Emotional fluctuations affect approximately 20% of women during menopause, making them one of the toughest parts of this natural life transition. Most women experience menopause symptoms for about seven years. These emotional changes can substantially disrupt daily life and relationships. The sudden changes between irritability, sadness, and anxiety leave many women feeling overwhelmed and confused.
Declining estrogen levels trigger these emotional symptoms by directly affecting brain chemistry and mood regulation. Sleep problems common during menopause can worsen depression symptoms and create a cycle of emotional instability. The good news is that women can find solutions that work, ranging from lifestyle changes to medical treatments.
This detailed piece explains the science behind these mood changes and helps women identify signs of more serious menopause depression. Women will find practical ways to direct themselves through this temporary phase with better emotional balance. The solutions range from NHS-recommended diet plans to cognitive behavioral therapy and natural supplements that can help restore well-being.
Understanding the emotional side of menopause
"One should remember that the menopause is a normal and natural process, and it should not be dreaded. Realizing that the condition is a natural occurrence which all women experience—if they live long enough—and a philosophical calm acceptance of this fact, will help lessen the nervous symptoms." — Lulu Hunt Peters, M.D., Physician and early 20th-century health educator
The way hormones interact during menopause affects way beyond just physical health—it changes emotional wellbeing deeply. Studies show that 4 in 10 women experience mood symptoms like in PMS during perimenopause [1]. These emotional changes become one of the toughest yet rarely discussed parts of this life change.
Why menopause affects your mood
Your changing hormone levels cause menopausal mood swings. Lower estrogen changes brain chemistry in several key ways. Estrogen gets more serotonin (the "happiness hormone") and thus encourages more calming brain chemicals when combined with progesterone [2]. Then, as these hormones go up and down before dropping, women often face:
- Irritability and anger
- Feelings of sadness
- Loss of self-esteem
- Anxiety and tension
- Trouble concentrating
These hormonal changes don't happen alone. Physical signs like hot flashes and night sweats can mess up sleep patterns. This creates a cycle that makes mood issues worse [3]. Research shows that "If you're getting too little or poor-quality sleep, you may have trouble making decisions, solving problems, controlling your emotions and behavior, and coping with change" [1].
Life's demands make things harder. Many women in their 40s and 50s juggle busy careers while raising kids and taking care of aging parents [1]. These biological and life changes combine to create perfect conditions for emotional ups and downs.
Stages of menopause and emotional changes
Emotional symptoms show up differently during menopause stages:
Perimenopause: The most intense mood swings happen in this early stage. Research shows that women in early perimenopause face a 30% higher risk of experiencing high depressive symptoms compared to premenopausal women [4]. Hormone levels swing wildly before dropping, which often leads to unexpected mood changes.
Menopause and Postmenopause: Some women feel more emotionally stable after reaching menopause (12 months without a period). Others still deal with mood swings. Studies reveal that postmenopausal women are 57% more likely to report serious depressive symptoms than during their premenopausal phase [4].
These emotional changes often appear before physical symptoms and sometimes before period patterns change [2]. This makes it easy to blame stress or other factors instead.
Menopause and crying: what's normal?
Sudden crying spells become one of the most unsettling emotional signs of menopause. These episodes can feel overwhelming and random. Sometimes tiny stress triggers them, or they just happen without any clear reason [4].
Women often say they feel emotionally "out of control" during these crying spells. This links directly to hormonal fluctuations that disrupt the brain's emotion control systems [4]. These reactions might seem too strong, but they come from real brain chemical changes, not personal weakness.
Keep in mind that crying spells happen often, but constant feelings of hopelessness or worthlessness that affect daily life might signal something beyond normal menopause changes [1]. NHS data suggests that asking for help early can reduce how menopause affects your health, relationships, and work [1].
This emotional experience feels tough, but it won't last forever. It's just a natural phase of life.
Recognizing when mood swings are more than hormonal
Mood swings are normal during menopause, but sometimes emotional changes point to deeper issues. Many women find it hard to tell the difference between regular hormonal changes and clinical depression because the symptoms often look similar.
Signs of menopause depression
Depression hits about 23% of perimenopausal and postmenopausal women [5]. These symptoms go beyond regular mood swings and can really disrupt daily life.
Here's what to watch for if emotional changes might be depression:
- Sadness, hopelessness, or feelings of worthlessness that don't go away for weeks
- Feeling empty inside instead of just being irritable or tearful
- No interest in things you used to love
- Extreme tiredness and zero motivation
- Problems with focus or making decisions ("brain fog")
- Changes in how you eat or sleep beyond typical menopause issues
Research shows women who have dealt with depression before are almost five times more likely to get diagnosed with major depression during menopause [6]. Studies also tell us women face higher risks of depression during perimenopause [7].
