Menopause Mood Swings: Causes, Treatment & Advice

Last updated 12.12.2023 | by Dr. Karen Pike | 11 Minutes Read

This article has been reviewed and fact checked by Dr. Karen Pike, a senior physician administrator and board-certified emergency room doctor actively working in northern California. Read more at our medical disclaimer page.

According to research carried out by the North American Menopause Society, around 23% of women going through perimenopause experience mood swings.

In fact, mood swings are among the top five most prevalent symptoms of menopause. One minute, you’re feeling fine; the next moment, you’re in tears or reeling in a blind rage.

But if you’re suffering from menopause-related mood swings, you’re probably not the only one who has noticed. Erratic moods can affect every relationship in your life, both at work and at home. So, it’s important to learn what causes them, and how to manage them.

I’ve noticed mild to moderate mood changes in myself during my menopausal journey, and I’ve treated and worked with countless others who have struggled to regulate their emotions during this transitional time.

But what causes this emotional turbulence during menopause? And what can we do to claim back a more stable, dependable version of ourselves?

In this post, I’ll discuss all of this and more. I’ll explain the symptoms of menopausal mood swings and why they affect so many women. Plus, I’ll share some of the best tips and treatments to help you navigate this midlife rollercoaster with a more level head.

What’s the Connection Between Menopause and Mood Swings?

Menopause officially commences once you’ve gone without your period for 12 months. Before this time, you’re in perimenopause, and your hormones begin to shift.

When estrogen and progesterone levels decrease, it can alter the chemical balance in the brain. A sudden drop in estrogen lowers the amount of serotonin produced in the body. Serotonin, often dubbed the ‘happy hormone,’ is responsible for balancing our moods. Less serotonin leads to low moods, depression, and feelings of hopelessness.

Lower levels of estrogen also contribute to other side effects, including brain fog, memory loss, insomnia, and fatigue.

During perimenopause, the body also begins producing less progesterone. If progesterone levels fall sharply, this shift can lead to estrogen dominance. This can cause depression, anxiety, irritability, and an increase in PMS symptoms.

The reproductive hormones estrogen and progesterone are the driving force behind menopause. But while levels of both decline as we enter this transitional phase, they also fluctuate. During parts of our cycle, estrogen levels can soar, and in others, they can plummet. These unpredictable shifts can send your already unstable emotions into chaos.

How Other Menopause Symptoms Impact Mood

Fluctuations in hormones are the primary cause of mood swings. But those fluctuations can also cause a whole host of other side effects. And unfortunately, many of them directly impact your mood.

Insomnia is a common complaint among perimenopausal and menopausal women. I struggled with bouts of insomnia throughout my perimenopausal years, and this chronic lack of sleep contributed to my own feelings of irritability. When my insomnia was at its worst, I was missing out on sleep night after night, and irritability quickly became my default mood.

Other side effects of menopause, such as weight gain, lack of libido, hot flashes, bloating, and vaginal dryness, can make this time of life feel like an overwhelming ordeal. And so, it’s no wonder so many women experience bouts of anxiety, depression, and unpredictable emotions during menopause.

Who is at Risk of Developing Menopause-Related Mood Swings?

Risk of Developing Menopause-Related Mood Swings?

Anyone going through perimenopause or menopause can suffer from mood swings. However, they’re more likely to be frequent and extreme in women who have:

  • Preexisting mental health problems, such as depression
  • A history of psychological illness
  • A history of mood swings in PMS
  • Past emotional trauma
  • Acute or chronic stress
  • Relationship issues
  • Physical illnesses such as diabetes, thyroid disease, and cancer
  • Undergone surgical or medical menopause

Women going through major life changes, such as illness, starting a new job, caring for elderly parents, or grieving for a loved one, are also more likely to suffer from erratic moods.

These factors are mostly out of our control. However, several lifestyle-related factors can influence and increase mood swings during your menopausal journey, too.

