Menopause-related Mood Swings

By Kristina Randle, Ph.D., LCSW

Hi, I’m 47 years old and last year I started having irregular periods and mood swings. My period then stopped completely for 9 months and my symptoms went away. Then it started up again and the mood swings/depression/anxiety came back even more severe. This is most severe the 2nd half of my menstrual cycle. Sometimes I feel so depressed I can’t get out of bed and cry for no reason etc. I have been started on citalopram by my PCP which has helped somewhat, but I’m still really struggling for the 2 weeks before my period. I’ve also started having obsessive thoughts regarding a pastor that was counseling me through some of these issues. My question is, could this be related to menopause and if so, wouldn’t HRT be more appropriate than an antidepressant to help with my symptoms?

A. The recent changes in your mood may be related to perimenopause. Perimenopause marks the beginning of a woman’s transition into menopause. It can vary significantly but typically it lasts for two to eight years before menopause begins. Irregular periods and changes in mood are common signs of perimenopause.

Would hormone replacement therapy (HRT) be a more appropriate treatment than antidepressants? The answer is, it depends. Some doctors may use HRT alone or in combination with antidepressants to relieve mood instability. Those treatments may work for some but results can vary. In your situation, antidepressants may not be helpful and another treatment is warranted. Another antidepressant may improve your response, or the dosing of your current medicine may need adjustment. All of the aforementioned possibilities need to be explored with your doctor, preferably with a gynecologist specially trained to work with menopausal or perimenopausal women.

If you have not done so already, consider making an appointment with a gynecologist. He or she may be able to determine whether HRT is appropriate.

I would also recommend that you begin researching hormone replacement therapy. A good resource is the U.S. Department of Health and Human Services women’s health website. The website can be found at this address.

Other great resources include the National Women’s Health Resource Center. Here’s a link to a resource they developed regarding hormone replacement therapy.

You can also try the North American Menopause Society.

An evaluation by a specialist is generally recommended when symptoms such as mood swings, irregular menstrual cycles, or hot flashes are negatively impacting your life. I think you’re at the point in which your life and well-being are diminished due to hormonal changes associated with menopause. I hope you are able to find a doctor who can bring you relief. I wish you the best of luck.

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Last reviewed: By John M. Grohol, Psy.D. on 19 Sep 2009

APA Reference
Randle, K. (2009). Menopause-related Mood Swings. Psych Central. Retrieved on August 21, 2014, from http://psychcentral.com/ask-the-therapist/2009/09/19/menopause-related-mood-swings/