Mental Health & The Menopause - Understanding the Emotional Impact of Menopause

Mood changes during menopause are common. For many women, they are the primary reason for seeking support from healthcare professionals. It is not unusual to feel persistently low without necessarily meeting the clinical criteria for depression. These shifts can feel confusing, frustrating, and overwhelming.

Common Mood Changes During Menopause

Some of the most frequently reported emotional symptoms at this time include:

• Low mood

• Tearfulness

• Irritability

• Anxiety

• Panic attacks

• Reduced motivation

• Overwhelm

• Rage

• Suicidal thoughts

Insomnia is also common and can worsen emotional regulation, creating a cycle that feels difficult to break.

Why Does Menopause Impact Mood?

Hormonal Fluctuations

Menopause is characterised by significant hormonal changes. During perimenopause, levels of oestradiol (a form of oestrogen), progesterone, and testosterone fluctuate unpredictably. After menopause, these hormone levels remain consistently low.

Research is still ongoing, but it appears that both the fluctuations and the eventual absence of these hormones may contribute to mood changes.

The Role of Progesterone

For most women, progesterone is often described as a 'calming' hormone. It promotes restful sleep and emotional steadiness. When levels fall, women may experience insomnia, increased anxiety, and difficulty managing stress.

Hormones and Brain Chemistry

Reproductive hormones also play a vital role in regulating neurotransmitters. Oestradiol, for example, influences the production and activity of serotonin (the "happy hormone") and dopamine (linked to motivation and pleasure). As hormone levels drop, the natural balance of these brain chemicals is disrupted, making mood disturbances more likely.

Lifestyle Factors

Low energy, joint aches, and a decrease in motivation can make it harder to maintain regular physical activity during menopause. Since exercise is a powerful mood regulator, reduced movement can contribute to a perfect storm of worsening symptoms.

Women who have a history of hormonal mood disturbances (such as PMS or postnatal depression), who experience high levels of stress, or who have underlying health issues may be even more vulnerable to significant mood changes during menopause.

How to Support Your Mental Health During Menopause

Exercise as Medicine

Exercise remains one of the most effective, evidence-based tools for improving mood. It boosts endorphins, supports healthy sleep, reduces anxiety, and enhances overall wellbeing. Activities do not need to be intense; walking, strength training, yoga, or swimming can all provide significant benefits.

Exploring Cold Therapy

Cold therapy, such as cold showers or cold-water immersion, has emerged as a transformative strategy for some in improving mental resilience. Some women find that regular exposure to cold helps reset their stress responses and improves overall mood and energy levels.

Considering Medical Support

For some, medication is an important part of managing mood changes. Hormone replacement therapy (HRT) can help stabilise hormone levels, while antidepressants or other medications may be recommended based on individual needs. Seeking professional advice can help identify the right path forward.

You Are Not Alone

Mood changes during menopause are real, valid, and extremely common. They are not a sign of weakness or failure. With the right support—whether through lifestyle changes, therapies, medication, or a combination of approaches—women can navigate this life stage with greater ease, resilience, and confidence.