SYMPTOM · PERIMENOPAUSE
Mood swings
Irritability that flares up out of nowhere, the feeling of not recognising yourself, reactions that are stronger than usual: mood changes are one of the most unsettling signs of perimenopause, for you and for those around you.
Why it happens
Fluctuations in oestrogen and progesterone have a direct effect on the neurotransmitters that regulate mood. It's the rapid swings in these hormones, rather than their gradual decline, that make mood changes feel more intense than before.
What tends to make mood swings worse
- Lack of sleep, which reduces your ability to regulate emotions.
- Tiredness that builds up over several days.
- Stress that isn't released and keeps adding up through the day.
- Dips in blood sugar from leaving too long between meals.
In the moment
- Pause before you react: 60 seconds is enough.
- Breathe deeply instead of holding on to the tension.
- Step away for a few minutes if you feel the tension rising.
Day to day
- Learn to spot your own warning signs so you can get ahead of them.
- Eat at regular times to avoid energy slumps.
- Give yourself time to recover, not just physical rest.
Are mood swings weighing on your day-to-day life?
A healthcare professional can help you understand what's going on and find what brings you relief.
For information only. This does not replace a personalised medical assessment.
If several of these symptoms ring true, it's no coincidence.
Menopause isn't just about hot flushes. Symptoms can begin years before your last period and affect sleep, mood, energy, memory, weight and intimate health.
Click on a symptom to find out more.
Brain fog
You search for words, reread the same sentence twice, lose the thread mid-conversation. Nothing to worry about: your brain is simply running slower, with less glucose to fuel it as oestrogen levels fall.
Sleep problems
Asleep in ten minutes yesterday, wide awake at 3 a.m. today, for no reason. Progesterone, which helped you switch off at night, is in shorter supply, and deep sleep takes the hit straight away.
Anxiety
Stress that spikes over an email, a meeting, running ten minutes late. Oestrogen affects serotonin: when it yo-yos, everything feels heavier to carry than before.
Joint pain
Knees that creak as you stand up, hands that feel stiff in the morning. Cartilage loses its best anti-inflammatory ally as oestrogen falls, and you feel as if you are rusting up all over.
Hot flushes
A wave of heat rising from the chest to the face, lasting one to five minutes. Deprived of oestrogen, the thermoregulatory neurons in the hypothalamus narrow the thermal neutral zone: a few tenths of a degree are enough.
Palpitations
Your heart suddenly races, with no effort and no reason. Oestrogen also influences the nervous system that sets your heart rhythm. Alarming in the moment, rarely serious.
Weight gain
Your tummy rounds out even though nothing on your plate has changed. Oestrogen redirects fat storage towards the abdomen, and your metabolism runs a little slower than before.
Low libido
Desire takes longer to arrive, or barely arrives at all. Oestrogen and testosterone fall, and sensitivity with them. The desire is still there; it just takes longer to get going.
Vaginal dryness
A feeling of dryness, sometimes a little discomfort day to day. Tissues lose their natural moisture as oestrogen falls. It is a common symptom, and still too rarely talked about.
Irregular periods
One cycle shorter, another dragging on, a month skipped altogether. Ovulation becomes less regular as the ovaries slow down. It is often the very first sign of perimenopause.
Night sweats
Waking up drenched in the middle of the night, sheets to change, sleep cut short. It is the same hot flush as during the day, night-time edition, and it wakes you just as surely.
Pain during sex
Discomfort, sometimes real pain, during or after sex. Tissues thin as oestrogen falls, and what never used to be a problem can become sensitive.
Dry skin
Skin that feels tight, marks more easily and seems to have lost some of its bounce. Collagen declines with oestrogen, by up to 30% in the first few years after menopause.
Chronic fatigue
Tiredness that will not lift, even after a good night. Broken sleep, falling hormones: your body runs less efficiently, and you feel it from morning to night.
Hair loss
More hair in your brush, a parting that seems to be widening. Oestrogen used to extend its growth phase. Without it, the cycle shortens and each strand gets finer.