These include:

  • A poor, unbalanced diet
  • Inadequate sleep
  • A lack of exercise
  • Alcohol and drug abuse
  • Overconsumption of sugar and caffeine

These lifestyle factors exacerbate several other menopause symptoms, too, for example, hot flashes and night sweats. So, to navigate your way through menopause as smoothly and seamlessly as possible, it’s a good idea to cut out bad habits and practice self-care wherever possible.

What Are the Symptoms of Menopause Mood Swings?

Symptoms of Menopause Mood Swings

During perimenopause and menopause, you may find yourself experiencing one or more of the following emotional symptoms:


Irritability is the most frequent mood change reported by perimenopausal women. In fact, up to 70% of women notice feelings of irritability during this transitional time.


Anxiety can manifest itself as an emotional state through feelings of worry and nervousness or in the physical form of a panic attack. People with a preexisting history of anxiety or anxiety-related disorders are at an increased risk of recurrent anxiety or anxious feelings during menopause.


Like anxiety, depression is more likely to affect those with a pre-existing history of the condition. However, some women also develop depression for the first time during menopause.

Research published by the Indian Journal of Psychiatry suggests that it affects up to 20% of women during their menopausal transition.

Perimenopausal Rage

Perimenopausal rage manifests as a sudden and intense feeling of irritation or anger that is disproportionate to the situation. It is different from generalized irritability as it provokes a stronger response. One moment, you may be feeling perfectly calm and relaxed, yet the slightest trigger sends you flying into a temper tantrum.

Other common symptoms of menopause mood swings include:

  • Sadness
  • Loneliness
  • Feelings of low self-esteem
  • Feelings of regret about the past
  • Feelings of hopelessness
  • Fearfulness
  • Aggressiveness
  • Uncharacteristic introversion
  • Self-isolation
  • Low motivation
  • Low energy levels
  • Brain fog
  • Forgetfulness
  • Digestive problems
  • Insomnia

Treatment for Menopause Mood Swings

There are several medical treatments for the emotional symptoms of menopause, including:

Hormone Replacement Therapy

Hormone replacement therapy (HRT) is used to treat many of the most common symptoms of menopause, including hot flashes, night sweats, low libido, and vaginal dryness. But it can also significantly reduce the severity and frequency of mood swings.

Most menopause-related mood swings are the result of hormone fluctuations and imbalances. So, by rebalancing and replacing lost hormones with HRT, your moods are likely to improve.

HRT isn’t always the answer, though. One must weigh the risks and benefits of such therapy. It is important to make this decision in collaboration with one’s physician.

Cognitive Behavioral Therapy

Cognitive behavioral therapy (CBT) is a form of talking therapy. It can help you to manage many of the emotional (and even some of the physical) symptoms of menopause.

It works by helping you to identify negative thought patterns and behaviors that contribute to mood swings and emotional dysregulation. Then, with the help of your therapist, you’ll learn to replace them with new, positive ones.

CBT has shown promise in easing stress, low mood, low libido, and sleep problems. Plus, it can also help with vasomotor symptoms such as hot flashes and night sweats.

This type of treatment is becoming increasingly popular and is often preferred by doctors since it carries no risk of side effects. Plus, CBT is a brief therapy. It often only takes four to six sessions for patients to see a marked improvement.

Lifestyle Advice to Ease Menopause Mood Swings

Sometimes during menopause, it might feel as if you are at the mercy of your ever-fluctuating hormones and that nothing you can do can help you gain control of your situation. But that’s simply not true. The way we live our lives, how we fuel our bodies, and the activities we fill our days with all have a huge impact on our overall physical and emotional health.

Here are some tips to get a handle on menopause-related mood swings:

Get Regular Exercise

Moving your body and breaking a sweat several times per week boosts low serotonin levels. This not only balances your mood but also helps to relieve stress and anxiety.

Eat a Balanced Diet

Excess sugars and refined carbohydrates are linked with depression and low mood. Instead, try to focus on a diet rich in protein, vegetables, healthy fats, and omega-3 fatty acids. Eating this way has been shown to have a positive impact on overall feelings of well-being. It will also boost your physical health, so you’re likely to see an improvement in several other menopause-related symptoms too.

