Why Is My Mood So Low or Irritable Around Menopause?

You snap at your daughter over a wet towel and spend the next hour feeling terrible about it. At 4 p.m. you’re teary over nothing you can name. Last year you were the calm one.

Why it happens

OWH¹ says the changes can come from fluctuating hormones, from the menopausal symptoms themselves, or from emotional responses to what’s happening in your body. Cleveland Clinic³ ties the mood symptoms of perimenopause to the decline in estrogen as your body transitions toward menopause.

The symptoms feed each other. The NHS² says hot flushes can cause palpitations or anxiety, and that memory and concentration problems can feel worse when you have sleep problems and feel exhausted. If night sweats or 3 a.m. waking are wrecking your sleep, your mood has a second reason to dip. For more on the other end of this, see brain fog and hot flashes.

OWH¹ adds one more detail. People who had mood problems with their menstrual cycle, or after having a baby, are more vulnerable. If PMS hit you hard, tell your clinician.

What it looks like

Cleveland Clinic³ lists irritability, depression and mood swings, with anxiety reported by many. The NHS² lists mood swings, low mood or depression, and problems with memory or concentration.

Depression is more than a bad week. The National Institute of Mental Health (NIMH)⁴ says it can cause severe symptoms that affect how you feel, think and handle daily activities such as sleeping, eating or working, and that it can affect anyone. The signs include persistent low mood, hopelessness, loss of interest and exhaustion. If that describes you, don’t write it off as menopause.

What helps

The sources agree on a short list.

Sleep. OWH¹ says to try to get seven to nine hours.

Movement. OWH¹ recommends regular physical activity and, for depression and anxiety, exercise at least 30 minutes most days. Cleveland Clinic³ says regular exercise has been shown to improve energy, mood swings and sleep problems.

Less alcohol and caffeine. OWH¹ says to moderate alcohol. Cleveland Clinic³ suggests limiting caffeine and alcohol.

Stress tools. OWH¹ lists stress-reduction techniques and support groups. Cleveland Clinic³ lists meditation and other stress management techniques.

Medical options. Cleveland Clinic³ says antidepressants can help with hot flashes, mood swings, anxiety or depression, and that hormone therapy can help stabilize fluctuating hormones. OWH¹ says to consider hormone therapy for mild mood shifts. For depression or anxiety, OWH says professionals may recommend therapy, medicine or both.

Which one fits depends on your symptoms and your health history, and that’s a conversation for your clinician. Our article on perimenopause explains the stage you may be in.

The play

Try this: a two-line mood note

Each evening for two weeks, write two lines: your mood from 1 to 5, and how you slept.

Add a mark for any hot flash or night sweat.

You’ll see whether the low days follow the bad nights. That pattern helps your clinician choose where to start.

When to get checked

Don’t wait if

1. Emergency

   If you’re in crisis or thinking about harming yourself, call or text the 988 Suicide & Crisis Lifeline at 988, or call 911. NIMH⁴ lists both for immediate help.

The NHS² says to contact your GP if you think you have symptoms of menopause or perimenopause and want to know your options, and that early advice can help reduce the effects on your health, relationships and work. Cleveland Clinic³ says to contact your provider if symptoms are unbearable or interfering with your quality of life. OWH¹ says to contact your provider if you have symptoms of depression or anxiety.

Book an appointment if any of these fit:

• Low mood, hopelessness or anxiety lasts most days
• You’ve lost interest in things you used to enjoy
• Your sleep is poor and your mood is sliding
• Irritability is damaging your work or relationships
• You’ve had depression, severe PMS or postpartum depression before
• You want to talk about hormone therapy or other treatment

The towel, the daughter and the tears still happened. They have an explanation, and the explanation has a plan.