Picture this: it’s a regular Tuesday, and you’re at the grocery store picking up a few essentials for dinner. You’re walking along, finding everything you need, feeling perfectly content. And then you turn down the coffee and tea aisle, ready to pick up your final item, and someone’s cart is blocking your path. You become intensely irritated– doesn’t this person know that there are other people in the store?
All of a sudden, it seems like everything is either going wrong, or just bugging you. The person in front of you in line won’t stop talking. You forgot the milk. You seem to be catching every red light on the way home. Most of all, you just feel blah.
By the time you get home and start cooking, it’s possible that everything has changed again. You might be feeling much better. Or you might be feeling less irritated, but more emotional.
If any of this sounds familiar, you are so far from being alone. Mood swings, especially during the time before your period or during perimenopause, are extremely common. So common, in fact, that the syndrome known as Premenstrual Syndrome (PMS) (the most common symptom of which is moodiness) has become a verb, and whenever one of my friends who is going through perimenopause starts to talk about something “weird” she’s experienced with her moods, every other woman in the group nods along emphatically.
What Causes Mood Swings?
There are many possible causes for mood swings, but a hormonal imbalance is often at the root. This might be because of fluctuating hormone levels during certain stages of your menstrual cycle or in the period leading up to menopause (perimenopause), or it may be an imbalance influenced by any number of environmental factors.
There might be some level of comfort in understanding that your moods are likely being caused by a fluctuation or imbalance in your hormones. Tracking your cycle and finding a pattern in your moods and emotions, for example, can be somewhat reassuring. But the thing is, even if we have a general idea that something hormonal is behind our mood swings, it doesn’t stop us from experiencing the full intensity of them!
Many of my patients describe feeling “out of control” when it comes to mood swings. It is also common to become extremely sensitive to things that normally wouldn’t affect you when hormones are influencing your moods. For many women, mood swings come with anxiety, a tendency towards a depressive mood, insomnia, or feeling overwhelmed. These issues can affect mental and physical wellbeing, as well as our relationships, and just about every other area of our lives.
I believe that women deserve more than to have the finger pointed at their hormones and then be dismissed! It is possible to get to the real root of a hormonal issue, find hormonal balance, and take control of erratic moods.
How Hormones Influence Mood
Hormones are complex chemicals that are involved to some extent in just about every function and process within our bodies. Our overall health is influenced in a myriad of ways by our hormonal health, and mood regulation is a classic example.
Sometimes, it is a chronic problem or imbalance (for example, low estrogen or progesterone or high cortisol) that leads to mood disturbances. Other times, the issue is more to do with too much (or too extreme) fluctuation. If your hormones are a rollercoaster, your moods probably will be too!
One of the hormones with the most power over our moods is estrogen. Estrogen actually influences mood in a few different ways, but one of the most important ways is through its relationship with serotonin.
Serotonin is a neurotransmitter (a brain chemical) whose main responsibility is influencing mood. Heavily fluctuating levels of serotonin will inevitably show up as mood swings, and estrogen actually influences how much serotonin we produce.
Low levels of estrogen often lead to low or inconsistent levels of serotonin, which can be a major cause of mood swings. Low estrogen can also lead to symptoms like brain fog, difficulty sleeping, hot flashes, headaches, bone loss, and memory issues.
Estrogen also helps to protect the brain and nerves from damage, to control levels of other important mood-related neurotransmitters, including dopamine and norepinephrine, and to increase feel-good endorphins. For all of these reasons and beyond, it’s important to pay attention to estrogen levels!
Of course, it’s normal for estrogen levels to change during different stages of a woman’s life. We know that estrogen levels change throughout our menstrual cycles in order to trigger ovulation, and we know that they change during the time before menopause, and after. The key is to find as much balance as possible, no matter which stage of life you are in.
Changes in levels of other hormones, including progesterone and testosterone, can also influence mood. In fact, it is often an imbalance between estrogen and progesterone that is the key problem.
Your functional medicine practitioner can work with you to assess any imbalances related to estrogen and other hormones, and how they might be affecting your moods.
PMS and Your Mood
Premenstrual Syndrome (PMS) describes any symptoms– physical and emotional– that show up before your period. These can include cramps, bloating, fatigue, and many other issues, but one of the most common is mood swings. Mood swings are different for everyone, and it’s not always a matter of feeling really happy and then feeling really angry or sad. Some people feel more emotional and teary during PMS, some people just feel more sensitive, others more irritable or angry.
Some women experience even more severe symptoms before their periods (severe depression, extreme mood swings). This is referred to as Premenstrual Dysmorphic Disorder, or PMDD.
Women who have a diagnosed condition such as anxiety or depression may also notice that their symptoms or conditions get worse in the week or two before their periods.
