Mood swings during menopausal transition

By Lee Hye-jun

I remember when my mother turned into a very different person during her menopausal transition. She would get emotional quite often _ she is a calm person in general _ and got annoyed easily at every family member. Looking back, I realized she was going through a big change of her life as a woman. I felt bad that I was not being more supportive of her.

A few years later, I brought up that time trying to have a sweet mother-daughter moment. Mom’s response was unexpected. She remembered neither being emotionally challenged nor giving me a hard time. How could she have forgotten it all?

Menopause is derived from the Greek words “men” (month) and “pausis” (cessation), a point when menstrual period permanently ends. During menopausal years, some women experience severe symptoms from estrogen deprivation, whereas others show unnoticeable reactions.

The most common discomfort is experiencing hot flushes, the sudden onset of a sense of intense heat over the head, neck, and chest, accompanied by an increase in heart rate. Hot flushes occur mostly in the first year after the last menses. Although, they disappear in 50 percent of women after four to five years, they last up to 15 years in 10 percent of women. Extremely low estrogen levels also leave the vagina dry, resulting in frequent vaginitis, painful intercourse and urinary diseases. Other common menopausal complaints are fatigue, headaches, irritability, aching joints and muscles, night sweats, and insomnia.

Many of us, including me, assume that estrogen deprivation at menopause is responsible for mood swings as well as physical disturbances. However, about 85 percent of women experience no mood difficulties during the menopausal transition while experiencing the same estrogen deprivation as other women. Indeed, statistically depression is less common among middle-aged women.

We tend to relate menopause and depression because middle-aged women face more life events that affect mood than women in other age group. The vicissitudes of life are commonly prevalent around menopause: major illnesses and even death in a spouse, relative or friends, retirement from work, separation from children, and financial insecurity. Moreover, a small population of women who are more sensitive to hormonal changes may have a tougher time undergoing an ordeal.

Additionally, mood is greatly affected by above-mentioned physical discomfort resulting from estrogen deprivation such as hot flushes, dry vagina, aching joints and insomnia. For example, hot flushes can disturb the quality of sleep, thereby diminishing the ability to cope with stress the next day.

Mood swing during menopausal transition can be a complex interaction of all of above. Particularly, women with underlying psychological problems are at greater risk of new onset of depressive symptoms.

My mom forgot about that time because she must have not experienced extreme mood difficulties or depression. She could have been simply irritated by the physical discomforts or perhaps I was just being annoying. If your mom shows mood swing lately, do not blame her hormone first. Look closely if she is going through a major life event or severe menopausal symptoms, and be supportive. Last but not least make sure you are not the reason.

The writer is a doctor at Maria Fertility Hospital in Seoul. For further questions, send an e-mail to the writer at hyejunlee@mariababy.com, or call the hospital’s English-speaking coordinator at 82 (Korea country code) 2 (Seoul area code) 2250-5577 begin_of_the_skype_highlighting 2250-5577 end_of_the_skype_highlighting, or visit the hospital’s website, http://eng.mariababy.com/.