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Mood swings, mental health symptoms and the menopause transition - what’s going on?

Mood swings, memory loss, depression and anxiety are common symptoms associated with the menopause transition. 15-50% of perimenopausal women experience some form of depressive symptoms with 15-30% diagnosed with a depressive disorder. This is pretty big!

So what’s going on? What’s happening during the menopause transition that could be contributing? And what can you do about it or prevent it?

There’s a few things going on…

Firstly, your brain is rewiring and recalibrating as the reproductive hormones decline.. Progesterone calms your nerves, stabilises your hypothalamic-pituitary-adrenal (HPA) axis and stimulates brain-derived neurotrophic factor (BDNF), which assists a healthy nervous system. During perimenopause, one of the first hormones to decline is progesterone so your brain needs to readjust. Oestrogen also helps the brain to manage inflammation, regulate your circadian rhythm (sleep-wake cycles) and boosts serotonin - the feel good/pleasure hormone. Oestrogen also helped to improve insulin sensitivity and supported the energy system of your brain. Simply put, with the fluctuating and eventual decline in these hormones your brain finds it difficult to function and to stabilise moods.

Secondly, your brain is changing structurally too. Gray matter is shrinking which affects higher cognitive functions, motor control, sexual functions and the regulation of other hormones. So this isn’t helping either.

Then, we throw into the pan, the other hormones that are fluctuating too. Testosterone, for example, which may be low during perimenopause, seems to have antidepressant effects and cortisol which may be high has been found in women with severe depression. Cortisol is our stress hormone - if we are stressed, cortisol stays high.

Studies have shown that there is an increased risk of developing depression during perimenopause if there has been a previous history of major depressive episodes or where there have been stressful event(s) in the preceding year. Furthermore, ethnicity, history of smoking, social demographics (like low social support, financial strain, lower education and lack of employment) and obesity may also contribute.

So what can you do?

Whilst you might not be able to change your genetic or your past habits, you can change your current food, nutrition and lifestyle choices which will help to manage weight, stress, reduce inflammation and support your brain and body during this adjustment period.

It’s time to take action. Try to:

  1. Identify, acknowledge and monitor your susceptibility or the existence of mental health concerns

  2. Change up your food and nutrition habits to remove trans fats and ultra-processed foods (these are inflammatory), and add in plenty of green leafy vegetables, wholefoods, and Omega 3 fatty acids

  3. Minimise your stress levels - avoid stress where you can, regular gentle exercise (but not too much or too intense), reduce alcohol and give yourself permission to take things slowly.

Mood swings, memory problems, anxiety and depression do not need to rule your life. Perimenopause may be seen as a ‘Window of Vulnerability’ by some but by embracing this time and modifying your habits, it can be the ‘Window of Opportunity’ instead.

If you need help tackling your mood swings, memory problems, anxiety or depression, then book a Complimentary Call with me to find out how I can help you further.

P.S. If weight gain or being overweight is your main challenge, and you realise now that this might be contributing to your mental health symptoms, take a look at my FREE downloadable ebook on “Why Losing Weight is Even More of a Struggle in your 40s and what you can do about it” - available here.


Briden, L, 2021, Hormone Repair Manual, MacMillan

Bromberger JT, Kravitz HM. Mood and menopause: findings from the Study of Women's Health Across the Nation (SWAN) over 10 years. Obstet Gynecol Clin North Am. 2011 Sep;38(3):609-25. doi: 10.1016/j.ogc.2011.05.011. PMID: 21961723; PMCID: PMC3197240.

Toffol E, Heikinheimo O, Partonen T. Hormone therapy and mood in perimenopausal and postmenopausal women: a narrative review. Menopause. 2015 May;22(5):564-78. doi: 10.1097/GME.0000000000000323. PMID: 25203891.

Weber MT, Maki PM, McDermott MP. Cognition and mood in perimenopause: a systematic review and meta-analysis. J Steroid Biochem Mol Biol. 2014 Jul;142:90-8. doi: 10.1016/j.jsbmb.2013.06.001. Epub 2013 Jun 14. PMID: 23770320; PMCID: PMC3830624.

Musial N, Ali Z, Grbevski J, Veerakumar A, Sharma P. Perimenopause and First-Onset Mood Disorders: A Closer Look. Focus (Am Psychiatr Publ). 2021 Jul;19(3):330-337. doi: 10.1176/appi.focus.20200041. Epub 2021 Jul 9. PMID: 34690602; PMCID: PMC8475932

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