Irritability and intense mood swings are extremely
common symptoms of perimenopause and hormonal imbalance — just being in perimenopause
increases your chances of having both problems. And for women with a history of
PMS, these symptoms can become even more pronounced during the hormonal transition
Irritability is a real problem for perimenopausal women — it’s their top complaint.
Harvard researchers found that when women are in or near perimenopause, it’s twice
as likely that they’ll develop serious mood issues. But still, many doctors offer
no real way for patients to resolve — or even relieve — this distressing and discouraging
Losing your temper, snapping at your favorite people and feeling angry most of the
time can make a difficult time of life seem unbearable — and unpredictable. But
you really can reduce, or even prevent, irritability in perimenopause so you feel
calmer, more at ease and just plain happier.
“The bitch factor” — causes of irritability in perimenopause
Many women are stunned to experience irritability for the first time during perimenopause.
And they’re even more shocked to learn that their irritability is rooted in the
physical changes their bodies are undergoing in perimenopause. We’ve heard the perimenopausal
“bitch factor” described in colorful detail:
- “It’s like a buzzing deep in my head that just grows louder and louder.”
- “I feel so irritated that I could chew through steel!”
- “I get really annoyed at little things until I just fly off the handle and start
These women and many others tell us that when they take out their irritability on
family members, co-workers, or even complete strangers, they regret it instantly
and feel guilty for losing their cool.
Irritability in perimenopause is thought to be triggered by extreme hormonal changes,
especially abrupt fluctuations during perimenopause that alter the balance between
key neurotransmitter systems in the brain. Then as estrogen naturally decreases
during perimenopause, testosterone rises, leading directly to mood changes like
irritability. So whether it’s from reduced estrogen, imbalanced testosterone, decreasing
levels of progesterone or
estrogen dominance, irritability can occur with all types of hormonal fluctuation.
This type of hormonal imbalance can spark all types of perimenopause symptoms including
irritability, and many of these can make moodiness even worse. When physical menopause
symptoms —like hot flashes and night sweats — affect your body, they can wake you
from a sound sleep which in turn will make you feel even moodier and more irritable.
What’s your “tipping point” for irritability?
Hormonal imbalance is the starting point for many women’s irritability as a perimenopause
symptom, but there are plenty of other factors that can magnify the hormonal bitch
factor. Chronic stress can amplify the effects of changing estrogen and progesterone
levels in perimenopause and menopause, as well as the delicate balance between those
hormones. In many cases, it’s a question of not having enough of some things while
having too much of others:
Factors that magnify hormonal irritability
Pressure to succeed
Time spent at work
Essential fatty acids (EFAs)
Chronic, ongoing stress
Un-met emotional needs
Irritability may have sneaked up on you in perimenopause but there are real, physiological
reasons for it, even though it doesn’t seem like a physical problem. And the best,
most effective solutions for irritability in perimenopause aren’t mysterious. By
giving your body what it needs during perimenopause, you can feel less irritable,
more even-tempered and much, much calmer.
Three steps to prevent irritability in perimenopause
Since so much of irritability in perimenopause is generated by hormonal factors,
and maintaining hormonal balance is the best step you can take to control
your personal “bitch factor.” For women, keeping good hormonal balance is really
a work-in-progress — our hormones fluctuate and shift throughout our lives. Still,
healthy hormonal balance is so much easier when we respect and respond to those
Here’s what we recommend to help you prevent irritability and
moodiness in perimenopause — and beyond:
1. Find the warning signs of hormonal imbalance in your own
With a little practice, many women learn to spot the small shifts that signal impending
hormonal changes. Like PMS, perimenopause is a time when hormone levels rise and
fall dramatically, generating a wide range of symptoms. Some women feel it in their
bodies as sudden fatigue, hot flashes, headaches, or even cravings.
Others say their thinking becomes muddled
(menopause brain!) or they begin to have disrupted sleep. If you feel as
if your irritability erupts “out of nowhere,” slowing down enough to notice any
small changes can help you head off full-blown irritability.
- Watch: Look at funny animal videos on the internet — silly but
- Sing: Belt out a song you know well, as loudly as possible. Sound
vibrations can “reset” your mood.
- Breathe: Stop whatever you are doing and take 5 deep, measured
breaths (5 counts in, 5 counts out).
- Go: Step outside right away. A quick change of scenery can do wonders
as can some fresh air.
- Vent: Call a friend, tell her what’s up and release your irritability
for a few minutes.
2. Nudge your hormones into balance with nutrition.
Eating a lot of processed food, refined sugar and trans fats leads directly to an
increase in irritability and mood swings — studies show it clearly. So when you’re
not feeling grounded, choose simple proteins, whole fruits and vegetables, and well-sourced
fiber. Think seriously about enriching your daily nutrition with a
solid multivitamin, micro-distilled omega-3s as fish oil, and broad spectrum probiotics.
Certain phytotherapeutic dietary supplements with diverse botanical ingredients
and extracts can help create a foundation for longer-lasting hormonal balance and
can relieve symptoms as well.
3. Exercise (at least) enough so you sleep well.
Irritability in perimenopause often starts as a slow burn that builds over time
until you lose your temper. Two of the biggest aggravating factors for hormonal
imbalance and irritability are interrupted sleep and lack of exercise. Exercise
blows off the steam of building moodiness and sleep allows your body the time it
needs to rest and repair. Get the best of both worlds by adding in a few short exercise
sessions every week. When your body is physically tired, it’s much easier to drift
off to sleep — and stay that way. This single step can make a night-and-day difference
in your irritability, your ability to get quality sleep and overall wellness.
If you’re in the habit of being irritable and moody a lot of time, any — or all
— of these steps can help you break those patterns. Everyone gets angry and loses
their temper sometimes, so don’t be too hard on yourself. When you find the right
opportunity to make a positive shift, take it. Being able to laugh at yourself and
have self-compassion when you feel irritable can keep your personal bitch factor
turned down low and on the back burner.
Gordon JL, Girdler SS, Meltzer-Brody SE, Stika CS, Thurston RC, Clark CT, et al.
Ovarian hormone fluctuation, neurosteroids, and HPA axis dysregulation in perimenopausal
depression: a novel heuristic model. Am J Psychiatry. 2015 Mar 1. 172 (3):227-36.
Golomb BA, Evans MA, White HL, Dimsdale JE (2012) Trans Fat Consumption and Aggression.
PLoS ONE 7(3): e32175. doi:10.1371/journal.pone.0032175
Alexander, G., et al. 2002. Replication of a premenstrual decrease in right-ear
advantage on language-related dichotic listening tests of cerebral laterality. Neuropsychologia,
40 (8), 1293–1299. URL (abstract): http://www.ncbi.nlm.nih.gov/pubmed/11931932 (accessed
Northrup, C. 2006. Women’s Bodies, Women’s Wisdom, 106-107. NY: Bantam Books.
Bayer, 2008. Interhemispheric interaction during the menstrual cycle. Neuropscyhologia,
46 (9), 2415–2422. URL (abstract): http://www.ncbi.nlm.nih.gov/pubmed/18420232 (accessed
Relieve your menopause
and perimenopause symptoms today