Just thinking about the signs of perimenopause can make you angry. There’s mood swings, anxiety, depression, insomnia, night sweats, brain fog, and hot flashes. Who wouldn’t feel irritable to the point of fury? But irritation can actually be a menopause symptom in and of itself. Hormonal fluctuations during perimenopause, combined with the typical stressors of life in your 40s and 50s (like juggling work, family, and caring for aging parents), can push you over the edge, even if you’re the type who’s usually not quick to anger. In fact, one study found irritability was the most common symptom for 70% of perimenopausal women.
But this isn’t the same sort of irritation you felt a few years ago at the driver who cut you off or the home printer that never seems to work right. Hormonal rage can take normal irritability to the next level, making you instantaneously feel irrational and overwhelmed. But just because your meno-rage feels unstoppable, doesn’t mean there aren’t any steps you can take to make yourself feel better.
What Do Hormones Have to Do with It?
It might be surprising to learn that “hormonal rage is not a clinical symptom," says Sheryl A. Kingsberg, PhD, chief of behavioral medicine in the Department of Obstetrics and Gynecology at University Hospitals Cleveland Medical Center. "But what we know is that perimenopause opens a window of vulnerability to mood disturbances, including depression, anxiety, and anger.”
However, even though it's not considered a symptom, hormonal rage is — like all your other perimenopausal symptoms — driven by hormonal change. “The hormonal shifts that result from the decline and inconsistencies in estrogen and progesterone production can lead to everything from cognitive brain fog to irritability,” Kingsberg says. “It’s similar to the PMS mood changes, including anger, that some women experience during their menstrual cycle. These hormonal fluctuations can interact with neurotransmitter function, including serotonin” — the natural chemical that helps regulate mood and impulse control.
Hormonal shifts, compounded by the stress and exhaustion of dealing with other menopause symptoms — not to mention life in general — can create the perfect storm.
Other Perimenopause Symptoms Can Be Triggers
While there’s certainly a brain chemistry and hormonal component at work here, we can’t discount the fact that other perimenopause symptoms, like insomnia and hot flashes, can increase irritability. It’s a circle of cause and effect: “Symptoms like night sweats cause a lack of sleep, and poor sleep puts anyone at risk of a lower tolerance for everyday annoyances,” Kingsberg says. As your body eventually adjusts to a decrease in estrogen, your wild emotions should stabilize. But since menopause is a marathon, it’s a good idea to learn some techniques to help quell the rage.
Simple Tips to Cool Your Jets
Take Care of Your Physical Self
“There are many potential ways to reduce irritability and anger,” Kingsberg says. “Making quality sleep a priority can help by improving overall health and quality of life, and reducing negative stressors. Regular exercise has been empirically shown to help reduce physical symptoms associated with chronic stress.” It’s also a way to naturally boost serotonin in your body, research shows. Eating a balanced, healthy diet is another good option for managing mood swings. Even making slight improvements, such as reducing caffeine intake, can help. (Studies suggest that caffeine may worsen menopausal hot flashes and night sweats, which is reason enough to cut down!)
Practice Anger Management
First things first: don’t be so hard on yourself. Remember that this rage you feel is the result of numerous biological stressors, not any kind of personal failing. Once you realize that you’re not losing your marbles, take a deep breath. “Taking time to focus on self-care is key. Using some mindfulness-based techniques, such as yoga, meditation, and simple breathing exercises, can help reduce feelings of stress or rage, and they may also help you get better sleep,” Kingsberg says. Studies suggest that the practice of mindfulness techniques is associated with improved sleep.
“Another proactive therapeutic tool that can alter negative ways of thinking is cognitive behavioral therapy,” Kingsberg adds. CBT is a short-term and problem-specific talk therapy treatment that’s delivered by a trained mental health professional. Techniques focus on awareness: When does your anger usually erupt? What are your triggers? Then you work on taking specific, methodical steps to retrain your brain so you can manage anger more effectively. To learn more about CBT and where to find a licensed practitioner, visit the Association for Behavioral and Cognitive Therapies.
When to Seek Professional Help
“Not everyone needs it, but if self-help strategies and lifestyle changes are not sufficient, then I encourage people to ask for help. Women don’t need to just suck it up and wait it out when there are many excellent treatment modalities for perimenopausal symptoms,” Kingsberg says. “More and more menopause experts are now accessible, whether you start with your OB-GYN or a mental health professional.” (To find a menopause practitioner in your vicinity, check the database of the North American Menopause Society.)
And above all, remember — you're not the only one going through this. You're not a jerk, just a regular person dealing with the ups and downs of perimenopause. Now, take a deep breath and count back from 10.
Gina Way is a writer and editor specializing in beauty, health, and lifestyle content. Her work has been featured in Marie Claire, Harper’s Bazaar, Martha Stewart Living, Real Simple, Cosmopolitan, and Shape. She also writes digital content for Allure, The Cut, Refinery29, Vogue, Oprah Daily, Violet Grey, Well + Good, and more.