When to seek professional help
You should talk to a doctor if emotional symptoms start getting in the way of your life. Get help if you notice:
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Thoughts about suicide
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Bad feelings that stick around more than two weeks
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Pulling away from people and activities
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Anxiety that won't let up and stops you from doing regular tasks
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Strong physical symptoms with anxiety (heart racing, chest pain, feeling dizzy)
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Sleep problems worse than usual night sweats [7]
"It's important to realize that the mental symptoms of menopause are as real as the physical ones, and you should not wait to seek help if you are struggling," notes NHS Inform [5]. The hormonal changes of menopause can make existing mental health conditions like bipolar disorder or schizophrenia worse [8].
Dr. Louisa James, who treats many menopausal women, explains the subtle differences: "The rage is different as well. You can get irritability with clinical depression or feel more short-tempered, but that irrational thinking and feeling that everything's out of perspective—that tends to be worse with the hormonal type depression" [6].
Menopause and mental health in the UK
Mental health support for menopausal women has gotten more attention in the UK lately. A Newson Health survey found 95% of women saw negative changes in their mood and emotions during menopause [6].
The numbers paint a worrying picture. About 38% of women who asked healthcare professionals about menopause symptoms were offered antidepressants instead of hormone replacement therapy [6]. This suggests doctors might not always spot the hormonal roots of menopausal emotional symptoms.
UK residents dealing with serious mood issues can turn to:
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Their GP for assessment and referral
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NHS mental health services, including talking therapies
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The Samaritans (116 123) for immediate emotional support
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Specialized menopause clinics for complete care [9]
The NHS believes early advice can reduce how much perimenopause and menopause affect your health, relationships and work [10]. Remember, mental health challenges during menopause don't mean you're "losing your old self"—your body is going through real changes that respond well to the right treatment [9].
Lifestyle changes that support emotional wellbeing
"The very best way that you can help yourself is to develop and sustain a positive attitude. The way you think and feel about everything will make all the difference to your experience." — Caroline Carr, Author of 'Menopause: The Guide for Real Women', menopause educator
Lifestyle changes are one of the best ways to handle mood swings during menopause. Simple daily habit changes can substantially reduce emotional symptoms without medication.
NHS menopause diet plan and exercise
Your food choices affect your emotional wellbeing during menopause directly. Studies show that increasing wholegrains, fruits, and vegetables while cutting down on fats can help reduce hot flushes and mood disruptions [11]. A Mediterranean-style diet helps improve vasomotor symptoms that often lead to emotional instability [12].
Nutritionists recommend these steps to balance hormones:
- Eat calcium-rich foods (700mg daily) to keep bones healthy [13]
- Add phytoestrogens from soy products, lentils, and flaxseeds [13]
- Cut back on caffeine, alcohol, and spicy foods that trigger mood swings [13]
Physical activity stands out as the most powerful natural mood stabilizer. Research shows women who exercise regularly feel less depressed because movement boosts "feel-good chemicals" like serotonin [14]. The NHS suggests 150 minutes of moderate-intensity exercise weekly, plus two strength-building sessions [11]. Walking or cycling are great ways to get these benefits.
Sleep hygiene and stress reduction
Bad sleep and stress create a cycle that makes menopausal mood swings worse. Start by making your bedroom sleep-friendly—cool, dark, and quiet [15]. A regular bedtime routine helps, so stay away from screens before sleep [16].
Rhythmic breathing works well to manage stress. Here's a simple exercise: breathe in slowly through your nose for five counts, then breathe out for five [17]. Your body naturally relaxes as you exhale.
Progressive muscle relaxation, visualization, and mindfulness meditation help reduce stress and hot flushes physically [18].
Creative outlets and social connection
Creative activities give you a powerful way to process complex emotions during menopause. Art, writing, singing, or crafts bring both joy and healing benefits [19]. One woman found that painting menopause self-portraits turned into unexpected therapy and started conversations with other women facing similar challenges [19].
Social connections matter just as much. Research shows women with strong social networks feel more positive about menopause and experience less depression [20]. A study found that women who joined hosted social groups like the University of the Third Age (U3A) had fewer climacteric and depressive symptoms [20].
Don't withdraw socially—a common reaction during menopause. Instead, join support groups or community activities that promote meaningful connections.
Medical and therapeutic options
Medical and therapeutic treatments can help women who don't deal very well with severe menopausal mood symptoms. These treatments include everything from talking therapies to medications that doctors can tailor to each woman's priorities.
What to take for menopause anxiety
Women with ongoing mood swings during menopause can consider these medication options:
- Antidepressants: SSRIs like paroxetine—the only FDA-approved nonhormonal medication for hot flashes [21]—can help improve mood. Fluoxetine and venlafaxine are also helpful and might reduce hot flashes even if you don't have depression [1].
