Most women expect the physical symptoms of menopause when they arrive. But few realize that not only do these symptoms kick in a lot earlier, anywhere from five to ten years prior, but are also accompanied by emotional symptoms.

Perimenopause.

This time prior to the menopause is known as the perimenopausal. Perimenopause, which can start from as early as a woman’s mid to late thirties, usually happens for most women in their mid-forties and continues until she reaches the menopause.

Symptoms such as night sweats, hot flashes, sleep difficulties are what most women expect. But there can also be raging mood swings, uncontrollable crying, depression and anxiety symptoms. Which can also seem to appear almost overnight.

This can seem like it’s come out of the blue as women can be fooled by a continued monthly normal cycle. What most women don’t realize is that it’s a shift in hormone levels which sets perimenopause into motion. Women can have regular monthly cycle but their hormones are still changing. This gives them the false impression that they are not perimenopausal.

During perimenopause progesterone is decreasing each year. But estrogen levels are also rising and falling erratically as well. This can leave a woman feeling like she’s in a constant state of PMS (premenstrual syndrome).

Depression Symptoms.

Research is showing that the 45 – 64 age group in women have a higher level of depression, even if they have no history of depression, than another age group. This also coincides with the perimenopause and menopause stages. This group of women also record the lowest emotional well-being of any age group.

It is thought that declining estrogen levels could be a contributing factor. Alongside a drop in serotonin, a neurotransmitter which helps us to feel happy and in a more positive state of mind. Add to this all the physical symptoms, night sweats, sleep difficulties, extreme tiredness, hot flushes, etc. Plus any family difficulties or stress the woman may have to deal with, you can see how this could cause emotional and mental health issues.

What Are The Emotional Symptoms Of Perimenopause And Menopause?

Emotional symptoms are every part of perimenopause or menopause as the physical ones. We need to treat them as proactively as we do the physical symptoms.

Some of the emotional changes experienced by women can include:

1. Irritability
2. Feelings of sadness
3. Lack of motivation
4. Anxiety
5. Aggressiveness
6. Difficulty concentrating
7. Fatigue
8. Mood changes/swings
9. Tension
10. Depressive like symptoms
11. Sleep problems

If you are feeling these symptoms please tell your doctor how you are feeling. So they can also rule out other medical conditions and you can receive the right treatment.

How Can I Cope With The Emotional Changes Of Perimenopause And Menopause?

We are so much more geared to helping our children through the physical and emotional stages of teen years than we are towards perimenopause and menopause. Women forget to help themselves with their own hormonal changes. We sometimes don’t even realize we need to seek help and advice on this topic.

Often we may be helping our child with their changes and fail to see that we too need support as we are going through these changes ourselves. You have to treat the emotional symptoms every bit as proactively as you do the physical symptoms.

Self-help, including getting informed and reaching out for help is part of this treatment. Irritability and feelings of sadness are the most common emotional symptoms experienced by women during this time. These, and other emotional symptoms, can often be managed with lifestyle changes. Plus getting the right HRT.

These can include the following:

1. Getting your basic self-care right has to be a priority at this stage. I’ve listed a number of basic self-care needs that must be met in order to support our own mental health in multiple blogs and videos. You can check these out here. But to start with try to take at least 5 minutes for yourself each day and during your week. It’s best if you schedule it in or you will just pass it over. If possible have a self-care day or half day for yourself once a month. Taking care of your basic needs means you are more likely to also set healthy boundaries with others. Thus reducing your stress in two ways.
2. Eating a balanced diet and exercise will help your hormonal balance. Please speak to your GP, or ask to be referred to a dietician or nutritionist for support with this one.
3. You could start by cutting back on or avoiding sugar, caffeine and alcohol. Some women will tend towards increasing alcohol during these years as a means of coping. But reaching out for help is far better. If you find alcohol has become a problem for you please see your GP. Sugar cravings may also increase with hormone fluctuations. Something you may have to watch but a balanced diet and getting the correct hormone replacement should help with this. But again please seek appropriate professional advice on this.
4. Meditation, yoga, tai-chi, any form of relaxation will help with stress reduction. With daily practice these will also help both your physical and emotional symptoms. I have a series of meditations you might like to try on Spotify and Itunes.
5. Journaling really helps reduce your stress levels and helps you cope with your emotions better. Try to get all your thoughts out of your head once a day. Preferably before bed that way it gives your brain a chance to rest and help improve sleep. Try doing a brain dump. Start with your to do list, shopping list, appointments and go from there. Allow all your thoughts and emotions to flow. You could also use your journal and meditation practice to notice any negative though patterns. What are the dominant negative thoughts that come up for you? Begin to notice and challenge this kind of thinking. Begin by asking yourself if this thought is true? Then use positive affirmations to counter this bully in your head.
6. Gratitude work has also been shown as one of the best ways to lift your mood and keep it up longer. Simply write down 3 things you are grateful for after your nightly brain dump. This will also help you finish your day on a positive note.
7. Reduce stress levels and review your priorities. Women at this age may still be raising children, working and looking after elderly parents. We get pulled in all sorts of directions. But we need to fit in time for ourselves first. You need to be willing now to reduce what’s on your to do list and ask for help. If you haven’t already done so by now get you healthy boundaries in place (you and with others). Build a continual stop list, I’ve outlined the importance of this before and how to do it, check the link above. It can be a great way of creating boundaries, reducing your to-do list and your stress. I know saying no can be very hard but it’s one word we need to start learning and using now. Again I’ve outlined in a blog and video how you can learn to say no.
8. Sleep problems are a real issue between increased anxiety symptoms and night sweats. There are a number of self-help things you can do to help here. Cutting back on the caffeine and sugar will help as will reducing your stress. Create a bedtime routine, yesjust like kids we need our bedtime routine and about 1 hour to wind down before bed. Make sure your bedroom is conducive to sleep.  So it’s a no-go zone for work, TV, and technology. I have also outlined more ways you can try to improve your sleep and you can find a blog on this here. Seek support for HRT options from your GP to help with your overall symptoms plus sleep medication if needed.
9. Connect with friends and family. There are two reasons for this. We need to make sure we have our team of positive supporters surrounding us. People who won’t judge us, will listen and support us no matter what. Please let go of the negative people from your life. Instead nurture those solid positive friendships instead. Secondly we all need to have some daily fun. Even if it’s just a quick chat and a laugh on the phone. These moments of lightness help us feel better about what is going on in life, cope better and reduces our stress levels.
10. Take up a hobby or develop one further into a business idea. Hobbies and interest are a great way to connect with others. But they can also boost our self-confidence as we feel more competent and are meeting with like-minded people.

Perimenopause and menopause can also coincide with many stressful life events. Such as death of parent, downsizing your home, children leaving home and divorce. It can be extremely stressful. But also a time of reflection and change for us.

You don’t have to cope alone with any of these changes or stresses. If you have any symptoms of depression, anxiety or feel unable to cope please reach out to your doctor. HRT does help and other medication, if needed, and therapy can and do help here also. You can also self-refer for private therapy.

Work With Me.

Remember you are allowed to ask for support. No one is an island. If you need extra support then you can also work with me. We all struggle with stress and overwhelm from time to time. If you find this has become a problem for you and you’d like some support then schedule an appointment with me.