What is the psychology of menopause and why does mood change at this time? Learn ways of coping with anxiety, sleep problems and mood changes in menopause.
In your mid-forties, or as you approach fifty, you may one day find yourself crying for no reason, flaring up at the smallest thing, or waking at three in the morning drenched in sweat and unable to get back to sleep. The answer to "What is happening to me?" is often the menopausal transition. But this period is not only hot flushes and irregular periods; feelings, thoughts, relationships and sense of identity are also affected by this process. The psychology of menopause is a subject that deals with the emotional side of this transition and that has been talked about more and more in recent years. In this article I will try to explain why mood can change during menopause, the psychological struggles that are common, the particular burdens faced by women going through this period in Turkey, and the steps you can take to manage this process better.
What Is the Psychology of Menopause?
Menopause is the permanent end of the menstrual cycle and is generally defined as twelve months without a period after the last one. From a psychological point of view, though, the period that really matters is often perimenopause, the transition, which begins several years before menopause. During this period hormone levels do not decline smoothly; they follow a course of ups and downs. These fluctuations can affect mood as well as the body.
The psychology of menopause looks as a whole at how these biological changes are reflected in a person's feelings, thoughts, relationships and view of themselves. An important point here is this: menopause is not an illness but a natural stage of life. However, being natural does not mean that it is not demanding or that support will not be needed.
Not every woman experiences this period in the same way. Some pass through it with almost no difficulty, while others go through marked physical and emotional changes lasting for years. In this variation, alongside biological factors, past experiences, life circumstances and the meaning the person gives to this period also play a part.
What Are the Common Psychological Changes in Menopause?
Mood swings
Sudden urges to cry, irritability, impatience and spells of sadness are frequently reported changes. Some women liken this period to the mood swings they experienced in adolescence or before their periods. Women who have previously had marked mood changes before their periods or after childbirth may also be more sensitive during this transition.
Anxiety and restlessness
In perimenopause, anxiety symptoms that have never been experienced before can appear. Palpitations, a feeling of inner distress, unexplained tension and sometimes panic-like attacks may be seen. Hot flushes themselves can create a sudden alarm sensation in the body, so they can be confused with anxiety.
Sleep problems
Night sweats and hot flushes can interrupt sleep. Interrupted sleep in turn increases tiredness, irritability and difficulty concentrating the next day. This two-way relationship between sleep and mood is one of the most important vicious circles of this period. To support your sleep routine you can also make use of the suggestions in the article on how to get over insomnia.
Mental fogginess
Forgetfulness, difficulty finding words and distractibility are among the complaints many women describe. This can trigger the worry "I'm not as good as I used to be", especially in working women. This fogginess is also often closely linked to disturbed sleep and stress.
Risk of depression
The menopausal transition is known to be a period in which the risk of depression rises in some women. Those who have had depression before and those who enter this period under intense stress may be more vulnerable. Prolonged sadness, loss of interest and hopelessness should be kept apart from ordinary mood swings and should be assessed. For the general signs of depression, you can look at the article on symptoms of depression.
Why Does Mood Change During Menopause?
To understand the psychology of menopause, we need to look beyond hormones. The emotional changes in this period usually result from a combination of three layers.
The biological layer
Hormones such as oestrogen interact with systems in the brain linked to mood, sleep and cognitive function. The fluctuation and decline of these hormones can affect emotional balance. In addition, physical symptoms such as hot flushes and insomnia put indirect strain on mood.
The psychological layer
For many women menopause is a concrete reminder of ageing and the passing of time. The end of fertility creates a feeling of liberation for some women, while for others it can bring a sense of loss and grief. Changes in body image, weight gain and worries about appearance can also affect how a person sees themselves. The thought "I'm not who I used to be" can turn the changes experienced into a question of identity.
The social layer
Menopause often coincides with one of the busiest periods of life. Children in adolescence or leaving home, elderly parents who come to need care, growing responsibilities at work and changes in the relationship are the typical burdens of this period.
Menopause is a time of transition in which not only the body but life itself is reorganised; struggling in this transition is not weakness but a human response to change.
Menopause in Turkey: A Period Carried in Silence
In our culture, menopause has for many years been a subject that is not openly discussed, brushed aside as a "women's matter". Many women meet this period with very little information from their mothers or those around them. Remarks such as "In our day nobody complained about things like this" or "It's your age; it's normal" can lead to the difficulties being ignored.
In this period, many women are in the "sandwich generation", caring at the same time for their children and for their ageing parents. When the need to keep working because of the cost of living, the effort to hide menopausal symptoms at work and responsibilities at home come together, women have almost no time left for themselves. I covered this multi-sided burden in detail in the article on the sandwich generation.
Say a fifty-year-old teacher has not slept properly for weeks because of night sweats, notices her patience with her pupils wearing thin, and goes in the evenings to look after her mother in hospital. She is angry with herself: "I never used to be this irritable." What this woman is going through is not only a hormonal change; it is a period in which biological, psychological and social burdens are growing heavier at the same time.
Menopause at work
For working women, perhaps the hardest part of this period is the effort to hide symptoms at work. A hot flush that starts in the middle of a meeting, distractibility after a sleepless night or difficulty finding words can trigger the worry "I'll look incompetent." Yet these symptoms have nothing to do with a person's ability or experience. If possible, making small adjustments in your work environment can make daily life easier: for example sitting by a window, keeping water with you, scheduling important tasks for the hours when your energy is higher, and strengthening the habit of taking notes. Sharing the situation with a colleague or manager you trust can also lighten your load.