Get 7-9 Hours of Sleep Per Night

Experts recommend getting 7-9 hours of sleep per night, every night. Any less than this, and your emotional and physical health may begin to suffer. I found that a lack of sleep was the driving force behind my own irritability and mood swings throughout perimenopause. And it was only when my sleep improved that these psychological symptoms completely resolved themselves.

To tackle insomnia, try going to bed and waking up at the same time each day. Avoid blue light emitting devices close to bedtime, and cut out caffeine and alcohol.

Practice Yoga and Meditation

Both yoga and meditation can make you feel more grounded in your body and more present in the moment. And making these practices a regular part of your routine can help you manage mood swings. Not only that, it can also help you cultivate a more positive and connected mindset so that you can continue to thrive long after menopause has passed.

I took up yoga to help alleviate menopause symptoms such as irritability and insomnia, and I found great results. And although I no longer suffer with these symptoms, I still incorporate yoga into my life and enjoy its stress relieving benefits.


How long do menopause mood swings last?

Mood swings can appear at any stage during perimenopause. Some people find their mood swings only occur at certain points throughout their cycle. Others may experience fluctuating emotions all the way through their perimenopause journey.
But by the time most women reach menopause, their hormone levels restabilize and drop off. And with it, the worst symptoms of mood swings subside.

What other factors can contribute to mood swings?

Mood swings are often related to hormones, be it during our menstrual cycles or as a symptom of menopause. However, there are plenty of other factors that can contribute to mood swings, including certain medical conditions. These include:
Bipolar disorder
Thyroid issues
Sleep disorders
Multiple sclerosis
Parkinson’s disease
Prescription medications

How do I talk to my partner about my menopause mood swings?

Menopause mood swings are challenging for the person going through them, but they can also present challenges for our relationships and our partners, too.
If you are suffering from mood dysregulation as a result of menopause and it’s affecting your relationship, open communication is key.
Explain to your partner that your fluctuating moods are not their fault, nor are they a reflection of your relationship. Instead, they are an expected side effect of the menopausal journey you are on.
It can be useful for each of you to set some rules and boundaries that you can implement if and when things get heated.
You might also want to invite them to read this post and explore the rest of the blog here at We have a whole host of informative and educational reads that can help your partner to understand more about the transition you are in and how best to support you through it.


Menopause is a challenging time for many women, and the emotional and physical symptoms can affect every aspect of your life.

Mood swings are a common complaint, particularly during perimenopause. Even the most laid-back women, myself included, can find themselves flying off the handle or bursting into tears at random moments throughout the day.

But if you’re struggling with menopause-related mood swings or emotional problems, don’t suffer alone. Reach out for help from trusted friends and family with whom you can talk openly about your feelings. Consider counseling or talk therapy, such as CBT, and speak to your doctor, who may be able to suggest other treatments.

Your body is going through an important transition, and your hormones are shifting in a way they’ve never shifted before. Go easy on yourself, and remember that this, too, shall pass.

Once a woman reaches menopause and enters her post-menopausal years, the hormonal roller coaster comes to an end. The majority of the most bothersome menopause symptoms, including mood swings, taper off, and you will feel more like yourself again.



  • Dr. Karen Pike

    Dr. Pike is a senior physician administrator and board-certified emergency room doctor actively working in northern California. She received her undergraduate degree at Dartmouth College, where she graduated Phi Beta Kappa and played collegiate soccer. She attended Georgetown University for medical school and performed her residency in emergency medicine at Stanford University. She was part of the first-ever, women-majority emergency medicine program in United States. Dr. Pike is also the primary medical consultant for “Grey’s Anatomy,” a role she has held since the pilot episode when she partnered with Shonda Rhimes as the show’s original medical consultant. At her hospital, she was the second woman Chief of Staff. Today serves as the Director of the Emergency Department. Whether in leadership or direct patient care, her dedication to excellence in communication, quality, and collaboration is unwavering.

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