The Menopause Expert - Rebecca Hulem

Managing Mood Swings

By Rebecca Hulem

Managing mood swings that show up in the perimenopause/menopause transition can feel like you’ve been given the assignment of trying to stay seated in a roller coaster, without a cross bar, while at the same time putting on a happy face and not look terrified! It’s challenging to say the least.

Many women have described the mood swings as feeling like a mild anxiety and overwhelm to a raging out of control feeling of wanting to chop somebody’s head off. Sadness rises up easily which is confusing because most of the time we don’t know what we’re feeling sad about. Crying at the drop of a hat at seemingly ridiculous triggers can leave you feeling out of control, weak in constitution and a loss of self esteem.  Just when you thought you had your whole life figured out, bam, you get hit with mood swings that you don’t understand and are unprepared for. Partners and friends feel helpless too as they stand by and wonder what’s going on.

So what is going on? Why all of the sudden do we feel so out of control with our feelings. And more importantly what can we do about it?

Perimenopause Mimics Puberty

Remember when you were going through puberty and seemingly with no reason one day you felt happy and on top of the world, and the next you were crying, lashing out at your mother and couldn’t stand your best friend? Without knowing or understanding it your hormones were the cause of the out of control feelings. The ovaries were beginning to produce estrogen and more importantly progesterone, two hormones that regulate menstrual cycles. Progesterone is the major player whose main job is to regulate moods, menstrual periods and sleep cycles. Once ovulation kicked in and your menstrual periods became regular, your mood swings became less intense too.

Fast forward thirty five years and the mood swings are back; this time with a vengeance. Just when you thought you have all the major balls of your life circulating in sync in the air, they all come tumbling down. Once again Progesterone is the culprit of major mood swings. Why? Because now your ovaries are winding down and ovulation is sporadic and when ovulation stops so does the right amount of progesterone that helps to regulate moods, sleep and menstrual periods.

How to Manage Moods Swings during the Perimenopause/Menopause Transition

Managing mood swings during the perimenopause/menopause transition can be divided into three categories:

  • Lifestyle choices
  • Complementary and Alternative therapies
  • Medical/Prescription intervention

I always recommend that healthy lifestyle choices need to be firmly in place first before considering other choices. Many women won’t need any further intervention. But if they do other choices are available and can be safely combined.

Healthy Lifestyle Choices include: daily exercise, a healthy diet, and stress reduction practices.  Daily exercise like walking, jogging, hiking, or if you prefer to work out in a gym, any class or machine that will get your heart pumping  and help you burn up calories. Your body needs this to burn up excess energy so it won’t create anxiety in your body. Exercise also strengthens your heart, lungs, and helps to prevent bone loss that can accelerate after menopause. Not to mention it will also help you maintain a healthy weight.

A healthy diet:  is one which includes fruits, vegetables, whole grains and plant based proteins like beans, lentils, legumes and soy. Omega three fatty acid fish like salmon is important to include in your diet at least three times a week.

Stress reduction practices such as meditation, tai chi, and yoga will help calm the mind which in turn will help reduce the anxious feelings that bubble up unexpectedly. The deep breathing taught in meditation, tai chi and yoga, if practiced regularly, will train the brain to deal with the anxious thoughts and feelings.

Complementary and Alternative therapies may include a variety of “natural health products”, vitamin and mineral supplements, and homeopathic medicines, as well as traditional Chinese medicine such as acupuncture or acupressure massage. Aromatherapy, using essential oils, has many benefits too to help calm the mind, relax the body, and reduce hot flashes. A Naturopath physician is the practitioner I would recommend consulting for herbs and homeopathic products to relieve mood swings and anxiety. Vitamin B-6, 50 to 100mg a day is suggested for all women who suffer from mood swings related to PMS or perimenopause/menopause.

Medical/Prescriptive Intervention: This approach usually requires a visit to your GYN doctor to assess/ discuss if a prescription is needed to manage your mood swings. Prescriptions that have been used range from low dose BCPs (which have progesterone in them) which will reduce mood swings and also regulate menstrual periods if they are irregular; to a mild antidepressant that works to reduce anxiety and depression. Most women won’t require this approach but the beauty is every woman is different and there are many choices available if needed.

In closing, the comforting thought about mood swings during the perimenopause/menopause transition is that they’re very common and you’re not going crazy. In addition there are a lot of things you can do to regain a feeling of being back in control, you don’t have to suffer and believe it or not they will pass. And I know this might sound crazy but I believe the mood swings that show up during midlife are a “wake up” call for us all to help us slow down and take the time to be kind and loving to ourselves. The same love, kindness and attention we’ve been giving to everyone else all our adult life. Our time is here!

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