Hot flashes, bad sleep, mood shifts… understandably, menopause can leave you feeling on edge. Irritability and even sudden anger or rage are common during menopause. These changes often happen because of hormonal fluctuations, sleep disruption, and stress, but there are ways to manage them.

What is irritability?

Irritability generally means feeling frustrated, angry, or impatient more easily than usual. There isn’t a strict medical definition, but many people describe it as a shorter temper or feeling “on edge” most of the time. During menopause, these feelings often stem from hormonal changes that affect how your brain regulates mood.

How common is irritability during menopause?

Irritability is very common, affecting up to 70% of people during menopause. Shifting hormone levels—especially fluctuating and declining estrogen—influence brain areas that regulate mood, such as the amygdala and hippocampus. Combine that with hot flashes, night sweats, and disrupted sleep, and it’s easy to see why irritability can increase at this time.

Read more about the stages of menopause.

Signs of irritability

1. Feeling angry, impatient, or frustrated more often
2. Snapping at others or losing your temper quickly
3. A constant sense of tension or restlessness
4. Certain noises, sensations, or interactions feel more irritating than usual

Tips to help manage irritability during menopause

Check in with your healthcare provider

Irritability can be linked to menopause, but it can also signal other conditions like anxiety, depression, or thyroid imbalance. Your provider can help rule out underlying causes, review medications, and recommend tailored treatments.

Review your medications

If you already take medication for mood or anxiety, it may need adjusting. Talk to your provider about whether a dosage change or alternative prescription could help stabilize your mood.

Manage stress

It’s easier said than done, but stress can amplify irritability. Try tracking your triggers to see what worsens your mood and what helps calm you. Techniques like deep breathing, journaling, and mindful breaks can help you reset when tension builds.

Try yoga, meditation, and mindfulness

Mind-body activities such as yoga, tai chi, and meditation can reduce stress hormones and improve emotional balance. Regular practice has been shown to improve mood and sleep in people going through menopause.

Support your physical health

Exercise regularly, eat a balanced diet, and stay hydrated. Limiting caffeine, alcohol, and nicotine can also help reduce irritability. Even small lifestyle changes can make a big difference to how you feel day to day.

Can hormone therapy (HT) help?

Yes, for many people, hormone therapy (HT) can improve mood and reduce irritability. Estrogen affects parts of the brain responsible for regulating mood, and studies show that HT can help stabilize these fluctuations.

HT is often recommended for low mood and mood swings associated with menopause. It can also help manage other symptoms like hot flashes and poor sleep, which indirectly affect mood. Estrogen interacts with brain areas that regulate mood, including those affected by changes in hormone levels. Several studies have found that HT can improve mood by supporting these areas and helping to stabilize emotional responses.

In real-world terms, this means that HT can ease symptoms like depression, mood swings, and irritability for many people. It’s one of the treatment options recommended for emotional symptoms during menopause, especially when other symptoms like hot flashes or poor sleep are also present.

That said, HT is not always the best fit for everyone. It can be helpful, but it may not be the right treatment for related conditions like anxiety, depression, or bipolar disorder. Your healthcare provider can talk you through the full picture and help you explore both hormonal and non-hormonal options, including antidepressants, which can help with some menopause symptoms.

HT can also improve a wide range of other menopause symptoms, including hot flashes and sleep issues. But it’s not suitable for everyone, so it’s important to get personalized medical advice before deciding whether it’s right for you.

Read more on the risks and benefits of HT here.

FAQ: Irritability and menopause

Why do you get irritable during menopause?

Irritability during menopause can be caused by both physical symptoms and hormonal changes. If you’re dealing with hot flashes, poor sleep, aches and pains, or other uncomfortable symptoms, it’s natural to feel more on edge. Physical discomfort can take a toll on your mood and increase emotional sensitivity.

At the same time, hormonal fluctuations—especially changes in estrogen—can directly affect the parts of your brain that regulate mood. Estrogen plays an important role in several brain structures, including the amygdala, hippocampus, and hypothalamus. These areas help control emotional responses, so when estrogen levels drop, it can lead to mood shifts like irritability, anxiety, or sadness. That’s why feeling short-tempered or overwhelmed is such a common part of perimenopause and postmenopause.

How can I talk to my friends and family about irritability?

Irritability during menopause is common, but it can still put strain on your relationships. Talking to friends, partners, or family members about what you’re experiencing can help them understand your perspective and support you better.

Try to bring it up during a calm moment, when you’re not in the middle of feeling upset. If often helps to explain that hormonal changes are affecting your mood and that this is a well-documented part of menopause.

Here are some helpful questions and prompts to guide the conversation:

• What tends to happen when you feel irritable?
• Are there specific triggers that make you feel angry, overstimulated, or frustrated?
• Is it harder to manage your reactions than it used to be?
• What have you found helpful when trying to calm down or feel better?
• Are you actively seeking treatment or support?
• Is there anything they can do that might help when you’re having a tough day?

You might want to share trusted resources (like this page) so they can learn more. Having your support system understand what’s going on can make it easier to ask for space, patience, or encouragement when you need it.

When should you see a healthcare provider?

It’s a good idea to talk to a healthcare provider if irritability is affecting your daily life or relationships. While mood changes are common during menopause, they can sometimes overlap with other conditions like anxiety or depression, and getting the right diagnosis and support is important.

You should seek help if you’re experiencing any of the following:

• Ongoing feelings of sadness, low mood, or emotional numbness
• Persistent anxiety, worry, or panic
• Struggles with work, parenting, or relationships because of irritability
• Difficulty managing day-to-day tasks or feeling overwhelmed by small things
• Any concerns about your mental or emotional wellbeing

Seek urgent help immediately if you are:

• Having thoughts of hurting yourself or others
• Thinking about suicide or self-harm
• Seeing, hearing, or sensing things that others don’t
• Experiencing strong or unusual beliefs that feel out of character
• Feeling like something is seriously wrong and you’re not sure where to turn

A healthcare provider can talk with you about all your options, including hormone therapy, non-hormonal treatments, and mental health support. You don’t have to wait until things feel unmanageable to ask for help.

Learn more – the latest irritability and menopause research

• 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.