Navigating the Storm: Understanding and Managing Rage, Anger, and Irritability in Perimenopause and Menopause

Navigating the emotional rollercoaster of perimenopause and menopause can be a challenging and overwhelming experience. Our resident women's health and menopause expert Dr Fionnuala Barton sheds light on the root causes of these emotional fluctuations and provides effective strategies for managing these intense emotions. 

As we transition through perimenopause and menopause, the sea of hormonal changes can bring about unexpected emotional turbulence. Among the waves of fluctuating hormones, emotions like rage, anger, and irritability can surface, leaving us feeling overwhelmed, sidelined and out of control.  
The holiday season can often intensify these feelings with the added pressure to create a perfect experience, from gift-giving to family gatherings to overall merriment.

Hormonal fluctuations, particularly the decline in oestrogen and progesterone, play a significant role in the emergence of intense emotions during perimenopause and menopause. These hormonal shifts can impact neurotransmitters in the brain such as serotonin, dopamine and noradrenalin which are important for mood regulation and emotional responses. Additionally, sleep disturbances, anxiety and other physical symptoms such as hot flushes and pain associated with this life stage can contribute to more reactive and heightened emotions. 

The often irrational and unpredictable anger and rage and extreme irritability can have profound effects on various aspects of daily life. They can permeate into our relationships with loved-ones and colleagues and cause strain or even conflict. And it does not stop there: the emotional toll can impact decision-making, work productivity, and overall quality of life. The first steps to finding and maintaining balance in our emotions is to recognise what is happening and take positive action with self compassion. The following are some practical strategies to consider.

1. Regular Movement: Enjoying regular movement, nourishing exercise and activity has been shown to alleviate mood swings and reduce feelings of anger and irritability. Exercise helps release endorphins, the body's natural mood elevators, and provides a healthy outlet for built-up tension and stress.

2. Mindfulness and Relaxation: Incorporating mindfulness practices such as deep breathing, meditation, yoga and journalling into daily routines can promote emotional balance. These techniques help us stay present in the moment, reducing the intensity of emotional reactions and foster a sense of calm. Try a simple “box-breathing” exercise: breathe in through your nose for a count of 5; hold for5; breathe out of your mouth for 5 and hold for 5.

3. Prioritise Quality Sleep: Addressing sleep disturbance is crucial as we process so many of our emotions and experiences during deep sleep. Establishing a consistent sleep routine, creating a comfortable sleep environment, and practising relaxation techniques before bedtime can contribute to more restful nights with more consistent access to that all important restorative deep sleep.

4. Seek Support: Do not be afraid to be open with friends, family, or even mental health professionals during this time. Think about what advice you might give to someone going through what you are experiencing: and treat yourself with that same level of love, compassion and care. Sharing feelings and experiences can help validate them, helping us feel more deeply understood and less isolated on this emotional journey.

5. Healthy Lifestyle Choices: It can be incredibly hard to motivate yourself to make healthy lifestyle choices when emotions are running amok, but maintaining a balanced diet, staying hydrated, and avoiding excessive caffeine and alcohol can help maintain steady blood sugar and stress hormone levels. This in turn helps promote more stable emotional well-being. If anger, rage and irritability are accompanied by isolation, loneliness or being at the bottom of everyone else’s priority list, the simple act of taking care over our nutrition and lifestyle can have a powerfully positive effect and contribute to more internal calm and ease. Eating adequately nutrient-rich foods provide essential building blocks required for making hormones and neurotransmitters required for optimal emotional, cognitive and physical health.

The journey through perimenopause and menopause can be complex and messy but taking a pause, acting with self compassion and regaining a sense of control can be enormously empowering. This list is by no means imperative or exhaustive so I encourage anyone struggling with the rollercoaster of emotions to pick and mix a few accessible strategies that you might be able to fit into your life. In doing so, I hope you may weather the storm and perhaps even emerge stronger and more resilient to enjoy calmer seas ahead.

By Dr Fionnuala Barton www.themenopausemedic.com