Many women will experience symptoms like fatigue, irritability and sadness during perimenopause, but there are lots of ways to ease the effects. We spoke to Vhi Clinical Lead for Women’s Health, Dr Fiona Belton, about what causes these kinds of emotional symptoms, the things we can do to alleviate them, and when we should seek professional help.

What emotional changes can you expect during perimenopause?

Perimenopause is the transitional time before menopause begins. During perimenopause, you can experience symptoms of menopause, but your periods have not yet stopped. Dr Belton highlights that not all women will experience noticeable emotional changes during perimenopause, but for those who do, the most common symptoms include:

• Worsening premenstrual syndrome (PMS). PMS is a combination of physical and emotional symptoms that many women get in the second half of their cycle, before the start of their menstrual period. Its exact cause is not known. It may be related to hormonal fluctuations in the body and /or the response of the chemicals in the brain to these fluctuations.
• Tiredness.
• Poor motivation or lack of interest in things you normally enjoy.
• Irritability, anger and less tolerance.
• Not feeling like yourself.
• Feeling teary, weepy or overwhelmed.
• Anxiety or depression.
• Low mood and low self-esteem.
• Low libido.
• Poor sleep.

The symptoms can start in the early to mid-40s for some women and can be quite gradual. For some people, emotional symptoms of perimenopause start earlier than the physical symptoms, such as hot flushes, sweating and irregular periods.

The cause of emotional changes during perimenopause

The fluctuation and decline in certain hormones, especially oestrogen (oestrogen is a female hormone that plays a vital role in many functions of a woman’s body), around perimenopause affects many areas of our bodies, including the brain, causing a myriad of symptoms such as those mentioned above.

Self-help measures that can help with emotional changes

Lifestyle is an important part of managing emotional wellbeing. Exercise is one of the more helpful ways of managing these emotional changes, particularly when practiced outdoors in nature. Even walking for 20-30 minutes a day can have a big impact on our mood, according to Dr Belton. Mediation and mindfulness may help some women, and, meditation apps can be useful. A healthy diet is important, and whole foods are optimal.

A Mediterranean diet is also recommended by Dr Belton, due to its concentration of healthy fats, vegetables, pulses and lean meats.

It's important not to be too hard on yourself if you fall short on exercise, mindfulness, or diet; as Dr Belton explains, “Even one little change can have a positive effect on you and make it easier to then make another small change. You need to set yourself achievable goals, starting as small as is feasible for you. Start with climbing the stairs at work or getting outside for 10 minutes of your lunchbreak.”

Seeking professional help for the emotional symptoms of perimenopause

If your emotional changes are affecting how you function each day, your relationships or how you feel about yourself, Dr Belton states it’s time to seek help from your healthcare provider. She highlights the importance of not letting the emotional changes of perimenopause get out of hand and start to affect your day-to-day life. If this happens, it’s important you get help from your healthcare provider so they can assess your circumstances and recommend treatment.

Your healthcare provider will always recommend exercise, a balanced diet, and good lifestyle choices as a means of dealing with perimenopause symptoms. They will assess the severity of your symptoms and recommend additional treatment, if needed, which may include HRT, cognitive behavioural therapy (CBT), psychotherapy or other medications. There are plenty of management options, and together with your healthcare provider, you’ll find what’s right for you.

This guide will hopefully help you understand that any changes you’re going through emotionally are completely normal during perimenopause, and you are not alone in how you’re feeling. Remember, your healthcare provider is on hand to support you if things become too difficult to manage alone or are impacting your day-to-day functioning.
 

This content is for information purposes only and is not intended or implied to be a substitute for professional medical advice, diagnosis, or treatment. Always seek advice from your GP or an appropriate medical professional if you have concerns about your health, or before commencing a new healthcare regime. If you believe that you are experiencing a medical emergency call 999 / 112 or seek emergency assistance immediately. 

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