Mood Changes in the Menopause and Effective Treatments

Dr Rebecca Lewis

Low mood due to the menopause is a very common symptom but is often not recognised as being due to hormonal changes arising from the perimenopause and menopause.

As the ovary fails and the production of ovarian hormones (oestrogen, progesterone and testosterone) declines this has many effects all over the body. In particular the effects it has upon the brain can be hugely significant.

Oestrogen is vital for brain function and an area of the brain called the limbic system requires oestrogen to function properly. The limbic system has many functions but it is important in its role in mood, anxiety, memory and libido.

Low mood due to hormonal changes is not the same as clinical depression for many women but is often characterised by a low flat mood and described as a loss of joy and interest in life. This is often associated with a loss of motivation and fatigue. Anxiety is also a common symptom. Replacing a woman’s hormones with HRT will treat this low mood effectively.

Sadly, the mood changes of the menopause are often unrecognised as being due to hormonal changes and women are often given the wrong treatment with antidepressants.

NICE menopause guidelines state that HRT should be considered as a treatment for low mood that arises as a result of the menopause. NICE also states that due to lack of evidence antidepressants are not recommended to treat low mood in menopausal women who have not been diagnosed with clinical depression. It is important to note that those women who do have clinical depression can however be treated with antidepressants which can be safely used alongside HRT.

Despite this guidance a recent study showed that 66% of women were prescribed antidepressants for their menopausal symptoms.

There is increasing evidence that testosterone replacement helps improve mood, sleep, memory, concentration fatigue and libido and can often really transform women’s mood when added into the HRT regime.

It is also very important to address lifestyle with the following measures:

Regular Exercise- walking, yoga and pilates for example can really help lift mood especially if done on a regular basis.

Cognitive Behavioural Therapy which is a talking therapy is often very helpful.

Relaxation – Breathing exercises, Mindfulness etc

Make sure alcohol intake is not over the recommended amount of 14 units a week.

Healthy diet not too high in sugar and full of fresh fruit and vegetables.

Relaxation techniques, healthy eating and ensuring alcohol intake is within the recommended limits are all very beneficial.

photo by @fernandesse