Most women are aware that the menopause can cause physical symptoms such as hot flushes and aching joints. For many, changes in mood can be just as debilitating.

Research has shown that 61 per cent of women suffer anxiety during the perimenopause (the time leading up to your last period). Many, however, are unaware that they may be in the perimenopause, and that changing hormones may be responsible for this change in mood. 

What to expect

You may find yourself experiencing low mood, anxiety, an inability to concentrate, forgetfulness, low self-esteem and feelings of fatigue. Or several of these at once, leaving you feeling exhausted from being on a hormonal ‘rollercoaster’. “Other psychological symptoms of the menopause, related to hormonal changes, can be irritability and difficulty coping,” says Dr Heather Currie, founder of Menopause Matters and an associate specialist gynaecologist and obstetrician at Dumfries and Galloway Royal Infirmary.

“Mood changes are very common and can vary hugely in severity, type of problem and impact on the individual,” says Dr Currie.

“Women have oestrogen receptors throughout the body, including in the brain, and oestrogen lack can therefore have many different effects on your mood,” says Dr Currie. “Oestrogen influences the production and breakdown of serotonin, the chemical involved in the regulation of mood,” she says.

When your oestrogen levels drop during the perimenopause, so can your serotonin levels.

Life pressures

Sleep disturbance caused by hormonal changes and hot flushes (hyperlink to Hot Flushes page), will also impact your mood. “There are other life events, such as worry over elderly relatives, teenage children, and pressures from work that commonly occur around the time of menopause, that may also contribute to psychological symptoms,” says Dr Currie.

NICE recommendation is that HRT should be offered for treatment of mood changes which are hormonally related. “Cognitive Behavioural Therapy (CBT) can also be considered,” suggests Dr Currie.

If you would like to try an alternative method of lifting your mood, consider exercise. Exercise leads to the production of endorphins, or ‘feel good’ hormones, that lift your mood. Being outside when you exercise enhances this effect. Avoiding alcohol, which can trigger low mood, is another option. NICE also backs the use of the herb, St John’s Wort, to treat mild depression.

“If you find yourself suffering from mood swings, visit your GP and discuss your symptoms,” suggests Dr Currie. “Or join a forum, such as on Menopause Matters,” she says, “as realising you are not alone can help you get through this experience.”

For more information on how to manage your symptoms visit Menopause Matters.

Our Menopause Health blood test finger prick kit will check your hormone levels and the impact changes in these levels might have on your overall health and bone density. The profile includes an FSH test, LH and Oestradiol (oestrogen) hormone check. In addition, it assesses your levels of vitamin D and calcium, key markers for bone health. This test is designed for women at all stages of the menopause, from early perimenopause through to post-menopause.