Can menopause cause depression? Mood swings and irritability

What do mood changes in perimenopause feel like?

Mood changes in perimenopause can show up in very different ways. For some people, it means suddenly getting angry about things they used to shrug off, and running out of patience fast. For others, it is a sadness with no obvious cause, an urge to cry, or a restlessness that fills them from the inside. You might feel fine one day and feel that everything is closing in on you the next.

The NHS lists sudden mood changes, low mood, depression, irritability, stress and anxiety among the symptoms of menopause and perimenopause (NHS, Symptoms). Sources in Türkiye describe the same picture: the Turkish Society of Obstetrics and Gynecology (TJOD) lists irritability and depression; Hacettepe University’s Department of Public Health lists mood changes, depression and anxiety (anxiety disorder); and the Turkish Ministry of Health’s Public Health Directorate (HSGM) lists changes in emotional state among the symptoms of this period (TJOD; Hacettepe HSAD, 2024; HSGM).

It matters that what you are going through has a name: these changes do not mean “your personality has changed.” They are a known experience that many people go through in these years.

Why does menopause cause irritability and mood swings?

According to The Menopause Society, mood symptoms in perimenopause may be linked to large swings in estrogen levels, although the exact mechanism is not known (The Menopause Society, Mental Health). Hormones alone do not explain it. The same source notes that changes in areas such as exercise, diet and sex, stressful life circumstances and, in particular, hot flashes and sleep changes can also affect mood.

For many people, these ages are a busy time: growing children, aging parents and work responsibilities can all arrive at once. When hormone fluctuations land on top of that load, things that used to be easy to carry can start to feel heavy.

How are mood, sleep and night sweats connected?

It is hard to think about mood separately from sleep. The NHS notes that not being able to fall asleep or stay asleep can make you feel irritable, on edge and anxious, and that irritability and anxiety can get worse with sleep problems (NHS, Symptoms). Night sweats often break up sleep (The Menopause Society, MenoNote: Night Sweats). The day after a broken night, your patience runs thin and small things feel big.

That is why mood should be looked at together with sleep and night sweats, not on its own. For more detail, see the pages on menopause insomnia and night sweats.

Who is more likely to get menopause depression?

According to The Menopause Society, women are especially vulnerable to depression during perimenopause and the years right after menopause. The risk is highest for those who have had depression at an earlier point in their life (The Menopause Society, Mental Health). Anxiety disorders, meanwhile, are more common in women than in men from puberty through to menopause.

If you have had depression before, that is a good reason to keep a closer eye on yourself during this period and to act early if symptoms start to come back.

How long do menopause mood swings last?

It is not possible to give an exact length. The Menopause Society notes that vulnerability to depression rises throughout perimenopause and the years right after menopause; in other words, the window of risk does not close as soon as your last period happens (The Menopause Society, Mental Health). The NHS also says menopause symptoms usually last 7–9 years, sometimes longer, and can change during that time. For example, hot flashes may be the main problem for a while and later give way to low mood and anxiety (NHS, Symptoms).

So rather than waiting on the assumption that “it will pass anyway,” it makes more sense to keep track of how long your symptoms last and how much they affect your daily life. Some weeks may go well and others may be hard; what matters is being able to see the overall direction.

Normal ups and downs, or depression?

Everyone has bad days. What makes the difference is how long it lasts and how much of your life it touches. By The Menopause Society’s criteria, if hopelessness, trouble concentrating or making decisions, loss of interest in things you used to enjoy, and sleep problems last for most of the day, nearly every day, for at least two weeks, this may be a sign of major depression, and you should see a health professional (The Menopause Society, Mental Health).

If you have thoughts of harming yourself or ending your life, ask for emergency help without waiting.

What else can cause mood changes?

Not every change in mood is hormonal, and putting everything down to menopause can mean you miss an important problem. Things to keep in mind:

• Long-standing depression or anxiety disorder: If you have been diagnosed before, symptoms can become more noticeable again with menopause (The Menopause Society, Mental Health).
• Sleep disorder: The problem may have started with sleep. Sleep problems such as sleep apnea (breathing that stops and starts during sleep) can also cause night sweats (The Menopause Society, MenoNote: Night Sweats).
• Life events: Loss, separation, work stress or caring responsibilities can affect mood on their own.

The relationship between night sweats and mood does not run in just one direction either: The Menopause Society notes that mood problems such as anxiety and depression can also cause night sweats (The Menopause Society, MenoNote: Night Sweats).

What can you observe yourself?

Noting the following every evening for a few weeks makes patterns visible:

• Your overall mood for the day (for example, a score from 1 to 5).
• How many times you woke in the night, and whether you had night sweats.
• How many hot flashes you had.
• Your period days.
• Whether anything happened that day that put you under strain.

Do the bad days line up with particular nights or a particular point in your cycle? That question is the most productive starting point for a conversation with your clinician. If trouble concentrating and forgetfulness come along too, the page on brain fog and forgetfulness may help.

For this period, Hacettepe University’s Department of Public Health recommends rest and a regular sleep routine, regular exercise, relaxing activities such as yoga or meditation, and staying away from smoking and alcohol; it notes that exercise also supports mood (Hacettepe HSAD, 2024). These are general health tips; they are not expected to solve everything on their own.

When should you see a doctor about your mood, and what should you ask?

If mood changes are making your daily life, work or relationships harder, or if the two-week criterion above is met, see a health professional without waiting. Bringing a few weeks’ record of your mood and sleep, a list of the medicines you take regularly and information about any past episodes of depression or anxiety makes the appointment easier. At the appointment, you could ask:

• Is what I’m going through related to perimenopause, or should I also be assessed for depression or anxiety?
• How much are my sleep problems contributing to this?
• What options are there for me, and what are their benefits and risks?
• At what point should I contact you without waiting, when I feel unwell?

This page does not recommend any medicine or supplement; options are discussed with your clinician.