- Gabapentin: This nerve pain medication has shown good results for menopausal flushing symptoms, though you might experience side effects like dizziness [1].
- Clonidine: This blood pressure medication helps manage hot flashes that can trigger anxiety [22].
Women who experience low libido and mood issues might benefit from testosterone gel along with other treatments [22].
CBT and talking therapies
CBT stands out as a powerful tool for menopausal emotional symptoms. The National Institute for Health and Care Excellence (NICE) recommends CBT as the first choice to treat anxiety and depression during menopause [23].
CBT works well for both psychological and physical symptoms. Research shows it leads to "significant drop in anxiety and depression scores, as well as noticeable improvements to menopausal symptoms such as hot flushes and night sweats" [24].
You can access CBT through individual sessions, group therapy, online platforms, or self-help books—making it available for different needs [25].
Hormonal and non-hormonal treatments
HRT remains the most effective way to treat menopausal symptoms. HRT replaces falling estrogen levels and can:
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Help boost mood and overall happiness
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Help you sleep better
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Lower diabetes risk [26]
All the same, HRT isn't right for everyone, especially women with histories of breast cancer, blood clots, or certain cardiovascular conditions [26].
Other options exist. Besides the medications mentioned earlier, over-the-counter vaginal lubricants and moisturizers help with vaginal symptoms that might affect mood [21].
Follow-up care and monitoring
Regular monitoring will give a safe and effective treatment experience. Most women should plan for:
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Their first follow-up three months after starting treatment
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Yearly reviews if symptoms stay under control [22]
Healthcare providers check symptom control, possible side effects, weight, and blood pressure during these visits. They might adjust treatments based on these results [4].
The average treatment duration is about five years, though this varies by person. Gradually reducing treatment over 3-6 months helps prevent symptoms from returning [4]. Keep in mind that if severe symptoms come back after stopping, you might need to restart treatment at the lowest effective dose.
Natural remedies and daily habits that help
Most women prefer natural ways to handle mood swings before they start medication. Research by the British Menopause Society shows 95% of women would try natural remedies instead of hormone replacement therapy to manage symptoms like mood changes [2].
Menopause supplements and vitamins
The right nutrients can help balance hormones that affect mood. Vitamin D serves a vital role in how our brain works and regulates mood. UK government guidelines suggest taking 10 micrograms each day [27]. Magnesium kicks the parasympathetic nervous system into action. This helps the body prepare for sleep and might reduce stress levels [27].
Flaxseed contains omega-3 fatty acids that can reduce inflammation linked to mood problems. Vitamin B6 helps create serotonin - a mood-regulating neurotransmitter that specifically helps with anxiety and stress [28]. Zinc offers anti-inflammatory benefits that could boost brain health and improve memory issues for those with cognitive symptoms [28].
Herbal options: what's safe and effective?
Black cohosh stands out among herbal remedies. Studies involving 1,400 menopausal women revealed it cut down hot flushes and sweating by 25% [2]. St. John's wort does more than help with low mood - it might also reduce hot flushes and night sweats [2].
Safety remains a top priority. The NHS points out that "natural" products aren't always safe [29]. St. John's wort can cause serious side effects when combined with certain medications [29].
7 natural menopause treatments that really work
Current evidence supports these effective natural approaches:
- Mediterranean-style diet rich in phytoestrogens
- Regular physical activity (150 minutes weekly)
- Magnesium supplements for sleep and mood
- Black cohosh for hot flushes
- Vitamin D and calcium for mood and bone health
- Stress reduction techniques like yoga and mindfulness
- Omega-3 fatty acids for inflammation and mood stability
A healthcare provider should review any supplement plan you consider. Medical experts emphasize that over-the-counter supplements pack quite a punch and can interact with other medications [30].
Conclusion
Mood swings are among the toughest parts of menopause, but they don't have to control this natural life transition. A woman's emotional ups and downs have their roots in hormonal changes, and understanding this helps manage them better. It's vital to know the difference between normal mood changes and depression to get the right help.
Women going through this phase have several proven options they can use. A Mediterranean-style diet, regular exercise, and good sleep habits are the foundations for keeping emotions stable. CBT techniques also give women powerful ways to reshape thought patterns that fuel anxiety and low moods.
Some women might need extra help through hormone replacement therapy or specific medications that can bring substantial relief. Natural alternatives work well for those who prefer non-drug approaches. A mix of vitamin D, magnesium, and omega-3 fatty acids shows great potential to regulate mood during these hormonal shifts.
Women dealing with menopausal mood changes should know this challenging phase won't last forever. The right support and combination of treatments can help restore emotional balance. Menopause isn't just an ending - it's a transformation that millions of women handle well each year. They come through it with a fresh point of view and stronger emotional resilience.
