Menopause and Mood: How Hormonal Changes Disrupt Your Emotional Balance. How to Improve Your Mood.

Table of Contents

1. What really happens in your mind during menopause and perimenopause?
2. Increasing responsibilities in middle age: why so much pressure accumulates
3. Emotional symptoms of menopause you should not ignore
4. Risk factors and myths about menopause and mental health
5. Treatments and strategies to care for your psychic balance during menopause
6. How to support a woman in menopause: family, partner and environment

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A natural process that arrives just when life demands more from you can completely destabilize you. I’m talking about menopause, that stage many see only as “hot flashes and weight gain,” but that actually strikes the psychic balance head-on. And yes, it also affects your schedule, your relationships, your work and even your sense of identity. 😅

As a psychologist I hear the same sigh in the clinic again and again:

“I don’t know what’s happening to me. I have everything, but I feel on the brink of collapse.”

Most people attribute it only to stress, work, children, or a partner. Very few say upfront: “I think this is related to menopause.” And that’s where the big misunderstanding begins.

What really happens in your mind during menopause and perimenopause?

Menopause usually occurs between the ages of 40 and 50. Before menstruation fully stops, there is a transition stage called perimenopause, where hormones go up and down like a roller coaster. 🎢

In this phase, your estrogen and progesterone levels begin to decrease and fluctuate. Not only does your body change, your brain changes too. And here comes the interesting part.

These hormones influence key neurotransmitters such as:

• Serotonin: related to wellbeing and emotional stability.


• Dopamine: linked to motivation, pleasure, and drive.


• Norepinephrine: associated with energy and the stress response.

When hormones become unpredictable, all this internal chemistry is altered as well. Dr. Ashwini Nadkarni, of Brigham Psychiatric Specialties, explains that these changes modify brain circuits linked to memory, concentration and mood. In plain terms: you find it hard to concentrate, you forget simple things, you get irritated easily and your mood becomes more fragile.

In consultations, many women tell me things like:

• “I walk into a room and forget what I was going to do.”


• “I used to organize myself perfectly, now my head feels like a cloud.”


• “I cry over things that used to make me laugh.”

All of that does not mean madness or weakness. It means that a natural hormonal process directly affects your psychic balance.

A curious fact I often mention in my talks: many women experience perimenopause alongside what in astrology we see as a period of major life reviews, especially around fifty.

Intense astrological transits coincide with biological changes and growing responsibilities. It’s as if life says: “review everything… and do it while you sleep poorly.” 🙃

I suggest reading: They discover mental menopause in women

Increasing responsibilities in middle age: why so much pressure accumulates

As your body enters this hormonal revolution, your external life also rises in demands. This combination greatly increases emotional vulnerability.

In this stage many women tend to:

• Care for children entering adolescence or young adulthood, a busy time for the whole family.


• Support aging parents with more health problems or dependency.


• Sustain an increasingly demanding professional career.


• Lead household tasks, family logistics and financial matters.


• Face changes in the couple or even separations.

This is the well-known “sandwich generation”: you feel trapped between the needs of those who come after and those who came before. All at the same time.

I remember a patient, I’ll call her Laura, who told me:

“I arrive at work sleepy because my mother called me in the night, I get home feeling guilty because I didn’t see my children, I go to bed exhausted and with hot flashes. And on top of that I feel sad for no reason.”

The reason does exist. Your body is trying to adapt to a new biological stage, while your environment expects you to perform as if nothing changed. That mismatch between what your body needs and what your life demands opens the door to anxiety and depression.

The American College of Obstetricians and Gynecologists notes that anxiety and depression increase in middle age. However, many women don’t relate those symptoms to menopause and only think they “don’t know how to manage stress.” That hurts, because besides feeling bad, they blame themselves. 😔

Emotional symptoms of menopause you should not ignore

Many women immediately recognize hot flashes or weight changes. However, psychological symptoms go unnoticed or are minimized. Let’s name them so you can identify them without fear.

Common signs of altered psychic balance in menopause and perimenopause:

• Sudden mood swings without an obvious reason.


• Constant irritability or outbursts of anger.


• Persistent sadness or episodes of easy crying.


• A sense of emptiness, apathy or loss of interest in activities you used to enjoy.


• Anxiety, excessive worry, feeling like you “can’t keep up”.


• Sleep difficulties, nighttime awakenings, insomnia.


• Extreme tiredness despite not having done great exertion.


• Difficulty concentrating, a foggy mind or “brain fog”.

Many of these manifestations are related to:

• Sleep disturbances from nighttime hot flashes or frequent awakenings.


• Accumulated fatigue from long days and short nights.


• Mental stress due to increasing responsibilities.

In my practice I see a very clear pattern: when a woman improves her sleep, with medical and psychological support, her mood also improves. Insomnia behaves like fuel for anxiety and depression. If you sleep poorly continuously, your mind loses the resources to regulate your emotions.

Psychiatrist Nadkarni explains that hormonal changes also affect brain areas related to memory and attention. Hence the famous phrase from many patients: “My head feels like it’s full of cotton.”

Important: even if you never had emotional problems before, this stage can bring your first depressive or anxiety episode. That does not make you weak. It makes you human in the face of a real biological change.

Risk factors and myths about menopause and mental health

Not all women experience menopause in the same way. Some go through it with mild symptoms, others feel an emotional tsunami. What explains that difference?

Some risk factors that increase the likelihood of suffering disturbances in psychic balance during this phase include:

• Personal history of anxiety or depression.


• Undiagnosed or poorly controlled thyroid problems.


• Heart rhythm disturbances.


• Chronic infectious diseases such as Lyme disease.


