Menopause, Mood Swings & Mental Health

Menopause is a natural part of the aging process in women, and this period of transition can be accompanied by a range of physical and emotional symptoms, including mood changes.

During perimenopause and menopause, fluctuating hormone levels can affect the brain's neurotransmitter levels, leading to changes in mood and emotional well-being. This can manifest as irritability, anxiety, depression and mood swings.

Additionally, the physical symptoms of menopause, such as hot flashes, sleep disturbances and fatigue, also can contribute to changes in mood.

Board-certified family medicine physician Kimberland Anderson, MD, with Franciscan Physician Network in St. John, Indiana, discusses the hormonal changes of menopause and the impact they may have on your mental health and moods.

Why Do Hormonal Changes From Menopause Impact Some Women’s Moods?

The biological changes associated with perimenopause and menopause, such as hormonal fluctuations and decreased estrogen levels, can affect neurotransmitter levels and the brain. These hormonal changes can lead to changes in mood and cognition, including mood swings, anxiety, depression, memory loss and difficulty concentrating. 

Women in perimenopause, the transition period prior to menopause, are 40% more likely to experience depression than premenopausal women, according to an April 30 report in the Journal of Affective Disorders, which reviewed studies involving more than 9,100 women around the world. During perimenopause, the ovaries begin producing fewer female hormones, and fluctuating hormone levels can cause mood changes along with irregular menstrual cycles and other symptoms, researchers said.

“The hormonal changes that a woman could begin to experience in perimenopause and menopause may cause changes in mood and irritability,” explained Dr. Anderson, who practices at Franciscan Physician Network Hammond Clinic. “These changes can be very common or cause an exacerbation of already existing issues with mood.”

These changes may be more pronounced in women who are more sensitive to hormonal changes or who have a history of mood disorders.

“A woman going through menopause who is concerned about cognition and/or mental health should see her provider,” Dr. Anderson said.  “The provider would be able to evaluate her and address her concerns.”

Do Physical Changes From Menopause Impact Mental Health?

Some physical changes from menopause, such as night sweats and hot flashes, may be linked with depression and stress in women going through menopause.

According to a study at the North American Menopause Society, night sweats were significantly associated with depression and stress, while hot flashes were significantly associated with only depression in women going through menopause.

“The study showing a link between night sweats and hot flashes with increased stress and depression may be due to disruption of sleep and as indirect physical symptoms of the hormonal changes,” Dr. Anderson said.

These physical changes from menopause can be disruptive and uncomfortable and may lead to reduced self-esteem and body image issues, which can cause increased stress and depression in some menopausal women.

How Can Women Going Through Menopause Support Their Mental Health?

“Supporting mental health when going through menopause is key,” Dr. Anderson said. “The first thing is to be aware that there is a possible link between menopause and mental health.  Healthy diet, exercise and adequate hydration are very important as well as participating in activities that give fulfillment.”

Here are 5 ways that women going through menopause can support their mental health:

1. Seek professional help: If you are experiencing symptoms of anxiety or depression, it is important to seek help from a mental health professional. They can provide support and guidance to help you manage your symptoms.
2. Practice self-care: Taking care of your physical and emotional well-being is important during menopause. This may include regular exercise, eating a healthy diet, getting enough sleep, and finding ways to relax and destress.
3. Talk to friends and family: Sharing your experiences with loved ones can provide emotional support and help you feel less alone.
4. Join a support group: Many women find it helpful to connect with others going through similar experiences. Joining a support group can provide a sense of community and provide opportunities to share tips and advice with others.
5. Consider hormone therapy: For some women, hormone therapy can help alleviate symptoms of menopause and improve overall well-being. Discuss with your healthcare provider if hormone therapy is a suitable option for you.

Are Mood Changes With Menopause Temporary?

“Mood changes can be temporary,” Dr. Anderson said. “However, the average woman goes through 5-6 years of perimenopause/menopausal symptoms, so it is entirely possible that mood changes could persist for quite some time.  A woman should reach out to her provider when her symptoms, whether it be mood or hot flashes, are affecting her ability to function well in daily life despite making good lifestyle adjustments (healthy diet, exercise, hydration etc.).”

How Does Stress Impact Menopause Symptoms?

A history of stress is associated with worse menopausal symptoms and poorer well-being in midlife, according to a study published online in the journal Menopause.

Researchers found several associations between adverse experiences and menopausal or mental health symptoms, including:

• History of physical abuse, which was associated with worse menopausal symptoms, general health and symptoms of depression.
• History of sexual abuse, which was associated with worse menopausal symptoms and general health.
• History of financial instability, which was associated with worse menopausal symptoms, general health and symptoms of depression.

Past stressors can lead to chronic activation of the body's stress response system, which can weaken the body's ability to regulate hormonal and physiological processes. This can make the body more susceptible to experiencing worse symptoms during menopause. Additionally, past stressors may lead to changes in the brain and other body systems that can impact the body's ability to adapt to these changes.

“A history of stress on the body whether it be from past trauma, etc., may already impact hormone levels,” Dr. Anderson said. “Then when a woman is going through perimenopause and menopause hormone levels further change which can possibly lead to worsening menopausal symptoms.”

Women going through menopause should communicate with their healthcare provider and seek support to manage any mood changes and other symptoms. Treatment options may include hormone therapy, medication and lifestyle changes.