Feeling All the Feels? How to Find Your Calm When Perimenopause Messes with Your Mood

Dr. K Derezil MD
Apr 9, 2024
5 min read

Sisters, It's Time We Talk About Mood and Menopause. It seems we’ve found ourselves smack dab in the middle of yet another taboo topic that no one wants to talk about out loud: the emotional rollercoaster otherwise known as perimenopause. As if the hot flashes, night sweats, and killer cramps weren’t enough to deal with, now our moods have decided to come along for the wild ride too. Yippee.

But we’re not going to just grin and bear it, are we sisters? Oh no! We’re going to peel back the layers on this complex issue and get straight to the heart of what’s really going on here. Because the more we understand about how perimenopause affects our mood, the better equipped we’ll be to navigate these choppy emotional waters with insight, grace, and badass resilience!

So let’s dive right in, shall we? First, what exactly IS perimenopause and how the heck does it impact our mood? Perimenopause refers to the transitional phase leading up to menopause when our ovaries gradually produce less estrogen. It usually starts for most women in their 40s but can begin earlier. Now estrogen doesn’t just deal with our periods and fertility - it affects EVERYTHING including our brain chemistry and neurotransmitters like serotonin, norepinephrine, and dopamine which heavily influence our moods. So when our estrogen levels rise and fall erratically during perimenopause, these important brain chemicals get thrown out of whack too.

And that, my friends, is essentially why perimenopause often equals crazy mood swings! One minute we’re riding high, feeling optimistic and energetic. The next, the littlest thing sets us off and we spiral down into anxiety, irritation, or full-blown existential dread. Um...rude.

But while these mood swings can feel maddeningly unpredictable, the good news is they DO tend to follow a pattern connected to our menstrual cycle. Generally, most women find their moods at their worst in the lead-up to their period when estrogen and progesterone take a nosedive. The days after our flow ends tend to be our most stable, pleasant interlude. Then as estrogen starts rising again mid-cycle, mood and energy lift...until they eventually peak, crash and burn. Lather, rinse, repeat. What fun!

Now some lucky ladies sail through perimenopause without a noticeable mood ripple. But for many of us, the mood changes are very real and can range from mild (occasional crankiness or blues) to quite severe (intense depression or anxiety). But no matter where you land on that spectrum, your feelings are completely valid. There’s no prize for who suffers “more.” This crap is hard on ALL of us!

Just know that you aren’t losing your marbles, my sisters. This too shall pass! Our brains are simply reacting to the hormone chaos inside our bodies. And the good news is there are many effective strategies we can use to help balance our moods again. Let’s explore, shall we?

LIFESTYLE TWEAKS

While medications can provide more immediate relief when mood dips are severe, there are many simple lifestyle tweaks that can lift your spirits and emotional resilience from the inside out. Here are some of my top tips:

Move that bod!

Regular exercise helps boost feel-good neurotransmitters and is hands down one of the most effective natural mood boosters out there. Aim for 30-60 minutes of heart-pumping activity at least 3 days a week.

Go green.

Eating plenty of leafy greens and other veggies high in mood-supporting nutrients like magnesium, B vitamins, iron, and zinc pays dividends for your emotions.

Find your zen.

Yoga, meditation, deep breathing - any relaxing mind-body practice that combines gentle movement with mindfulness can mellow your mood, lower stress hormones like cortisol, and help you better manage difficult emotions when they arise.

Get some zzz’s.

Aim for 7-9 hours of quality sleep per night. Your brain balances emotion-regulating neurotransmitters while you snooze. Skimp on sleep, and you’re much more likely to feel off-kilter and overwhelmed during the day.

Track your cycle.

Use a period-tracking app or calendar to note your moods at different points in your menstrual cycle. This can help you spot predictable patterns and be prepared for potential dips and spikes in your mood.

Lean on your tribe.

Don’t isolate when you’re struggling. Turn to your partner, close friends, therapist, or support groups to process big feelings. Social connection is soothing for the soul.

Lather up.

Warm baths infused with magnesium or aromatherapy oils like lavender, chamomile and clary sage can be calming and mood-stabilizing.

SUPPLEMENTS

In addition to a healthy lifestyle, some key supplements can help provide extra support:

Magnesium

This mineral plays a role in regulating over 300 enzymes and neurotransmitters tied to mood, energy, sleep and stress response. Many of us don’t get enough from diet alone. Look for forms like magnesium glycinate or magnesium l-threonate that are optimally absorbed.

B Complex

B vitamins like B6, B12, and folate help produce neurotransmitters that influence mood. A peri-formulated B complex can help fill any nutritional gaps.

Omega 3s

Essential fatty acids like those found in fish oil and algae supplements boost serotonin and dopamine activity to help keep mood balanced. High-quality fish oil or algae EPA/DHA supplements are your best options here.

Adaptogens

These unique herbs like ashwagandha, rhodiola, and maca help your body adapt to stress, while gently balancing hormones and soothing frazzled nerves. Look for blends formulated specifically for menopausal women.

Saffron

This antioxidant-rich spice has been shown in studies to be as effective as prescription antidepressants for improving mood, with few side effects. Look for standardized capsules with 15 mg of active saffron extract.

5-HTP

This natural amino acid readily converts to serotonin, the feel good neurotransmitter. But stick to 50-100 mg per day, and avoid combining with antidepressants.

MEDICATIONS

If lifestyle measures aren’t providing sufficient relief from depression, anxiety, irritability or other severe mood issues, anti-depressants or anti-anxiety meds may help in the short term while your brain chemistry re-stabilizes. Some options to discuss with your doctor include:

SSRIs like Prozac, Zoloft, and Lexapro boost serotonin activity which dips during menopause. They can help with mood swings, anxiety, irritability and depression but may take 4-6 weeks to take full effect. Potential side effects include nausea, dizziness, headache, and low libido.

SNRIs like Pristiq, Fetzima, and Effexor block the reabsorption of serotonin and norepinephrine, another key mood-balancing neurotransmitter. They may improve mood, anxiety, and hot flashes. Side effects can include insomnia, stomach upset, and high blood pressure at higher doses.

Anti-anxiety meds like gabapentin (Neurontin), pregabalin (Lyrica), and buspirone (Buspar) reduce excitability of neurons to minimize anxiety, irritability, and hot flashes. Side effects may include fatigue, dizziness, and swelling.

The right medication coupled with proactive lifestyle strategies can make a potent difference helping you regain more emotional equilibrium. But give it time and be patient with yourself through the adjustment period as you and your doctor find the approach that works best for you.

You’ve got this, my sisters! I know the mood swings feel unnerving right now, but take comfort in the fact that this too shall pass. Stay the course with self-care. Reach out for support when you need it. And above all, be gentle with yourself as you navigate these challenging times. Our emotions may feel like a chaotic jungle gym right now, but that inner steel we’ve cultivated will see us through to the other side - stronger and wiser than ever!

This too shall pass,

Professor Peri