Are your menopausal moods out of control?

Changing hormone levels and the symptoms they produce can impact your whole life, but you’re not alone

Every week, I see women in their 40s and 50s at my clinic who make an appointment to say they are ‘losing it’. They think they have the onset of dementia; they are sad, low, angry, irritable, anxious, fed-up, out of control… the list goes on. Many are aware of common physical menopause symptoms, such as hot flushes or sweats, but not that the perimenopause and menopause can also have a huge psychological impact. So if you’re currently suffering, it’s important to know you’re not alone.

The menopause is the last period. You haven’t gone though it until you’ve not had a period for a year. The perimenopause is the time leading up to the menopause itself. You can have symptoms of the menopause, even though you may still be having periods, be they regular or irregular.

Psychological symptoms of the perimenopause and menopause may include a worsening of any premenstrual syndrome symptoms (if you still have periods), such as irritability or low mood. Many people will notice an increase in anxiety, such as feeling tense and fearful, and may have physical symptoms associated with this, such as shortness of breath or palpitations.

Depression can occur, with persistent and often overwhelming feelings of not only sadness but also worthlessness, uselessness or thinking that you’re a failure. This can also lead to physical symptoms, such as difficulties sleeping or changes to your appetite.

‘You may feel tense and fearful’

Irritability is common, too. You may be irritated by everything and nothing, often snap or not be able to control yourself. Mood swings can occur, where your mood may rapidly veer from low to irritable to normal and back again. There can also be difficulties with memory and concentration.

These symptoms are all related to the change in hormone levels. Oestrogen does not only affect your reproductive system, it has an impact on your whole body, including your brain. Falling levels of oestrogen affect the production of serotonin in the brain, sometimes called the ‘happiness’ neurotransmitter, which is involved in sleep, mood and more. Oestrogen receptors are found in the areas of the brain important for memory and concentration too. This means menopausal changes can influence every area of life, from personal and family relationships, your sex life and your ability to function at work.

While this all sounds frightening, the good news is that there are solutions that can help. The first-line treatment for mental health symptoms, which start around the time of the perimenopause and menopause, is hormone replacement therapy (HRT), as opposed to antidepressant medication. (Although if you’ve previously been diagnosed with depression, which has recurred, it may be more appropriate to start an antidepressant medication.) Talking therapies, such as cognitive behavioural therapy (CBT) can also be helpful. Interestingly, CBT can be beneficial when it comes to hot flushes! It’s important to get help and not suffer alone, so see your GP to discuss available and suitable options for you.