PMS and Menopause
PMS, mood, and attitudes at midlife: If you’ve ever experienced severe PMS, you know it’s a real, biological phenomenon that can throw your body and mind into a state of disarray. PMS-related mood swings appear linked to the effect of wide hormonal fluctuations on the brain’s neurotransmitters.
Perimenopause is a time of great hormonal flux, so it isn’t surprising that it might set the stage for the onset or increase of PMS symptoms. Add in life’s stresses and poor sleep quality and you’ve got a recipe for what has been described as “blue moods.”
It’s estimated that about 10 percent of women experience mood swings during perimenopause. These changes are temporary for most women. But a history of PMS or postpartum depression appears to increase the likelihood of bothersome symptoms during perimenopause. This suggests that there is a subgroup of women especially vulnerable to mood disturbances at times of hormonal fluctuations. Whatever your experience, it is important to factor in other possible influences.
The Melbourne Women’s Midlife Health Project offers some insight. Dr. Lorraine Dennerstein at the University of Melbourne led this research, which is one of the few long-term population studies looking at well-being during the menopausal transition. While following midlife women over time, the researchers found that mood (positive or negative) did not seem to correspond to any of the hormones they measured. (Keep in mind, however, that it is difficult to characterize changes in hormonal levels during the menopausal transition.) What they did find, however, was that during the menopausal transition, women are more vulnerable to stressors.
It may be impossible to completely sort out sleep issues, sensitivity to hormones, and sensitivity to life’s stresses. But figuring out what may be contributing factors is definitely worth doing. Once you identify the underlying issues, it will be easier to find solutions.
It has been a common (mis)assumption, even among health care providers, that menopause causes depression. One participant in our program revealed that her mother had committed suicide when she turned fifty. The woman’s immediate conclusion was that she, too, would succumb to a deep depression when she reached menopause. But studies show menopause does not cause depression. Depression in women has been found to peak in their thirties, not their forties. In reality, rates of depression decline after menopause.
The Melbourne Women’s Midlife Health Project found no increase in the incidence of major depression or negative moods with menopause. They reported that despite life’s stresses and menopausal symptoms, many women at midlife were more likely to report positive moods than negative moods.
Work by Dr. Nancy Woods and the Seattle Midlife Women’s Health Study has also helped debunk the idea that waning estrogen makes women inherently depressed. Here, study investigators followed 205 women as they passed through the menopause transition. They found no significant association between depressed mood, menopause, hormone levels, or age. Their research suggested that a woman’s outlook actually improved as she passed through the transition. The factors that most accurately predicted feelings of well-being tended to be some of the very topics we address in our mind/body programs. They included:
- good health
- adequate income
- social support
- positive perceptions of stress and health
Women with severe and extended menopausal symptoms do experience negative moods. The Melbourne Women’s Midlife Health Project reported that women undergoing surgical menopause (in which symptoms tend to be more severe) and women who had menstrual problems before menopause reported more negative feelings.
The study showed that other contributors to negative mood included prior depression, health issues, negative attitudes about menopause, and social and family stressors.