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The moods of menopause

You’re irritable, you can’t sleep and you can’t remember where you put your keys. Was that a hot flash?

Menopause can cause a variety of physical and mental symptoms.

“Hot flashes and night sweats can keep you from sleeping well, which can cause problems in your thinking and memory, your mood, even a lack of interest in sex,” says Judi Chervenak, MD, associate clinical professor of reproductive endocrinology at Montefiore Medical Center in New York.

Menopause affects women in different ways. You may notice only a change in the pattern of your periods and have few bothersome symptoms, you may feel more energetic, or it could be a difficult time, as your body chemistry changes.

Menopause typically begins after age 45, but symptoms can begin years before periods cease and last, in varying degrees, for months or years. The reproductive hormones estrogen, progesterone and testosterone fluctuate from very high to very low, which can cause irritability, anxiety and depression, Serotonin and dopamine, the “feel-good” brain chemicals, also decline with age.

“Keeping a symptom diary to record the symptoms you’re having, what makes them worse, what makes them better,” Dr. Chervenak says, “can be very empowering. It will also provide information to share with your health care provider.”

The hormonal changes of menopause can affect the way you feel and think, but, around this time, many women are experiencing significant life changes. They may be adjusting to an empty nest as children go out on their own, they may be moving to a new residence, experiencing changes in the marriage, even divorcing. Many women begin to take on caretaking roles with aging parents at this time. These changes can add to emotional upheavals.

If you’ve had mood swings with PMS, you’re more likely to have them with menopause. You may be at risk of major depression if you’ve been depressed before or have a family history of depression.

Treatments for menopause symptoms
Therapies for severe symptoms include antidepressants or anti-anxiety medications or hormone therapy, sometimes in combination. If your doctor recommends hormone therapy for severe physical symptoms, your sleep and mood symptoms will improve too. Hormone therapy, typically estrogen combined with progestin, carries some health risks for some women and is not prescribed for mild symptoms or for long-term use. You and your doctor should carefully weigh the risks and benefits.
Working with a therapist, cognitive behavioral therapy can help you cope with life stressors.

Some women choose herbal and nutritional remedies that may mimic estrogen, such as soy products, black cohosh and valerian root. They sometimes seem to help, but their effectiveness and safety have not been proven. Discuss their use with your doctor.

To help reduce mood swings and memory problems

The good news is that cognitive function and mood swings usually improve following the pre-menopause period.

If you feel very depressed, see your health care provider right away. If you are feeling suicidal, call 911 or go to an emergency room immediately.

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