How can partners and family members help?
In this period the most important contribution of those close to you is not to take the changes as a personal attack, and to listen patiently. Asking "Has today been a hard day? How can I help?" instead of "Irritable again?" helps a woman feel understood. Redistributing responsibilities at home is also a concrete and valuable form of support.
What Can You Do to Protect Your Mental Health During Menopause?
1. Keep a symptom diary
For a few weeks, note down your hot flushes, sleep quality, mood and the events that challenge you. These records help you see patterns and give concrete information when you talk to your doctor. For example, you may notice that you are more irritable the day after nights when you sleep badly.
2. Calm breathing for hot flushes
When a hot flush begins, your body gives off an alarm signal, and anxiety can accompany it. In these moments, breathing slowly and deeply, making the out-breath long and telling yourself, "This is a hot flush; it will pass in a few minutes," can reduce the anxiety added to the sensation. Trying to observe the sensation rather than panicking can lessen its effect.
3. Arrange your sleep environment
Keep your bedroom cool, choose thin, layered clothing, and avoid heavy meals, caffeine and alcohol before bed. When you wake in the night, try not to look at the clock; if you cannot sleep for a long time, get out of bed and do something calm in dim light.
4. Bring movement into your life
Regular walking, swimming or stretching exercises support mood, sleep, and bone and heart health. Even starting with short walks a few days a week can make a difference.
5. Build a new narrative for yourself
Try to think of menopause not only as a loss but as a transition. You can ask yourself these questions: "What do I want to make more room for in this new stage of my life?" "What have I been putting off for years?" These questions can help you see the change not as an end but as a new beginning.
6. Talk and share
Sharing what you are going through with friends going through the same period, with your sisters or your partner reduces the feeling of loneliness. Telling your partner what you are experiencing in this period can prevent misunderstandings in the relationship.
When Should You Seek Professional Support?
For physical symptoms, it is important first to talk to your gynaecologist; the medical options that can be applied in this period are assessed by the doctor. From a psychological point of view, you may consider seeking support from a specialist in the following situations:
- If sadness, loss of interest or hopelessness has lasted longer than two weeks
- If anxiety or panic-like attacks are affecting your daily life
- If sleep problems have continued for a long time and are impairing your functioning
- If anger and irritability are causing serious problems in your relationships
- If you feel worthless or completely lost in this period
These symptoms on their own do not amount to a diagnosis; assessment is possible through meetings with a specialist. Whether medication is needed is decided by a psychiatrist. If you have thoughts of harming yourself or do not feel safe, please call 112 (emergency services) without delay.
How Is the Psychology of Menopause Addressed in Therapy?
Cognitive behavioural therapy is one of the approaches used in working with the mood changes, anxiety and sleep problems experienced in menopause. In this approach, thoughts such as "I'm no use any more" and "Everyone notices how much I've changed" are examined and a more balanced view is developed. The cycles of anxiety that accompany hot flushes and night waking are addressed; we work on behavioural methods that support sleep patterns. Research shows that cognitive behavioural methods can help in coping with the distress caused by some of the symptoms experienced in this period.
A schema therapy perspective, on the other hand, can contribute to understanding the deep beliefs that come alive in this period. For example, a woman who has defined her worth all her life through caring for others or looking young and attractive may go through a deeper questioning of identity in this period. In therapy these beliefs are noticed and work is done to help the person develop a more compassionate and flexible view of herself.
This process is shaped according to the person's own pace and needs. You can get information about individual work on the individual therapy page.
Frequently Asked Questions
Does menopause cause depression?
The menopausal transition is a period in which the risk of depression rises in some women, but not every woman experiences depression. Having had depression before, intense stress and sleep problems can increase this risk. Prolonged sadness and loss of interest should definitely be assessed.
Is irritability normal in menopause?
Irritability is common in this period because of hormonal fluctuations, sleeplessness and growing life burdens. However, if irritability is seriously affecting your relationships and daily life, getting support can be helpful.
Is the forgetfulness experienced in menopause permanent?
The mental fogginess experienced in this period is temporary in many women and is often linked to disturbed sleep, stress and hormonal fluctuations. If the forgetfulness is steadily increasing or clearly affecting your daily tasks, a doctor's assessment is useful.
How long does the psychological side of menopause last?
The emotional changes usually become pronounced during perimenopause, and how long they last varies from person to person. In many women, mood becomes balanced again in the post-menopausal period. Treating this period not as an ending but as a move into a new stage of life makes adjustment easier for many women. Giving yourself time and rearranging your daily life according to your changing needs is also an important support in this process. You do not have to carry what you are going through alone; it can help to know that getting support from a specialist is possible.
Bu yazı genel bilgilendirme amaçlıdır; tanı veya tedavi yerine geçmez. Yaşadığınız güçlükler için bir ruh sağlığı uzmanına başvurmanız önerilir. Acil bir durumda lütfen 112'yi arayın.
Eda Erkan Alapala
Klinik Psikolog. İstanbul Kent Üniversitesi Klinik Psikoloji Tezli Yüksek Lisans mezunu; bilişsel davranışçı terapi, çocuk merkezli oyun terapisi ve çocuk-ergen psikoterapisi alanlarında eğitimlerini tamamlamıştır.
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