapy. You can do it while taking antidepressants or other meds.

To some extent, your experience with menopause likely will mirror the attitude of your culture. Some celebrate age and wisdom, and offer a move up in society. Others praise youth and urge women to fight growing older. Some even forbid the discussion of menopause at all.

You can define your own reality:

  • Remember 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.
  • Enjoy the creative, physical, and spiritual outlets you find as you manage your emotional symptoms.
  • Seek support from your doctor or health care system, community, and other women.

Physical and Mental Symptoms That Can Affect Your Emotions

Insomnia: Lack of sleep can be a cause-and-effect problem. Anxiety and depression can lead to sleep problems, which in turn can darken your mood. Meanwhile, physical changes, like dips in estrogen, can trigger hot flashes that disrupt your sleep. Either can make you feel anxious or moody.

Low doses of estrogen and progesterone can help with chronic insomnia during menopause. Oral progesterone can also make you drowsy without the daytime hangover. Ask your doctor if this form of HRT could help you get more rest.

A combination of lifestyle and self-care techniques also can cut stress and tame symptoms that keep you up at night:

  • Watch what you drink. Caffeine can hinder getting to sleep, while alcohol can interrupt it.
  • Exercise. Keep it a daytime thing, though. Too much activity before bedtime can keep your body stimulated.
  • Study techniques that link the mind and body, such as mindfulness meditation. This practice helps you focus on the present, moment to moment. One study showed that it didn’t affect hot flashes but helped lessen anxiety and improve sleep.

Memory and focus problems: It’s normal to find it hard to concentrate and remember things. Doctors don’t know why this happens around menopause. Depression and anxiety can make you notice it more, though.

There are lots of ways to keep your mind sharp. Try a few:

  • Read, do a puzzle that challenges you, or solve math problems to give your brain a workout along with your body.
  • Try to limit activities that don’t make you think, like watching TV.
  • Check in with your doctor for support and new techniques to hone your memory.

Body image: You might notice some weight gain now. It’s likely 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.


WebMD Medical Reference



CDC: “Women’s Reproductive Health.”

The 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.”

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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