How to Manage Menopausal Mood Changes

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Woman with hormone replacement tablets

The changes that happen to women during and prior to menopause are many and complex, but the mood changes caused by shifting hormones can be amongst the most frightening, if left unaddressed, writes medical researcher and female health advocate, Dr. Emily Handley.

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It’s an unavoidable part of life for all women, but Menopause and the mood changes that frequently accompany it, are often reduced to a punchline. But there’s nothing funny about the impact menopause can have on women’s emotional and mental health.

The good news is that there a variety of options open to women to help reduce or manage the emotional ups and downs of menopause. 

Diet and exercise

It starts with maintaining a healthy lifestyle. Healthy eating and exercise are especially important for women going through changes in hormone levels. Moderate and high levels of exercise can reduce stress in women going through menopausal transition, and even more so in postmenopausal women where it can reduce feelings of depression and anxiety. Regular exercise can also improve sleep quality; a critical factor in regulating mood changes. Yet in perimenopausal women, introducing moderate to heavy exercise can increase anxiety and depression. This may be due to increased cortisol, which can result in fatigue and stress. Turning to lower intensity activities such as yoga can help alleviate anxiety while promoting physical activity .

Maintaining a healthy diet goes hand in hand with regular exercise. Diets high in refined carbs and sugars can wreak havoc on your blood sugar levels and increases the risk of depression in postmenopausal women.

Dairy products promote sleep quality, with foods high in glycine such as milk and cheese promote deeper sleep during menopause. Salt intake also impacts mental health during menopausal transition; a low-moderate sodium diet creates a better mood, compared to a diet with no salt restriction.

Including antioxidants such as blueberries and dark leafy greens in your diet is correlated with a decreased risk of depression. Overall gut health can aid in managing or preventing hormone-associated mental health issues and can be maintained using probiotics found in fermented wholefoods such as yoghurt, tempeh and kimchi.  Polyunsaturated fatty acids (PUFAs) found in fatty fish, walnuts, and algae-derived omega-3 supplements have a significant impact on mental health during menopause. Polyunsaturated fatty acids can also have positive impacts on neuropsychiatric disorders, such as anxiety disorders – and may even prevent anxiety and depression.

Hormone treatment therapies

Hormone replacement therapy (HRT) is used to medically reintroduce female hormones to the body. These come in a number of combinations that all have pros and cons depending on the symptoms experienced and medical history. Hormone replacement therapies have recently been shown to have some efficacy in the prevention of depressive symptoms. For women who have not had a hysterectomy, estrogen plus progesterone treatment is needed – though these treatments do come with a small risk of developing breast cancer, which increases with time. Estrogen alone is suitable after a hysterectomy, while tibolone – a synthetic steroid hormone – has some estrogen, progesterone and testosterone effects. The newest HRTs contain estrogen with selective estrogen receptor modulators with few side effects. Hormone replacement therapies need to be tailored to each individual and coming off of them can also cause mental health problems. While HRT is still an essential part of maintaining well-being in many women experiencing hormone changes, it is imperative to learn which combinations will suit you best and what complementary therapies may benefit.

Neuropsychiatric medications

Neuropsychiatric medications predominantly work on a type of chemical in the brain called neurotransmitters that carry messages between brain cells. Antidepressants treat depressive symptoms and anxiety, with four main types that work on different hormones and neurotransmitters, depending on individual needs. Studies have shown that for those suffering severe depressive episodes during hormonal transitions, antidepressants combined with. Hormone replacement therapies have the best therapeutic outcomes. Yet for many, using antidepressants can come with side effects and adverse events, and may not be beneficial for those experiencing depressive mood that are considered a major depressive episode. Just remember, that if you are considering these medications or taking them already, it is important to continue consulting with your doctor to determine dosage and when to cease medication.

Mind-body interventions

Combining medications with alternative treatment options have been shown to provide the most positive outcomes. Mind-body medicine involves a range of treatments that consider the way our mental and emotional health impacts our physical health. Therapies that encourage this perspective include meditation, mindfulness and yoga. These approach the person as whole, while attempting to avoid the introduction of other substances to the body.

For women who experience side-effects from certain medications; do not have the option of hormone-replacement therapy; or simply want greater relief from their symptoms, mind-body therapies can be a positive alternative. In one study, meditation was found to reduce self-reported depression scores in menopausal women, whilst in another study, weekly mindfulness sessions resulted in a significant improvement in participants’ quality of life and sleep quality. The most important thing is to continue consulting with professionals as to which combination of therapies will be best for you, your symptoms and your lifestyle.

The light at the end of the tunnel

It’s important to remember that menopause and hormonal changes are not an illness – they are a part of life. But that does not mean you have to live with debilitating symptoms of hormone fluctuation without relief. Use the information here to approach hormonal changes holistically and be open with what symptoms you are feeling. No single approach will work for everyone, and it is essential to work with health professionals to find a hormone management plan that suits the individual.

This article provides general information only, and does not constitute health or medical advice. If you have any concerns regarding your health, seek immediate medical attention.