Menopause and irritability
Hot flashes, bad sleep, feeling blah… understandably, menopause can leave you feeling a little cranky. It’s also common to feel an increase in irritability and rage or anger, which are caused by the hormonal changes that happen at this time.
IRRITABILITY DEFINITION
Irritability can show itself in several different ways. There is no strict medical definition but irritability generally means that you easily find yourself getting angry, annoyed, or impatient.
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HOW LIKELY IS IRRITABILITY DURING MENOPAUSE?
Very likely. Up to 70% report feeling annoyed and irritable during menopause.
Read more about the stages of menopause.
SIGNS OF IRRITABILITY
Getting angry or annoyed quickly
Being snappy and impatient
Having a constant sense of tension
Certain sounds and sensations irritate
TIPS TO HELP WITH IRRITABILITY DURING MENOPAUSE
Check in with your healthcare provider
Menopause is just one of many possible causes of irritability. It is especially common in several mental health problems including depression, anxiety disorders, and bipolar disorder. Speak to your healthcare provider to ensure that you have the right diagnosis – especially as depression and anxiety become more common at menopause.
Take a look at your medications
If you have depression, anxiety, or another disorder that can contribute to irritability, ask your healthcare provider to check your medication. Would you benefit from a higher dose? Or a change in prescription?
Manage stress
It’s easier said than done, but stress can make your irritability worse. Think about the things that trigger your feelings of irritability. It may help to keep a log of your feelings and things that may help or hinder your mood.
Think about yoga and meditation
There is growing evidence that mind-body activities, such as yoga, tai chi, and meditation, can help to reduce stress and enhance your mood at menopause.
Prioritize physical health
It’s easy to let it slide, especially when you feel overwhelmed. However, a healthy lifestyle can help to ease irritability. In particular, try to get some exercise, eat a balanced diet and cut down on caffeine, alcohol, and nicotine.
Can hormone therapy (HT) help?
HT is recommended for low mood at menopause, which often goes hand-in-hand with irritability. It is also thought to help with mood swings. Speak to your healthcare provider to find out if this could be an option for you. Non-hormonal treatments for menopause may also help, including antidepressants, which can help with some menopause symptoms.
We know that HT has a positive effect on the brain when it comes to the changes seen with menopause (including those which cause conditions related to irritability). Multiple studies have found that HT affects the parts of the brain responsible for regulating your mood.
This translates into real-world improvements too. Many studies have found that using HT can help to ease depression and mood symptoms in menopause, and HT is recommended as a treatment for low mood and mood swings at menopause.
HT can also effectively treat many other symptoms associated with menopause, such as hot flashes, and sleep disturbance, among others. Read more on the risks and benefits of HT here.
This is not the full story. HT can be helpful but it is not always the best treatment for certain conditions which can be related to irritability, including depression, anxiety, and bipolar disorder. Speak to your healthcare provider for personalized advice on the best treatment options for you.
It is also important to be aware that HT is not suitable for everyone. Your healthcare provider will be able to tell you more about the best approach for you.
IRRITABILITY AND MENOPAUSE FAQs
Irritability has a few different components. If you are feeling physically unwell – for example, because of hot flashes, aches and pains, and poor sleep that comes with menopause – it can have an impact on your mental health.
Likewise, the hormonal changes of menopause can cause mood changes including irritability, regardless of whether you have any other symptoms.
During menopause, estrogen levels fluctuate and ultimately decrease. Estrogen is known to work on several structures within the brain which regulate mood. These include the amygdala, hippocampus, and hypothalamus. When estrogen levels change, these structures are affected. This ultimately leads to mood changes which are so common at menopause, including irritability.
Irritability is very common at menopause and can have a big impact on your relationships. It is important to be open with your loved ones about the way you are feeling and the effect it is having.
Try to have the conversation in a calm and non-confrontational environment. Be aware that you may all find it difficult to discuss these issues.
You may choose to talk about your experience. Some pointers to discuss could include:
- What happens when you feel irritable?
- What makes you feel angry, enraged, or annoyed?
- Do you find it more difficult to control your temper than previously?
- What helps you to feel better?
- Do you have a plan to address your symptoms?
- Can they do anything to help you?
You may wish to share this page with them to give them the facts. You may also find it useful to have them on board if you are seeking treatment.
Speak to your healthcare provider if irritability is causing you problems, especially if you experience:
- Feeling sad, depressed, or low
- Struggling with feelings of anxiety or worry
- Finding your relationships affected by irritability
- Struggling to cope with your day-to-day life as a result of your symptoms
- Any other worries or concerns
Seek urgent help if you are:
- Having thoughts about hurting yourself, suicide, or otherwise harming yourself or others
- Hearing things, seeing things, or experiencing other unusual sensations
- Having strong or unusual beliefs which others can not understand
- Having any other serious concerns
- Born L, Koren G, Lin E, Steiner M. A new, female-specific irritability rating scale. J Psychiatry Neurosci. 2008 Jul;33(4):344-54. PMID: 18592028; PMCID: PMC2440789.
- Innes KE, Selfe TK, Vishnu A. Mind-body therapies for menopausal symptoms: a systematic review. Maturitas. 2010 Jun;66(2):135-49. doi: 10.1016/j.maturitas.2010.01.016. Epub 2010 Feb 18. PMID: 20167444; PMCID: PMC3031101.
- Mayo Clinic, Menopause diagnosis and treatment
- Wharton W, Gleason CE, Olson SR, Carlsson CM, Asthana S. Neurobiological Underpinnings of the Estrogen – Mood Relationship. Curr Psychiatry Rev. 2012 Aug 1;8(3):247-256. doi: 10.2174/157340012800792957. PMID: 23990808; PMCID: PMC3753111.
