Skip to main content

Verified by Psychology Today


5 Ways to Cope with Menopausal Mood Swings

Simple strategies can help improve your experience of menopause.

Key points

  • Many women struggle with menopausal symptoms, including severe mood swings.
  • Lifestyle changes can have a significant effect on mood before, during, and after menopause.
  • Clinical trials have also demonstrated the effectiveness of CBT and hypnotherapy in the management of menopausal symptoms.

Mood swings that occur during menopause make many women feel out of control, while at times affecting their relationships and causing them difficulties in the workplace. The North American Menopause Society reports that approximately 23 percent of women experience mood swings before, during, or after menopause.1 Anecdotally, the percentage may be much higher.

Perimenopause is the period that leads up to menopause and can last several years, with some women experiencing perimenopausal symptoms for up to fifteen years. During this time, women experience a fluctuation and decline of hormones that play an integral role in mood regulation.

123rf, aside
Source: 123rf, aside

What Hormones Are Responsible for Menopausal Mood Swings?

1. Estrogen

Estrogen is the main female sex hormone and is produced in the ovaries. It has a major impact on mood, primarily by affecting levels of serotonin in the body. Serotonin is a mood-balancing chemical that is sometimes called the “happiness hormone.”

During perimenopause, as estrogen levels start to drop, so do levels of serotonin. This internal shift is one of the reasons why many women feel more depressed and are more likely to cry at the drop of a hat than they would've been in the past.

2. Progesterone

The other significant sex hormone in a woman’s body is progesterone. Like estrogen, it begins to drop during perimenopause. As progesterone levels fall, estrogen may become the dominant hormone, leading to irritability and depression.

Progesterone is also responsible for calming the brain and promoting sleep. Low levels of progesterone are associated with a range of symptoms including sleep disturbances, migraines, hot flashes, and unexplained anxiety. The combination of these symptoms can have a major impact on mood.

Hormonal Fluctuations and Imbalance

Hormones are complex, as are the human mind and body. And when it comes to menopause, they don't always change in predictable ways or decline at a steady rate.

Instead, the production of estrogen tends to become unstable and unpredictable. At times, the ovaries may start to overcompensate and try to produce more estrogen, resulting in a hormonal surge. At other times, there will be a noticeable reduction in estrogen. Overall, these fluctuations can upset the delicate balance of hormones in relation to each other and be highly destabilising in terms of mood.

Lack of Sleep, Life Changes, and Growing Responsibilities

Lack of sleep is a major problem for many women during menopause, and it has a significant knock-on effect on mood. What's more, menopause is also a time when many women must juggle countless responsibilities including taking care of children and/or elderly parents (the sandwich generation), a high degree of career responsibility, and the prospect of aging. Trying to meet this wide range of responsibilities can feel particularly difficult when you’re exhausted, experiencing hot flashes and night sweats, and coping with unpredictable hormone fluctuations.

How Can You Manage Menopausal Mood Swings?

Half of the population will go through menopause at some point. Yet while some women experience only a minor disruption in their lives, others are stopped in their tracks as the result of their mood swings.

Adopting a biomedical solution can be an option for some women; Hormone Replacement Therapy (HRT), for one, may offer relief by replacing the female hormones that are in decline. However, not all women are suitable candidates for HRT and, although small, there is an increased risk of some cancers, including breast cancer.

Anti-anxiety and anti-depressant medications can relieve some of the difficult mood symptoms for women—but, as with HRT, medications can have negative side effects and not all women wish to take them. Luckily, whether in conjunction with a medical approach or as an alternative to it, there are many measures you can take to help minimise the impact of mood swings during menopause.

1. Sleep

The devastating impact of a lack of sleep is one of the main challenges I hear about in my clinic. One client, Chloe, described how, out of the blue, she began awakening suddenly with a pounding heart. “I started waking up, feeling like I’d been shot or something," she recalled. "In a total panic. At other times, I wake up soaked in sweat. Sleep’s become a nightmare.”

There are, fortunately, some ways to cope with this nightmare scenario. Avoiding spicy foods, alcohol, and coffee can all help reduce the risk of a hot flash happening during the night. Napping during the day, if you get a chance, can also help you catch up on lost sleep.

2. Lifestyle changes

Menopause isn’t an illness, but it is a significant change. Some women find it useful to look at their lifestyle and responsibilities and think about what might need changing to support their evolving needs.

Another client, Marianne, told me, “I refused to admit I couldn’t cope. I just thought that I had to keep on doing what I’ve always done. It felt like an utter failure to do anything else." But eventually, she said, "I felt so down and ill that I stopped doing overtime, became strict about leaving on time, and got a cleaner for my dad whose house I’d been cleaning in my spare time. It’s amazing how much better I felt just after doing these things.”

Admitting that some things aren’t working for you as well as they previously did isn’t a failure. It’s a recognition that you need to take control of your life at this point.

3. Therapy

Hypnotherapy and cognitive behavioural therapy (CBT) have both been proven to help women significantly during menopause. While CBT can be effective at helping women respond more positively to menopausal symptoms—including vasomotor symptoms, sleep issues, and sexual dysfunction—which in turn helps minimise their impact,2 hypnotherapy has been shown to reduce hot flashes and night sweats by as much as 74 percent.3 Hypnotherapy may also help with mood, self-esteem, sleep, relaxation, and the exploration of life issues.

4. Yoga, meditation, and mindfulness

Stress has a negative impact on mood, and yoga and meditation have a great track record in helping people reduce their stress levels. Many women undergoing menopause find yoga to be a helpful way to relax and improve mood; similarly, both meditation and mindfulness practices may help women feel better about themselves.

5. Diet and exercise

Looking after yourself by making adjustments to your diet and exercise routine can also help manage mood swings. Avoiding certain foods which tend to trigger hot flashes and night sweats—including coffee, spicy foods, and alcohol—other dietary changes such as reducing sugar levels, staying hydrated, and ensuring that you eat enough vegetables and protein-rich foods can all help to stabilise your mood.

The mind and body are connected via the vagus nerve, which transmits information from the mind to the gut and other organs, and from them back up to the mind. What you eat has a direct effect on how you feel. What's more, finding the right type of exercise not only helps self-esteem but also tends to have mood-lifting benefits, helping to minimise some of the effects of the hormonal imbalances you may be experiencing.

If having to think about your body in this way is new to you, you’re not alone. Client Una summed up her journey like this: “I suddenly reached an age where I felt rubbish doing everything I’d always done. I was achy, exhausted, and upset all of the time. As much as I didn’t want to change anything, I noticed a huge difference when I started cutting down the booze, meditating, and eating healthily. I couldn’t go back to the old me now.”



2. Green SM, Donegan E, Frey BN (2019) Cognitive behavior therapy for menopausal symptoms (CBT-Meno): a randomized controlled trial. Menopause. 26(9):972-980. doi: 10.1097/GME.0000000000001363. PMID: 31453958.

3. Elkins, G, Fisher, WI, Johnson, AK et al (2012) Clinical hypnosis in the treatment of postmenopausal hot flashes. Menopause: The Journal of the North American Menopause Society DOI: 10.1097/gme.0b013e31826ce3ed

More from Claire Jack Ph.D.
More from Psychology Today