JUNE 2004

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Welcome to Perimenopause Mood Swings

Whether it’s a quick temper or feeling suddenly low, most women have experienced symptoms of premenstrual syndrome (PMS) on some level or another. Approaching menopause tends to accentuate them -- creating what some have called perimenopause mood swings.

A woman’s moods are susceptible to influence from hormone changes. Some younger women have recognized that just prior to their monthly periods, they will become cranky or depressed. A certain percentage of these women will have more severe mood problems each month and be diagnosed with premenstrual syndrome (PMS). But at least these mood problems are predictable -- flaring up right before the monthly period.

When the menopause transition begins, women whose mood was previously affected by hormone fluctuations (as PMS or postpartum depression) may have mood problems again. Although the symptoms may be similar than those experienced in younger years, they can be more intense.  What’s more, the timing of symptoms is less predictable because of the irregular timing of periods that is so common during perimenopause. On any given day, a perimenopausal woman won’t know what her hormones are doing and how she will feel.

While there is not a clear reason for these mood changes, some have been attributed to:

  • Fluctuating hormone levels (high estrogen one day, low the next)
  • Sleep deprivation, due to night sweats and hot flashes
  • Increased stress levels from new changes in the woman’s life (such as jobs with increasing responsibility, needing to care for aging parents, teenagers in the house or older children returning to the home, partners with midlife crises, and so forth) 

When mood changes begin to affect daily life, seeking help from a healthcare provider is recommended. They can help determine if these mood swings are due to perimenopause, a side effect of medication, a symptom of a medical condition, or the result of depression or anxiety. A variety of lifestyle changes, coping skills, and/or prescription therapies may be recommended. For example, mood disturbances resulting from sleep deprivation due to hot flashes usually improve when hot flashes are treated. While no hormone drug is FDA-approved for relief of psychological symptoms, oral contraceptives may be prescribed to provide a constant level of hormones and help stabilize mood in perimenopausal women -- even for those not requiring birth control.

The following are some simple, do-it-yourself strategies that may help alleviate minor mood swings:

  • Make time for walking or exercising. Release those happy-making endorphins whenever possible.
  • Relax (this takes practice). Make efforts official with deep breathing or meditation. Learning and practicing these techniques just might do the trick.
  • Laugh, stroll through the park, take up photography…you get the idea. Try to overcome the blues with pleasurable activities in any combination. Reward yourself with a treat, find a creative outlet, get a manicure, or rent a silly movie. Nurturing your mental or emotional needs is a good mood waiting to happen.


Last reviewed: June 2004


Menopause Flashes brings you facts, guidelines and suggestions for a manageable menopause transition. We hope our efforts are making a positive impact on your experience.
-- NAMS Board of Trustees


"Menopause is certainly a ‘life-changing’ experience. And that means body-changing, mind-changing, and more. It affects us most every day -- now and well into the future. At Menopause Flashes, we understand the importance of the menopause experience. From the first signs right through to the years after, it is our goal to provide the knowledge and understanding you need to take charge of the situation. Menopause will change your life. Menopause Flashes will make sure you’re ready."

—Libby Contestabile, RNC, BScN
Menopause Flashes



This newsletter, developed under the direction of the Consumer Education Committee
of The North American Menopause Society (NAMS), provides current information,
but not specific medical advice. It is not intended to substitute for the judgment
of an individual’s healthcare provider.
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