Uncategorized Moods, Midlife & Menopause! Oh My!


Just as we’re hitting our stride in our 40’s and 50’s, feeling more confident and less worried about what other people think, along comes the hormonal roller coaster of menopause and suddenly even the most self-assured, happy, joyful and compassionate among us feel a shift in our emotions.

Sometimes it’s a little tremor and we can quickly course correct. And, sometimes, like my patient Sara, it’s a full-blown tectonic shift and we find ourselves anxious and crying for little reason, feeling like we hardly know ourselves anymore. Sara, a high-tech manager who handles boatloads of stress daily was snapping and irritable, having to steal time from her schedule to go have a quick cry in the bathroom. This was completely out of character and she headed in to see me for an evaluation.

She was worried that there was something seriously wrong and wasn’t sure what to do, where to start and as she said, was worried that she’d be like this forever. “Is this what my life is going to be like now?” she asked.

Luckily I’d known Sara for over 20 years and knew that this was a huge shift. After a few questions about sleep and periods, we came up with a menu of options she could consider.


Is it all in our heads?

When it comes to changing moods and menopause, what’s going on? Is it in our heads? Well, yes and no. You see, our moods are influenced by many different factors and one factor in particular, Serotonin is impacted by menopause. Serotonin, which is our brain’s feel-good neurotransmitter helps us feel happy, calm, less anxious and wards off depression. If you’ve read my blog on Hot Flashes and Night sweats, then you know that when serotonin is plentiful, it also helps blunt or decrease hot flashes and night sweats.


When it comes to our emotions and moods, the hormonal roller coaster of midlife as estrogen levels decline, the levels of serotonin are also reduced. But that’s not all, with less estrogen, there are few serotonin receptors and less uptake of the little serotonin that is present. No wonder women at midlife around the world, regardless of their circumstances, are more prone to anxiety and depression.


For women who have been challenged with PMS, depression and/or anxiety in the past, menopause can make things much worse. For women who have been able to manage their moods and find balance with mindfulness, meditation, therapy, counseling and medications, sometimes menopause tilts that delicate balance toward worsening feelings. If this is your experience, it’s helpful to make note of it, when you speak to a provider.


Less Serotonin + Less Sleep = Less Energy, Less Joy

With lowered serotonin levels, not only are women more likely to be depressed or anxious, they also are more susceptible to Hot Flash and Night sweat triggers. Why is that important? Well, night sweats are a huge disruptive factor in sleep and with less sleep comes more irritability and depression. If you’ve read my blog on sleep, you know that women who have fragmented sleep from frequent night sweats and other sleep disruptions are not only exhausted but are more likely to have brain fog and mood changes.


How to improve your mood at midlife

I can’t offer a magic wand, one-size-fits-all, try this one and only magic solution. But what I can offer is this: 

  • First, awareness is key. If you’re at midlife and your moods have changed significantly for the worse, if you’re more depressed, anxious, have thoughts of harming yourself, or are so irritable you’re afraid you might do or say something regrettable, do talk to your health care provider. 
  • Look for a Menopause Practitioner, who has been certified by the North American Menopause Society (NAMS) who knows how to connect all the dots and can provide a complete evaluation.
  • Have your Thyroid tested – Our thyroid hormones influence mood, temperature and energy level and about 10% of women have a thyroid condition that needs to be addressed.
  • Ask yourself if now is the time to work on some of the things that are challenging how you feel and how you interact with others. We have more tools than ever before to obtain personal coaching, counseling, therapy, and diving deep into self-help books. Therapy and counseling are much more nurturing than you might think and work with you in the way you want. They don’t dredge up the past or ask people to talk about their difficult experiences. What they do is help provide the tools you need for the challenges you want to work on. 
  • Work on improving your sleep naturally. Read my blog here.  
  • Consider melatonin supplements to help you sleep.
  • Talk to your provider about over-the-counter non-hormonal remedies. The following have clinical data to support their use.
    • Equelle – This is the soy metabolite (S-Equol) and has no residual soy in it, has been shown in research to improve both sleep and irritability.  
    • Serenol – This is derived from a plant source and has a serotonin-like effect. 
  • Talk to your provider about using Estrogen to help increase serotonin and reduce sleep fragmentation from Night sweats and the triggers that disturb sleep. 


You can find even more information on Remedies and Relief in my eGuide. 


Take care and Be Well

Nurse Barb

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Disclaimer: The information provided on this site is intended solely to serve as a guide to Perimenopause and Menopause and to provide basic evidence-based information about the symptoms, long and short-term impact to health, the causes, as well as the risks and benefits of various treatment options.

This site does not claim to prevent, cure or treat any medical disorder or disease. It is designed to inform and support decisions that should be made with your own personal licensed healthcare provider. It is not intended as a substitute, nor should you use this as a substitute for the medical advice and/or gynecologic care given by your own licensed healthcare professional. It is your exclusive responsibility to seek medical care as needed. No pharmaceutical or medical device companies contribute to the content or the cost of providing this education.

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