• Vitamin B12 deficiency or other important nutrient deficiencies.


• High consumption of alcohol, tobacco or caffeine.


• Chronic stress and lack of emotional support.

On more than one occasion we discover in consultation that a woman who feels “crazy” actually has a B12 deficiency or an untreated thyroid problem. With appropriate tests and treatment, her mood improves markedly. That’s why I always recommend combining psychological and medical evaluation.

There are also many harmful myths:

• Myth: “Menopause only affects the body; the mind has nothing to do with it.”
  Reality: hormonal changes directly influence brain chemistry and mood.



• Myth: “If you get depressed during menopause, it’s because you can’t adapt.”
  Reality: it’s not a lack of character. It’s a biological process plus a context of high demands.



• Myth: “Talking about menopause is embarrassing, better to endure it in silence.”
  Reality: silence increases distress, isolation and delays professional help.

Dr. Esther Eisenberg, of the editorial board of the American College of Obstetricians and Gynecologists, notes that many patients attribute these changes only to daily stress and don’t link them to this transition. That lack of knowledge complicates early diagnosis and appropriate treatment.

Added to this is something I see a lot: ageism and stigma. In many cultures, society values youth and regards aging with suspicion, especially in women. The result:

• It’s hard for you to admit you’re entering menopause.


• You prefer to keep quiet about emotional symptoms for fear of being seen as “old” or “unstable.”


• You don’t ask or seek reliable information, and end up consuming miracle cures that only empty your wallet.

And here’s a curious fact: in communities that value mature women as wise and respected, intense emotional symptoms tend to appear less frequently. Culture not only influences what you feel; it also influences how you interpret what you feel.

Treatments and strategies to care for your psychic balance during menopause

The good news: there are many ways to relieve the emotional symptoms of menopause. You don’t need to give up or endure everything in silence. I always recommend an integral approach that combines medicine, psychology and lifestyle changes.

1. Medical and hormonal treatments

According to women’s health specialists, hormone therapy can help significantly reduce hot flashes and stabilize mood in some cases.

• In women with a uterus, a combination of estrogen and progesterone is usually indicated.


• In women without a uterus, estrogen alone is often prescribed.

This type of therapy is not suitable for everyone, because each body and medical history is different. Your gynecologist should evaluate risks and benefits in your specific case.

When hormone therapy is not advisable, some antidepressants and other medications can reduce depression, anxiety and even hot flashes in certain cases. This involves joint work between psychiatry and gynecology.

2. Psychological therapy

Cognitive behavioral therapy is very useful to:

• Challenge catastrophizing thoughts like “I’m useless now,” “my life is over.”


• Learn anxiety management techniques and emotional regulation.


• Improve sleep habits and time organization.

In my practice I combine cognitive-behavioral tools with work on self-concept and sense of purpose. Many women feel grief for the fertile stage that ends. However, they also discover a new freedom: they no longer revolve so much around other people’s expectations.

In a motivational talk about menopause, an attendee told me something I never forgot:

“I thought I was losing my youth, and instead I gained my authenticity.”

That phrase sums up well what we can achieve when we accompany this process with awareness.

3. Lifestyle and deep self-care

Some everyday changes make a big difference:

• Regular physical activity: improves mood, regulates sleep and decreases anxiety. You don’t need marathons; walking, dancing or yoga with consistency is enough. 🙂


• Balanced diet: prioritize fruits, vegetables, quality proteins and healthy fats. Avoid excess sugar, alcohol and ultra-processed foods.


• Sleep hygiene: keep schedules, reduce screens before bed and create a relaxing nighttime ritual.


• Reduce tobacco and alcohol: both increase the risk of depression and worsen hot flashes.


• Personal pleasure spaces: reading, art, music, meditation—whatever connects you with yourself.

Dr. Eisenberg warns about the rise of commercial products that promise immediate solutions to menopause. Many of these options lack scientific support and prey on desperation. Always consult professionals and be wary of anything that promises miracles without effort.

How to support a woman in menopause: family, partner and environment

If you are not going through menopause but live with someone who is, you also play a fundamental role. The environment can become a support network or a factor that worsens distress.

Some powerful ways to support:

• Listen without minimizing: avoid phrases like “it’s an age thing” or “you’re exaggerating.” Better ask: “What do you need from me right now?”.


• Get informed: when you know about hormonal and emotional changes, you better understand reactions you once judged.


• Share responsibilities: don’t let her carry household tasks, childcare or eldercare alone.


• Validate her achievements and life journey: self-esteem in this stage is very sensitive. Acknowledge her experience and value.


• Encourage dialogue: talk about menopause as something natural, not a taboo.

When I run workshops for couples, a very beautiful moment often emerges: upon understanding that mood changes don’t come from “bad mood for no reason,” but from an intense biological and life transition, empathy grows. From there, living together improves a lot.

Opening up dialogue and normalizing the topic reduce stigma and relieve psychological burden. When public figures speak about their experience it also helps many women say: “this happens to me too, and I’m not alone.”

In summary: menopause represents a natural process that coincides with increasing responsibilities. That combination can generate deep alterations in psychic balance, but it doesn’t have to ruin your wellbeing. When you understand what is happening in your body and mind, seek help in time and choose reliable information, you can transform a feared stage into a stage of reconnection with yourself. 💫

If you notice changes in your mood, sleep or energy and you are in your forties or fifties, don’t let it pass. Ask yourself:

• Could this be related to menopause or perimenopause?


• Have I talked about this with a health professional?

Your mental health matters as much as your physical health. You deserve to go through this transition with information, support and dignity, not with guilt and silence.

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