A woman with light brown hair and a light pink, long sleeve shirt rests her head on her hands while leaning on a gray couch indoors during daytime. The woman looks to the left of the frame, and has a thoughtful expression.

What is it?

Feeling more irritable, tearful, anxious, or just generally “on edge” than usual, often for no clear reason, is a really common part of perimenopause and menopause.

Why does it happen?

Oestrogen and progesterone both affect the brain chemicals involved in mood, including serotonin (the one linked to feeling good). As these hormones swing around unpredictably during perimenopause especially, your mood can become harder to control than it used to be.

In a large UK survey of women aged 45–55 with current menopause symptoms, mood changes were reported by 69% of them. Poor sleep and hot flushes often make mood worse too as they tend to feed into each other rather than being separate problems.

Things that can help

  • Regular exercise, which has a genuinely strong effect on mood
  • Prioritising sleep as poor sleep and low mood often go hand in hand
  • Cutting back on alcohol, which can make both anxiety and sleep worse
  • Talking therapies like CBT, which have good evidence specifically for menopause-related mood and anxiety
  • Staying connected to people as isolation tends to make mood symptoms worse

Can anything medical help?

HRT is often a good first option for mood symptoms that are clearly tied to menopause, especially if you’re also having hot flushes or sleep problems.

One thing worth knowing: standard antidepressants (like SSRIs or SNRIs) aren’t well proven to help low mood that’s purely down to menopause, rather than a diagnosed depressive illness, so these usually aren’t the first thing tried unless depression has been separately diagnosed. If mood is a big issue for you, your prescriber will set out the right approach for your situation as part of your plan.

When to get more help

Mood changes linked to menopause usually come and go alongside your other symptoms. Get help sooner from us, your GP, or more urgently if needed if you’re experiencing:

  • low mood most days for two weeks or more
  • losing interest in things you’d normally enjoy
  • thoughts of harming yourself, or feeling like life isn’t worth living

If you’re having thoughts of suicide or self-harm, please contact your GP urgently, call 111, or in a crisis call 999 or go to A&E. The Samaritans are also available free, any time, on 116 123.

The bottom line

Mood changes during menopause are common, hormonal, and treatable — you don’t have to just push through them. If mood is a big part of what you’re going through, it’s worth mentioning so we can factor it into your plan.

Not sure if what you’re feeling is menopause-related? Try our symptom checker, or book a menopause consultation — we can help work out what’s likely to help.

References

  1. BMS Conference Poster: Not just hot flushes — British Menopause Society, UK survey of 4,014 women aged 45–55
  2. NICE NG23: Menopause — identification and management — SSRIs/SNRIs and menopause-related low mood