Dealing with Perimenopause Rage

Feeling a bit moody, short-tempered, and less patient during perimenopause?

Turns out you’re not alone. According to the American College of Obstetricians and Gynecologists, around 4 in 10 women experience mood symptoms during perimenopause that can include feeling irritable, moody, and unlike their normal selves.¹ 

But another mood-related symptom that may present, is a significant uptick in anger or rage. Let’s look a bit further at perimenopause rage, how you can identify it, and what you can do to manage it.

Watch a brief video on managing mood swings during perimenopause and menopause from Chief Medical Officer, Dr Alyssa Dweck, below: 

Can Perimenopause Cause Anger Issues?

The short answer? Yes, possibly. The good news is that mood swings, a short temper, and irritability aren’t just “in your head,” and the even better news is that these changes are likely temporary.²

The more detailed answer? Yes— but it's complicated. That’s because while perimenopause can contribute to anger issues, the underlying reasons may not be so straightforward. In fact, it’s possible (and likely) that a combination of different variables are responsible for the perimenopause rage you may be experiencing.

Let’s dive into a few common perimenopause symptoms, the many reasons behind them, and how they may contribute to symptoms of anger or rage.

Perimenopause Rage Symptoms

Perimenopause rage looks different for everyone – and not everyone will experience this symptom. Here are a few common indicators that you may be experiencing classic perimenopause rage³:

• Mood swings – where you go from feeling emotionally stable in one moment to feeling irritable in the next
• Less patience
• Feelings of intense irritation
• Angry outbursts

What Causes Perimenopause Rage?

While changing hormones could be considered to be the main culprit of these mood shifts, perimenopause rage can have other causes as well.

Hormones Play a Role in Perimenopause Rage

In the years leading up to menopause, levels of estrogen and progesterone begin to decline.⁴  This can also have significant implications on levels of other hormones like serotonin, which is a hormone that supports feelings of well-being and contentment.⁵ Dopamine—the same “reward” hormone which is slowly released after things like exercise, laughing, or having sex— also declines as a result of other hormonal fluctuations experienced during the menopause transition.⁶

As these hormones decrease, feelings of irritability and anxiety can increase. You may find you have less capacity to take things in stride during this phase of your life, and situations that were once manageable, may now feel overwhelming and triggering.

*Enter, perimenopause rage.*

Physical Changes May Add to Perimenopause Rage

Hormones are certainly a driving factor in perimenopause rage. But a changing body and all the physical symptoms that can come along with it can play a role, too.

The following physical changes many women experience during perimenopause into menopause can exacerbate and/or trigger feelings of irritability and rage⁷:

• Poor sleep
• Hot flashes
• Weight gain
• Body changes that negatively impact self-esteem

What Can I Do to Manage Perimenopause Rage?

Knowledge is power. The more we understand perimenopause rage and hormonal mood changes, the more we can learn to better navigate them.

Know Perimenopause Rage Is Not Uncommon and Often is Temporary

When it comes to hormonal rage, solidarity may offer some comfort. While heightened emotions may have you feeling alone, rest assured that perimenopause rage is not an uncommon experience among women in their 40s and 50s.⁸ This means that in your circle of friends and acquaintances, you’re probably not the only one experiencing noticeable changes in your mood.

It may also help to learn that, in most cases, this shift won’t last forever. Feelings of rage or anger may come and go as estrogen levels fluctuate and then decline over time – and you will likely find balance again as your hormones adjust and even out.⁹ Until then, there are things you can do to better support your mood during perimenopause and beyond.

Lean on Your Support System

Consider opening up to friends, family, or loved ones about the changes you’re going through. Doing so will not only prepare them for your changing moods, but also may help you feel less alone.

One-on-one talk therapy or group counseling may also be beneficial, according to research. Some studies show that anger management therapy can be effective in as much as 75% of those receiving treatment, with cognitive behavioral therapy (CBT) being particularly helpful.¹⁰

Focus on The Basics of Self-care

We’ve touched on how physical changes can trigger or contribute to worsening perimenopause rage.

For this reason, consider trying to tackle the basics of self-care, including getting enough sleep at night, staying hydrated, and maintaining a nutritious diet throughout menopause in order to better support your mood.

Lack of self-care, like being sleep deprived, can increase negative moods such as rage.¹¹ So, while negative emotions may be part of the package of symptoms that comes with perimenopause, focusing on sleep, hydration, a nutritious diet, and other pillars of physical and mental health can be helpful in managing perimenopause rage.

Find Healthy Outlets

Now is a great time to prioritize activities that bring you joy and help to decrease your stress levels.

Exercise, for example, is strongly associated with mood improvements like reduced anger and hostility— even in durations as short as 10 minutes.¹² Similarly, leisure activities, such as group sports or spending time in nature are also associated with higher levels of psychosocial wellness and lower levels of depression and other negative mood states.¹³

So, if you’ve been looking for the right excuse to get outside and garden, try an activity with a friend, or explore a new hobby, now is the perfect time to do so!

Consider Prescription Medication(s)

If you find that your perimenopause rage or anger is getting out of control and disrupting your day-to-day quality of life, it’s certainly worth checking in with your healthcare provider. Certain prescription birth control pills or specific antidepressants, such as selective serotonin reuptake inhibitors (SSRIs), may be recommended to help manage your symptoms.¹⁴ Again, it’s always important to check with your healthcare provider, as they know your medical history best.

When Should I Visit a Healthcare Provider About Perimenopause Anger and Irritability?

If perimenopause rage begins to affect your quality of life and/or relationships, it’s important to talk with your healthcare provider. Your physician can help you understand what you may be going through, suggest medications or management options, and discuss a treatment plan that can help to manage your symptoms. They may also suggest exploring talk therapy with a specialist who more specifically understands these types of issues.

Perimenopause Rage is Not Uncommon

Remember, perimenopause rage is not uncommon among women during perimenopause. The good news is, it’s likely temporary, and there are ways to manage your shifting emotions as your hormones readjust.

Resources

1. https://www.acog.org/womens-health/experts-and-stories/the-latest/mood-changes-during-perimenopause-are-real-heres-what-to-know
2. https://www.sutterhealth.org/health/womens-health/menopause-mood-swings
3. https://www.healthline.com/health/menopause/perimenopause-rage
4. https://www.hopkinsmedicine.org/health/conditions-and-diseases/introduction-to-menopause  
5. https://www.hopkinsmedicine.org/health/wellness-and-prevention/can-menopause-cause-depression
6. https://www.urmc.rochester.edu/ob-gyn/ur-medicine-menopause-and-womens-health/menopause-blog/april-2015/moods-and-menopause.aspx
7. https://www.healthline.com/health/menopause/menopause-anger
8. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9244939/
9. https://www.healthline.com/health/menopause/perimenopause-rage#causes
10. https://www.apa.org/topics/anger/understanding
11. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6122651
12. https://www.sciencedirect.com/science/article/abs/pii/S0165032717312326
13. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2863117/
14. https://www.healthline.com/health/menopause/perimenopause-rage