FAQs
Q1. How can I manage mood swings during menopause? To manage mood swings, try regular exercise, maintain a balanced diet rich in fruits and vegetables, practice stress-reduction techniques like yoga or meditation, ensure good sleep hygiene, and consider talking to your doctor about hormone replacement therapy or other medical options if symptoms are severe.
Q2. What causes low mood during menopause? Low mood during menopause is primarily caused by hormonal changes, particularly the decline in estrogen levels. This can affect neurotransmitters like serotonin, which regulate mood. Other factors include sleep disturbances, life changes, and stress associated with this transitional period.
Q3. Are there natural remedies that can help with menopausal symptoms? Yes, several natural remedies can help. These include consuming a Mediterranean-style diet rich in phytoestrogens, taking supplements like magnesium and omega-3 fatty acids, using herbal remedies like black cohosh (after consulting with a healthcare provider), and practicing stress-reduction techniques such as mindfulness meditation.
Q4. When should I seek professional help for menopausal mood changes? Seek professional help if you experience persistent feelings of sadness or hopelessness lasting more than two weeks, have suicidal thoughts, withdraw from social activities, or if mood changes significantly interfere with your daily life. It's important to distinguish between normal mood fluctuations and more serious depression.
Q5. How effective is hormone replacement therapy (HRT) for managing menopausal symptoms? Hormone replacement therapy is considered one of the most effective treatments for managing menopausal symptoms, including mood swings, hot flashes, and sleep disturbances. However, it's not suitable for everyone, and the decision to use HRT should be made in consultation with a healthcare provider, considering individual health history and risk factors.
References
[1] - https://patient.info/womens-health/menopause/alternatives-to-hrt
[2] - https://www.hollandandbarrett.com/the-health-hub/conditions/womens-health/menopause/best-natural-menopause-cures/
[3] - https://www.webmd.com/menopause/emotional-roller-coaster
[4] - https://patient.info/doctor/hrt-follow-up-assessments
[5] - https://www.nhsinform.scot/healthy-living/womens-health/later-years-around-50-years-and-over/menopause-and-post-menopause-health/menopause-and-your-mental-wellbeing/
[6] - https://www.drlouisenewson.co.uk/knowledge/am-i-depressed-or-menopausal
[7] - https://health.clevelandclinic.org/is-menopause-causing-your-mood-swings-depression-or-anxiety
[8] - https://mentalhealth-uk.org/menopause-and-mental-health/
[9] - https://www.mymenopausecentre.com/symptoms/mood-swings/
[10] - https://www.nhs.uk/conditions/menopause/symptoms/
[11] - https://www.bupa.co.uk/newsroom/ourviews/menopause-exercise
[12] - https://www.nutrition.org.uk/nutrition-for/women/menopause/managing-menopause-symptoms-with-nutrition-and-diet/
[13] - https://www.cuh.nhs.uk/patient-information/menopause-a-healthy-lifestyle-guide/
[14] - https://www.healthline.com/health/menopause-mood-swings
[15] - https://www.sleepfoundation.org/women-sleep/menopause-and-sleep
[16] - https://www.nuffieldhealth.com/article/sleep-tips-when-youre-in-menopause
[17] - https://www.webmd.com/menopause/learning-relax-during-menopause
[18] - https://www.bristolmenopause.com/blog/managing-stress-to-alleviate-menopausal-symptoms
[19] - https://www.mymenopausecentre.com/menopause-stories/perimenopause-took-a-toll-on-my-mental-health-painting-helped-me-through/
[20] - https://pmc.ncbi.nlm.nih.gov/articles/PMC7696753/
[21] - https://www.health.harvard.edu/womens-health/nonhormonal-treatments-for-menopause
[22] - https://www.nhs.uk/conditions/menopause/treatment/
[23] - https://www.mymenopausecentre.com/blog/the-benefits-of-cognitive-behavioral-therapy-in-managing-menopause-symptoms/
[24] - https://www.gmmh.nhs.uk/news/life-changing-cbt-for-menopause-program-rolled-out-after-successful-pilot-6650/
[25] - https://www.nice.org.uk/guidance/ng23/resources/access-to-cognitive-behavioral-therapy-cbt-13553197309
[26] - https://my.clevelandclinic.org/health/treatments/15245-hormone-therapy-for-menopause-symptoms
[27] - https://www.drlouisenewson.co.uk/knowledge/do-i-need-supplements-during-menopause
[28] - https://www.menopausecare.co.uk/blog/menopause-supplements
[29] - https://www.nhs.uk/medicines/hormone-replacement-therapy-hrt/alternatives-to-hormone-replacement-therapy-hrt/herbal-remedies-and-complementary-medicines-for-menopause-symptoms/
[30] - https://www.healthline.com/nutrition/11-natural-menopause-tips
