Making sense of mood swings during perimenopause

How’s your mood been lately? If the answer is up and down, or if you’re feeling overwhelmed, tired, and a bit out of control, perimenopause could be a factor. 

What’s behind my mood swings?

During perimenopause (the years leading up to menopause), hormone levels — especially estrogen levels — begin to fluctuate. Estrogen interacts with serotonin, a hormone that helps stabilize mood and promote feelings of wellbeing. So as estrogen changes, it may also impact serotonin, leading to mood swings.

Some of the other changes during menopause can also put a dent in our moods, especially sleep disruptions (including those caused by hot flashes), and other symptoms (such as vaginal dryness) that feel uncomfortable or distressing.

Menopause also happens at a time when people may be going through lots of stress, from busy careers to kids leaving home and aging parents needing more care. 

All of these things can put a tremendous strain on our moods. So if your moods feel different from what you’re used to, please know that this is common during perimenopause, and you’re not alone.

Lifestyle changes that can help with mood swings

If your moods are getting you down — and up, and down — lifestyle changes can really help. Here’s what to try:

  • Be mindful about what you eat. A balanced diet with plenty of veggies, fruits, and whole grains can help your body feel well, which can improve mood, too. Try to cut back on caffeine, alcohol, and spicy foods, which can all contribute to hot flashes and make it harder to get good sleep at night.
  • Get plenty of sleep. We all know how awful it feels when you have a rough night’s rest. Over time, lack of sleep can take a huge toll on our moods. If menopause symptoms, like hot flashes, are making it hard to rest, there are lots of natural approaches that can help, or your doctor can prescribe medication to ease symptoms.
  • Add regular exercise to your routine. Studies show that exercise can lift your mood, reduce your risk for depression and anxiety, and help you sleep better! 
  • Make a plan to lower stress. You might like to try a mind-body practice such as deep breathing (there are lots of free apps that can guide you), mindfulness meditation, yoga, or tai chi. 
  • Talk to a therapist. A therapist can help you explore how you’re feeling and find meaning in your experiences.

Knowing when to get help

While mood swings are a normal — and temporary — part of perimenopause for many people, the risk for depression is also higher at this time, especially for people who’ve already experienced depression earlier in their lives. Clinical depression is a medical condition, and lifestyle changes can help, but you may also need more support to feel better. 

If you’ve spent weeks feeling sad, irritable, low on energy, or disinterested in the things you usually care about, please talk with your doctor. If you and your doctor agree that it’s time to treat depression, prescription hormones (HRT or a low-dose birth control pill) or an antidepressant may help. Therapy is also an important piece of the puzzle. 

Are you wondering what’s causing your mood swings? Want to talk through the lifestyle changes or medications that could help? Reach out to your provider for more information.

Reviewed by the Ovia Health Clinical Team


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