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Preventing irritability in perimenopause

Reviewed by Dr. Sharon Stills, NMD

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 to perimenopause.

A women experiencing iIrritability in menopause

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 symptom.

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.

woman experiencing hormonal imbalance and irritability in perimenopause

“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 yelling.”

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.

multiple exposure image of woman with irritability in perimenopause

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

Healthy eating
B vitamins
Essential fatty acids (EFAs)
Quality Sleep
Pressure to succeed
Time spent at work
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, restoring 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 changes.

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 body.
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.

Feeling cranky? Take a break with one of these ideas:

  • Watch: Look at funny animal videos on the internet — silly but effective.
  • 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.

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Herbal Equilibrium

Doctor-formulated natural support for hormonal balance during perimenopause and menopause






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Last Updated: November 23, 2023
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