Managing Mood Swings During Perimenopause

Perimenopause is far more than the occasional hot flush or irregular period. It’s a complex transition marked by shifting hormones that can trigger unexpected emotional responses, from irritability and anxiety to sudden anger and mood swings. For many women, it can feel unsettling or even like a personal shortcoming when, in truth, it’s a natural (though challenging) phase of life.

Despite its difficulties, perimenopause doesn’t have to feel chaotic. With the right knowledge, support, and self-care strategies, it’s entirely possible to navigate this stage with confidence and calm.

Understanding the emotional turbulence and recognising the root causes of perimenopause mood changes is the first step toward regaining a sense of balance and control. Small, consistent changes can make a powerful difference in how this journey is experienced.

Why do mood changes happen in perimenopause?

Sudden shifts from a stable mood to intense anger or irritability may signal the significant hormonal transition of perimenopause. This phase brings about a complex interplay of cognitive, chemical, and hormonal fluctuations that contribute to these mood changes. Some of the key factors behind perimenopausal mood swings are listed below:

• Brain chemistry: Hormones play a significant role in shaping mood during perimenopause. Due to the dipping levels of hormones like oestrogen, progesterone, and testosterone, mental health is hugely impacted. There is a complex interplay between the brain and ovaries, where reduced hormone levels can disrupt the production of neurotransmitters like serotonin and dopamine (key messengers responsible for mood regulation). When these levels become imbalanced, women may experience increased mood swings, anger, perimenopause irritability, brain fog, and even depression. 

• Demanding phases of life: A woman in her late 40s may find herself juggling between parenting children through adolescence, caring for ageing parents, maintaining long-term relationships, and meeting the growing demands of professional life. Amidst this chaos, perimenopause hits like a brick, and emotions start spiralling. These emotional challenges trigger perimenopause moods like hypersensitivity, anxiety, and increased irritability.

• Coinciding physical factors: Physical manifestations of perimenopause, like hot flashes, vaginal dryness, sleep issues, and unexplained fatigue, can be exhausting to cope with. Dealing with unexpected belly fat, a declining libido, and ongoing physical discomfort can lead to frustration, further fueling perimenopause emotional symptoms. 

• Hormonal fluctuations: The rollercoaster of hormone levels, especially declining oestrogen, throws the body out of balance. This hormonal turbulence is directly linked to mood shifts and emotional upheaval. 

• Stress: Life doesn't pause for perimenopause. With a million responsibilities piling up, stress levels are always high. Add perimenopausal symptoms to the mix, and dealing with daily stressors becomes even more challenging. 

• Sleep disturbances: Sleep issues like insomnia, restless nights, and poor sleep are common in perimenopause. Lack of quality sleep significantly impacts emotional regulation, often magnifying perimenopause mood changes like irritability, anxiety, and low mood. 

• Neurobiological adaptations: Recent research suggests that brain changes during menopause go beyond short-term neurotransmitter fluctuations, involving alterations in brain structure, connectivity, and energy metabolism in regions linked to emotional regulation and cognitive function.

Common emotional symptoms of perimenopause

The emotional rollercoaster women experience during this phase can be overwhelming, confusing, and intense, all at the same time. Some of the most common perimenopause mood swings are listed below: 

• Mood swings: Fluctuations in perimenopause moods are very common. You might feel teary and low one moment, then unexpectedly happy the next. Low energy, disinterest in once-enjoyed activities, and emotional instability are all common and natural. 

• Anxiety: Coping with the daily chores of life becomes overwhelming once anxiety kicks in. Constant worrying over trivial issues can make it hard to focus or function. These feelings of constant worry and anxiety can also lead to depression if left unmanaged.

• Increased irritability: You may find yourself losing patience more easily, snapping at small things, or getting emotionally triggered by symptoms or daily stressors.

• Forgetfulness or trouble concentrating: Misplacing your keys, struggling to recall names or events, and feeling mentally foggy are all signs of the cognitive challenges influenced by hormonal shifts. 

• Persistent feelings of sadness: Perimenopause can increase the risk of depression. Perimenopause mood changes may include persistent sadness, hopelessness, low confidence, loss of interest in things once loved, loss of appetite, and disturbed sleep patterns.

Tips to manage moods naturally during perimenopause

There are steps you can take to manage your perimenopause moods naturally. 

• Nourish with nutrition: It is no secret that nutrition plays a pivotal role in managing mood and physical symptoms during perimenopause. A well-balanced diet rich in lean proteins, whole grains, and essential vitamins (especially calcium and vitamin D) supports bone health and can make a huge difference in how we feel. 

• Pause and reflect: When you feel you would snap any moment or get caught in the heat of an argument, try taking a step back. Give yourself space to pause and reflect. This allows you to address the root cause of your anger and, in the future, help you manage the rage better. 

• Try mind-body therapies: Practices like yoga, tai chi, pilates, and meditation can help ease symptoms like fatigue, anxiety, irritability, and low mood. These therapies encourage mindfulness and promote a greater sense of balance and relaxation.

• Stress reduction: Stress can intensify perimenopause mood swings. Taking proactive steps to manage stress, whether through deep breathing, journaling, indulging in hobbies, or nature walking, can be fruitful. 

• Physical activity: Exercise is a great mood enhancer. Physical activity helps release endorphins, which support emotional well-being and reduce stress.

• Sleep: Prioritising sleep hygiene is crucial for perimenopause management. Whether it's working on a consistent sleep schedule, minimising pre-bedtime screen time, or simply upgrading your sleep environment, sleep is essential and helps in regulating hormones.

When to seek professional help?

While natural approaches can ease many perimenopause emotional symptoms, it’s important to know when to seek professional help. If you’re experiencing persistent mood swings, anxiety, or emotional distress that interferes with daily life, or if sleep problems become chronic, it may be time to consult a healthcare provider. 

Perimenopause: Not a personal failing

It is important to understand that feeling irritable, angry, or snapping at small things during perimenopause is completely okay. These mood shifts are a natural response to the hormonal fluctuations happening in your body, and there is nothing abnormal about them. Your emotions need space, and it has to be vented out somewhere; it is a natural part of coping. 

While it may feel overwhelming, circumstances won’t last forever; they will gradually fade away. With the right support of nutrition-dense diets, improved sleep cycles, consistent physical movement, and mindful practices, perimenopause emotional symptoms are manageable. Remember, perimenopause isn’t a sign of personal failing; it is a natural transition into a stage of deeper resilience and inner strength. 

Frequently Asked Questions

1. Why am I feeling more emotional or irritable during perimenopause?

Hormonal fluctuations, especially changes in oestrogen and progesterone, can directly affect neurotransmitters in the brain that regulate mood. This can lead to increased irritability, anxiety, sadness, or emotional sensitivity.

2. Can lifestyle changes really help with mood swings?

Yes, absolutely. Regular exercise, a balanced diet, quality sleep, and mindfulness practices like meditation or yoga can significantly improve mood stability and reduce emotional highs and lows.

3. When should I talk to a doctor about my mood symptoms?

If you’re experiencing persistent sadness, anxiety, panic attacks, or emotional changes that don’t improve with self-care, it’s time to speak with a doctor. These could be signs of a deeper imbalance that needs attention and support.