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Connecting with ... "Ms PeriMenopause"

The truth is, we’re all at different stages of our lives as women.  Several of my friends, sisters, and I are at this very interesting time in our lives, the menopausal transition, and yes, just beginning to meet, “Ms. PeriMenopause” for the first time ourselves.  Our 40-50 yo ‘girl-talk’ usually ends up with some discussion around the topics of hot flashes, or how much more difficult it is now to lose weight.

But what’s less often spoken of amongst my friends, are the symptoms of mood swings and irritability, which can also be symptoms of the peri-menopausal transition.  Have you seen yourself go from ‘zero-sixty’ in irritability (or anger), or get easily tearful over things that you know before wouldn’t have upset you so easily?  Well I certainly have.  Hopefully this bit of information will help you to understand some of the hormonal and emotional shifts that can occur in the perimenopause, giving us some control over that feeling of our ‘raging’ hormones...


The menopausal transition, or perimenopause, begins on average four years before the final menstrual period, and includes a number of physiologic changes that may affect a woman’s quality of life. It is characterized by irregular menstrual cycles and marked hormonal fluctuations, often accompanied by hot flashes, sleep disturbances, mood symptoms, and vaginal dryness.


Mood and Depression

Some women notice emotional symptoms as well, like irritability and mood swing…Or maybe she’s just not been feeling like herself.  Many patients ask me if depression is part of “the change “.  We do know that depression is more common in women in this age bracket, but less likely, actually caused by the menopausal change.  I try to get patients to prioritize their symptoms.  If hot flashes, night sweats and interrupted sleep (with some noticeable, but more minor mood shifts) are her story, I’d more likely attribute these symptoms to perimenopausal changes.  If her main complaint is major depressed mood, lack of energy/motivation, more serious crying episodes (and ‘oh-by-the-way’, I’m having hot flashes,) I’d have her consider further evaluation for depression as first priority, while offering options for menopausal symptoms secondarily.


How to Cope

Life is complicated.  It wouldn’t be fair to blame all female mood disorders on peri-menopause.  Career and economic stressors, family stressors with aging parents, raising children, teenager concerns, ‘empty nest’ issues, redefining relationships with friends/mate, body image issues, and medical health concerns could all be at play.  Though with that being said, the irregular and unpredictable hormone shifts of the perimenopause have been known to be associated with irritability and mood swings.  These symptoms may be aggravated by sleep disturbances, yet another symptom of the perimenopausal transition.

So if you’re experiencing some of the symptoms of the perimenopausal transition, give yourself a break!  Maybe this time we can blame some of it ‘on our hormones’.  Be kinder to yourself, and to others.  And take a look at your behaviors in interacting with others.  Take ownership of where our (over-reacting) emotions could be contributing to negative interactions.

Rest more.  Find relaxing activities and hobbies to enjoy.  Forgive.  Apologize.  And seek help from your health care providers if your emotional symptoms seem severe.



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