Is This Menopause, or Just a Really Bad Mood?

2/20/2014

Menopause and mood swings go hand-in-hand. In fact, menopause is linked to many fluctuations in a woman’s body. It can affect her from head to toe, and pretty much all the parts in between.

Migraines, hot flashes, increased sweating, vaginal dryness, bone thinning, and trouble sleeping are just a few of the maladies affecting women during the menopause years. Although menopause is blamed for these symptoms and more, health experts continuously remind women that it is a normal condition that all women experience as they age, but in varying degrees.

Scott Bergstedt, MD, ob/gyn with OBG-1of West Calcasieu Cameron Hospital has faced many women in his office who are not too pleased with their current state of circumstances during menopause. “They’re dealing with several symptoms and trying to continue with their normal lives. And, it’s different for every woman. Some women have a difficult time, others go through menopause with hardly any negative effects. For those that are having problems, there is no magic cure that will work every time,” he said.

Fluctuating hormones are generally accepted as the cause for mood swings. The body no longer produces any eggs for fertilization. As a result, a woman’s body stops producing hormones that trigger ovulation and menstruation. Gradually, periods and ovulation become erratic, sending hormones into a tail-spin. The hormones estrogen, progesterone, and androgens control serotonin levels in the brain, the chemical that manipulates mood. If serotonin drops, so does your mood.

Another common reason for mood swings during menopause is fatigue. Hot flashes and insomnia can cause a good night’s rest to become just a dream. Sleeping may become uncomfortable due to night sweats.

Increased stress during the years leading up to menopause, known as perimenopause, can also affect a woman’s mood. Change is stressful, and during these years kids leave home, retirement is closer, and the health of a woman’s parents may be declining, causing increased worry. With all these factors, it’s understandable that moods will fluctuate.

Dr. Bergstedt says that physically, menopause has four stages:

Premenopause –women who are anywhere between their mid-to-late 40s. This is the time when periods begin to get irregular, but they do not yet experience any of the classic menopausal symptoms such as hot flashes or vaginal dryness. “This term can be used in different ways, so if your doctor says you’re in premenopause, ask him or her how they define it,” suggested Dr. Bergstedt.

Perimenopause – describes women currently in menopause. Menstrual cycles are erratic and they may begin to experience hot flashes, migraines, and other symptoms. On average, women are about 47 years old when they hit this stage.

Menopause – refers to the final menstrual period. Once you are completely finished with periods for a full year, then you are considered to be through menopause, so technically the term describes the first year of not having a period.

Postmenopause – the last third of a woman’s life, this category describes all women who have completed their menstrual cycle.

To help alleviate troublesome symptoms normally associated with menopause, Dr. Bergstedt says lifestyle changes can often work better than patients might think. “In general, a healthy body will handle menopause better than an unhealthy one. Smoking and excessive alcohol use, a poor diet, and no exercise lead to a weak body, incapable of dealing with the extra stress of menopause. A diet rich in vitamins and nutrients along with regular exercise will go a long way in helping a woman feel good and energized; which will help her fight fatigue and perhaps help in handling mood swings,” he explained.

Hormone therapy, which includes combinations of estrogen and progesterone, have been controversial since the Women’s Health Inititiative (WHI) study was halted early several years ago. At that time, results were showing that long term combination hormone therapy increased the risk of heart disease, breast cancer, blood clots, and stroke. Updated studies are showing these findings may not be relevant to all postmenopausal women.

Researchers taking a closer look at the WHI study are saying that the increased risk of heart disease may be related more to the advanced age of the participants as opposed to the hormone therapy. Studies are showing that hormone therapy given to younger women at the onset of menopause, show no increased risk, and in some cases, decreased the risk of heart disease.

“Hormone therapy should be decided by the patient and her physician, because her family history and lifestyle choices make an impact on her risk of heart disease, even before hormones are brought into the mix,” said Dr. Bergstedt. More studies are underway to understand the hormonal link to heart disease.

In addition to hormone therapy, there are other medications to alleviate severe menopausal symptoms, such as antidepressants for mood swings and sleep problems. Medications such as clonidine and gabapentin can help reduce hot flashes related to menopause.

Although menopause tends to overstay its welcome, knowing that it is a temporary state can help women deal with the symptoms. Honest and open discussions with your ob/gyn can provide assistance in getting through the often severe symptoms so you can feel yourself again. And when you’re in a bad mood, it can be just that – a bad mood – instead of an array of menopause-related symptoms.

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