During menopause, lower estrogen levels may lead to irritability, fatigue, anxiety, sleep problems, and other factors that can affect mood. Hormonal changes may also affect levels of serotonin and norepinephrine, which may have links with depression.

Marking the end of one’s childbearing years can be bittersweet for many and painful for others. Noting changes in the body can prompt concerns about body image, while contemplating midlife, in general, can lead to bigger questions about one’s place and purpose in life. It can also be a time of gaining wisdom and confidence.

While they can be challenging, these feelings are part of the rollercoaster nature of lived experience. For some, though, the process is a bit more jagged.

This article discusses the symptoms, causes, and treatments for mood swings during and after menopause.

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Menopause takes place, technically, after a person has not had a period for 12 months. After this, they are considered postmenopausal, and many people see differences in their emotional symptoms. From start to finish, the process can take 2-10 years. During this process, a person is perimenopausal.

According to the North American Menopause Society (NAMS), close to 23% of peri- and postmenopausal people go through mood swings. NAMS is a nonprofit advocacy group, so it is important to note that there may be potential biases in reporting;

For some people, especially those taking hormones or having had their uterus removed, mood swings are their first indication that they are beginning to transition into menopause.

Learn 10 essential facts about menopause.

During the transition to menopause, levels of the hormone estrogen drop, causing wide-ranging changes throughout the body. Many of these changes have direct connections to menopausal mood swings.

For example, the drop in estrogen may affect how the body manages serotonin and norepinephrine, two substances that may have links to depression. However, research into this connection is inconclusive.

Lower levels of estrogen have links to irritability, fatigue, stress, forgetfulness, anxiety, and difficulty concentrating.

The impact of these changing hormone levels may not only have a direct cause-and-effect relationship with depression, anger, and anxiety. Hormone shifts may also intensify these feelings.

Also, researchers have found higher levels of a brain protein known as monoamine oxidase A (MAO-A) in people entering perimenopause. This protein has links to depressive symptoms.

Sometimes, reactions build on each other, such as with night sweats. These are hot flashes that take place when someone is asleep. Night sweats can be so intense that a person wakes in the night. Several nights of disrupted sleep can result in foggy thinking, irritability, and other characteristics associated with menopausal mood swings.

Risk factors

Two of the most important risk factors for difficult menopausal mood swings are a history of severe premenstrual syndrome (PMS) and prior episodes of depression or other significant mental health problems.

People may also have a greater risk of emotional problems during menopause if they have any of the following situations:

  • unsatisfactory relationships with loved ones
  • a great deal of stress in their lives
  • a difficult living situation

Some of the more widespread aspects of menopause mood swings include:

  • Depression: Depression is a common and serious emotional side effect of menopause. It affects up to 1 in 5 as they progress through menopause.
  • Anxiety: Many people experience tension, nervousness, worry, and panic attacks during menopause. Some may find their anxiety getting worse, while others may develop it for the first time.
  • Low mood: People may experience low mood and low self-esteem during and after menopause. Some may feel more tearful than previously or find themselves reacting more strongly to situations.
  • Irritability: Many people experience an increase in irritability during the early stages of the menopausal transition.

Other symptoms of menopause

Forgetfulness and ‘brain fog’ are common symptoms of menopause. Declining estrogen levels can impair a person’s memory and increase their risk of Alzheimer’s.

Insomnia is also common during menopause, affecting 40–50% of people during and after menopause. Sleep disruptions can contribute to mood swings, interfering with day-to-day functioning.

To cope with the changing landscape of their lives and menopausal mood swings, some people may decide to “self-medicate” with alcohol or other drugs.

Unfortunately, these choices make it more difficult to face and work through their concerns. It may also add substance misuse to the issues they need to address.

Emotional problems may not be as easy to see as other conditions, but they are no less painful, limiting, and potentially devastating.

Fortunately, help is available through counseling, medication, or a combination of treatments.

If menopause mood swings or emotional upheavals interfere with a person’s enjoyment of life, they should see a mental health counselor or seek a referral from a general practitioner.

Hormone replacement therapy

Hormone replacement therapy (HRT) can help treat several menopausal symptoms, including:

  • mood swings
  • night sweats
  • hot flushes

However, HRT can carry a small risk of breast and ovarian cancer, stroke, and gallbladder disease. As a result, the Food and Drug Administration (FDA) advises that people wishing to partake in HRT use the lowest available dose for the shortest possible time.


Many people find that interpersonal therapy and counseling help them deal with the mental health symptoms of menopause.

For example, studies show that cognitive behavioral therapy (CBT) may help to treat:

Lifestyle changes

Experts have found that exercise, diet, getting enough sleep, and pursuing supportive friendships can all help people with the emotional aspects of the transition into menopause.

Regular exercise is a great way to promote both mental and physical health. Being active helps relieve stress, improves mood, and makes it easier to put problems in perspective.

The Centers for Disease Control and Prevention (CDC) recommend 2.5 hours a week of moderately intense aerobic exercise, such as a fast walk, plus 2 days a week of muscle strengthening.

Diet can also help individuals reduce menopausal mood swings, especially one rich in protein and omega-3 fatty acids.

Some people have also found that practices such as tai chi, yoga, and meditation can help them feel more grounded and make it easier to manage stress, irritability, and other symptoms of menopause.

Learn more about the natural remedies for menopause symptoms here.

Menopause is a time of emotional and physical change. Many people experience mood swings during and after menopause. Other symptoms, such as hot flashes, night sweats, and increased irritability, may accompany these mood swings.

Fluctuations in hormone levels and other bodily changes may cause mood swings and other menopause symptoms.