Although a change in moods or emotions before your period is very common and fairly easily explained by a shift in estrogen levels (and levels of other hormones), it often points to a general problem with hormonal balance and regulation.
Some women are prescribed birth control in order to cope with symptoms of PMS, but this can actually make the problem worse or create more problems for some, especially if no real investigation into a woman’s specific hormonal health is done first.
Struggles with Mood in Perimenopause
I hear about mood swings from almost all of my patients who are going through perimenopause. They may experience and describe them in different ways, but they’re almost always there!
I often hear from women in my practice that they are struggling to deal with things that didn’t used to bother them– everything seems overwhelming. Or everything is irritating! It might feel like things are just getting to you more.
Again, mood swings and feelings of overwhelm or anxiety during this stage of life are often explained by fluctuating levels of hormones like estrogen, progesterone, and DHEA– but having this explanation doesn’t mean that you have to just sit back and live with it.
Mood swings during perimenopause often come with other symptoms like insomnia and hot flashes. And by getting to the root of your hormonal imbalances, these other symptoms might clear up too.
If you suffered from mood-related PMS symptoms during your younger years, you might be more likely to experience the same problem during perimenopause, as there may be an underlying hormonal imbalance at the root of both issues. But it’s never too late to start digging and healing!
It’s often the unpredictability and fluctuation of estrogen and other hormone levels that create the problem, and achieving hormonal balance is an important part of the solution.
The Role of Stress
Chronic stress influences both hormones and mood in so many different ways. And during stages of our lives when so many things are changing and going on– like perimenopause– this kind of stress is incredibly common.
When we’re overburdened with stress and our adrenal glands become fatigued, we often don’t produce enough of the sex hormones, because the body needs more of the stress hormone cortisol, this has a negative impact on progesterone levels and our other hormones and throws hormonal levels out of balance. This can, of course, lead to more mood swings, which can lead to more stress, and it all becomes a vicious cycle.
This is actually only one of the ways in which stress and adrenal fatigue influence hormones and mood swings. In order to achieve more balance in all areas of your health and life, finding ways to lower stress is absolutely essential.
Balancing Hormones to Tackle Mood Swings
Because it’s so common for mood swings, depression, and anxiety to show up alongside perimenopause, many doctors will prescribe antidepressants to women during this stage of life, rather than exploring the hormonal imbalances that might be at the root of the problem. In other cases, women are simply dismissed, or told that it’s “normal” to feel a little bit moody, and “no big deal”. I totally disagree! The way you feel is a big deal, it does matter, and it is worth getting to the bottom of.
Tackling hormonal imbalances and mood swings can make such a huge difference for your quality of life.
I think it’s a great idea to try to find a practitioner to work with you on really exploring your hormonal balance. Standard tests from a conventional doctor may help point to certain imbalances, but they may also miss certain nuances and signs. So, even if your doctor has told you that everything is normal or fine, if you don’t feel fine, don’t give up! Find a functional medicine practitioner who will work with you to get to the root of the problem.
Tips for Balancing Hormones and Stabilizing Mood
When we’re talking about balancing hormones, especially when it comes to mood swings that show up during our premenstrual phase or during perimenopause, one of the most important things to do is limit our intake of anything that is likely to contribute to fluctuations.
This includes limiting intake of alcohol (which is a depressant), caffeine (which can contribute to anxiety and fluctuations in mood and energy levels), sugar (which we all know can cause us to fly high and then plummet down), and white flour. Limiting excess salt, artificial sweeteners, and additives is also very helpful.
Focus instead on whole, balancing, anti-inflammatory foods. Intake of healthy, omega-3 fats is helpful, as well as foods that contain B6 (such as nuts and legumes), magnesium (dark leafy greens, whole grains, legumes), or zinc (organic poultry, wild-caught seafood, nuts).
Try to eat regular meals in order to keep your blood sugar stable. Make sure to also drink lots of water.
Supplementing certain nutrients including vitamins B6 and B12, magnesium, zinc, and calcium might help. It’s always best to talk with your practitioner before introducing any new supplements.
Regular exercise is one of the most helpful things you can do for mood swings– find a form of exercise that you love, and schedule it into your routine for a regular, stabilizing boost of feel-good chemicals.
Make sure to get good quality sleep, and find ways to unwind, manage stress, and take care of yourself, whether it’s yoga, meditation, a bubble bath, or– my favorite– just saying “no” when you’re overburdened.
Nobody feels great absolutely all the time, and we will never be able to eliminate mood changes altogether. But if you are experiencing frequent mood swings that interfere with your quality of life, I strongly believe that you can get to the root of the problem, balance your hormones, and start to feel better in all kinds of different ways. It’s just a matter of putting the puzzle pieces together!
Reviewed by Dr. Mark Menolascino, MD