Improving your mood in peri-menopause and beyond is important. Throughout this stage, our moods can be erratic and unpredictable. The more we know and implement positive changes, the better chance we have to improve our mood. Although the hormones estrogen, progesterone and testosterone mainly have to do with fertility, the levels in your body also have an impact on brain chemistry. Changes in hormones can cause a host of negative symptoms when it comes to mood, including anxiety, irritability and depression.
Many of the changes in how we feel mentally began with hormonal changes at puberty (pre-menopause). Our moods are again affected during pregnancy as well as after pregnancy (postpartum) due to fluctuating hormones. Finally, during peri-menopause, hormones naturally go up and down and ultimately decrease. Let’s look at hormonal changes during peri-menopause, what occurs and some solutions to help get you back in balance.
Hormone Changes in Peri-Menopause
Peri-menopause starts 7 to 10 years before you are in full menopause. A clear sign you may be entering this stage are irregular periods. Remember to check with your physician to discuss your symptoms and rule out any other medical concerns. The average age of menopause is 51 (no period for 12 months) but many women, including myself, can be in full menopause in their early 40’s. This means peri-menopause which usually comes with a host of unwelcome symptoms is happening in our 30’s. Most women report this to be a more difficult time than full menopause. Pre-menopause, noted in the diagram below, are the years of regular menstruation.
Role of Different Hormones
Let’s dig down and get to know some of our common and less common hormones. Many of us know a lot about serotonin, the feel good hormone associated with focus, happiness and calmness. Exercise helps increase this. We also hear a lot about dopamine, which has to do with rewards and motivation. You release dopamine when you eat foods you like or have sex. Many women report knowing less about how estrogen, progesterone and testosterone affect their moods. It’s no surprise that people associate these hormones with only fertility. However, their role is much more diverse and important to the female mind and body.
Estrogen helps regulate our moods. As we age and our ovaries produce less of this hormone, along comes irritability, depression and anxiety. Progesterone promotes calmness and relaxation. It lifts women’s mood as it is secreted during ovulation, which also occurs less as we age. Testosterone helps with fatigue and symptoms of depression. With erratic hormonal levels, it is no surprise that many women report depression, anxiety as well as difficulty concentrating, short-term memory loss and overall brain fog.
Depression and Anxiety
The first step in getting the help you need or making changes you can do on your own is identifying how you are feeling. Are you sad, truly depressed or anxious? Depression is a mood disorder that can affect your ability to continue with day-to-day activities, i.e., working, showering, and/or sleeping. It can also make tasks that are usually pretty easy seem quite difficult, such as brushing your teeth, taking care of your children or walking your dog. If you suffered with depression in your younger years, it is more likely this will re-appear in peri-menopause.
According to the World Health Organization, an estimated 3.8% of the population experience depression, including 5% of adults. Depression is about 50% more common among women than among men. Along with genetics and life events, changing hormones during peri-menopause certainly contributes to this condition for many women.
Anxiety is a normal human response to many stressful situations. It usually presents itself as a feeling of fearfulness or being tense. Anxiety can come on suddenly or creep up slowly. It is reported that 70% of women in peri-menopause will feel anxious at times. The good news is that as you get used to your hormone levels in menopause, anxiety subsides. However, the years in peri-menopause need to be addressed since anxiety is a predominant symptom that is exacerbated by hot flashes, night sweats and lack of proper sleep.
Steps to Improve Your Mood
There is no shame in feeling a bit down or struggling with your energy level for a day or two. However, if you are clinically depressed, i.e., unable to do usual simple tasks or suffering with debilitating anxiety, it is important to get help. Talk to a healthcare provider, a trusted friend or family member about how you are feeling. Asking for help is a courageous first step in helping improve your mood in peri-menopause along with incorporating some changes I have suggested below into your daily routine. Small changes can bring large results over time when done consistently. Check out my blog post You are in Control of Choosing New Habits.
I don’t usually suggest you discuss medications or hormone replacement therapy (HRT) with your physician before lifestyle changes. However, I feel when it comes to our mental well being, it may be a necessary first step. Changing habits and lifestyle requires energy and medication and/or HRT may be needed first. As these medications work to relieve anxiety, depression and other negative peri-menopausal symptoms, women can possibly feel energized to focus on their mental and physical health with support.
- Medication: Medications such as Selective Serotonin Reuptake Inhibitors (SSRIs) may be necessary to manage your anxiety and/or depression. Also, an added benefit is the off-label use for these medications. They can relieve hot flashes and night sweats which will improve your quality of sleep. This will then help with managing anxiety and depression. Talk to your healthcare provider to get direction on appropriate next steps.
- Hormone replacement therapy (HRT): Progesterone, Testosterone and/or Estrogen may be a solution for many women to combat poor moods along with other health risks such as thinning bones and heart disease. Progesterone is especially necessary for a balanced mood. Talk to your healthcare provider about these as an option. Discuss transdermal (a patch), a vaginal or rectal suppository as a means of delivery. These options are more effective for absorption of certain hormones as opposed to taking a pill. For some women, there are risks associated with using HRT. Risks depend on what hormone therapy you choose along with the dose and how long you are on this treatment.
- Food and Drink: Nourishing your body means you nourish you mind as well. Don’t skimp on nutrient-dense foods explained in my blog 7 Superfoods to Eat During Menopause. When it comes to food, drastically under-eating or abruptly taking in a large amount of processed foods can add to poor mental health. Consuming nutrient-dense foods can contribute to higher levels of well-being according to the World Health Organization. Limiting or eliminating caffeine and alcohol can also help with unwanted symptoms.
- Movement: Getting outside for a walk, incorporating weight training, yoga and/or stretching will release serotonin. This will help combat low moods. Meditating on a regular basis, even for 5 minutes a day, can help with anxiety as well.
- Connections and friendships: Connecting with other women and reaching out to friends is an important part of not feeling alone. We all have bad days and just talking about what is causing us stress can help alleviate the heavy feeling we often feel that is slowing us down.
- Sleep: Difficulty with sleep during peri-menopause and menopause is one of the most common complaints women report. Poor sleep can wreak havoc on your mood. Create a bedtime routine to help with setting you up for a good night’s rest. Stop caffeinated beverages by 2pm, go to bed at the same time each evening when possible, take a warm bath with epsom salts to relax and shut down your electronic devices an hour before bed. You will be getting a restful sleep in no time which directly impacts your mood.
- Breathing exercises: Using the 4-7-8 breathing technique can help relieve anxiety. It can instantly calm you in any situation. Breathe in for the count of 4 seconds, hold the breath for 7 seconds and breathe out for 8 seconds. It can be done anywhere to relieve stress or help with getting to sleep.
Feeling Better as you Improve Your Mood in Peri-Menopause
As we age, there can be a lot to feel overwhelmed about on a daily basis. If you listen to the news, interact with the public in some way and not living under a rock, stress is inevitable. During midlife for many women, we are usually busy with our careers, caring for children and possibly helping with aging parents all while trying to manage our own health. Many days can feel like a wave we can’t escape from. Putting positive habits in place to improve how we are feeling is what we deserve. Getting back in balance is work but so worth it to become your best self. You don’t have to do it alone. Check out my Work with Me tab to see how I can help.
I’m a registered nurse for over 24 years with a Masters Degree in Nursing (Education). I am also a Certified Women’s Health Coach specializing in helping women navigate changing hormones in their 30s and beyond after my own difficult experience through menopause. I believe women should truly thrive in midlife and not just survive!