Women report various emotional and psychological shifts during peri-menopause. Sometimes their partners or families complain about this symptom. As with other perimenopausal symptoms, these changes can be temporary, but they can also be unnerving.

Mood Swings

The good news about mood swings is that you may never experience them during perimenopause. Still, mood swings are a common complaint of perimenopausal women, and among women who cite symptoms in perimenopause, nearly 50 percent say mood swings are among the symptoms that bother them the most.

Whether you think of them as moodiness, temporary depression, or simply the blues, mood swings can be minor “speed bumps” in your day — or they can leave you feeling totally down and out. The experiences are as individual as the women who have them, but mood swings tend to take the form of intensified emotional reactions. Sometimes, the swing can take you high, and you feel a particularly strong delight in everything around you — the weather, a movie, your dinner companion. Other times, however, mood swings can take you on a wild roller-coaster ride of emotions, such as intense sorrow, despair, love, anger, anxiety, general depression, or fear. A typical anger response during a mood swing can leave your heart pounding, your face flushed, and your head throbbing. Mood swings can trigger bouts of crying and cause deep, dark feelings of hopelessness. Then, however dramatic they might be, mood swings may pass rather quickly, leaving you feeling a bit shaken and confused by the emotional ride.

Though mood swings seem to be emotional responses, they can, in fact, be a direct physical response to the changing hormonal levels in your bloodstream. In fact, many perimenopausal women experience mood swings along with other common symptoms of premenstrual syndrome (PMS), even when those women have never before suffered from PMS symptoms. Those symptoms include a wide range of physical and emotional markers, including gastrointestinal distress, headaches, pains in muscles and joints, fatigue, heart pounding, hot flashes, exaggerated sensitivity to sounds and smells, agitation, and insomnia.

Depression

Depression is a serious condition that should not be confused with brief episodes of feeling sad or overwhelmed. It is not a normal part of perimenopause, although many women use “depressed” to describe their quickly changing moods or tendency to cry easily. Chapter 8 discusses depression and its treatment in greater detail. If you find yourself feeling hopeless, desperate, or sad for long periods of time, see your health care provider or counselor to determine if this is part of adjusting to new hormone levels or something more serious.

Changes in Libido

Few things are more individual than libido. Everyone has a unique attitude toward sex and sexuality, and we all differ in our sexual habits and desires. While this undeniable (and delightful!) individuality may seem to contradict any generalizations about how sexual desire can change during menopause, many women do experience some types of changes during this time.

Many studies — including those of the famous Alfred Kinsey — indicate that both men and women can experience gradually declining sexual desire as they age. Pay special attention to the “can” in that last sentence. While not everyone undergoes a noticeable change in libido during menopause, many women report changes in their level of sexual desire. Some say they have more interest in sex and enjoy it more, while others say their desires have diminished, and still others say they find sex increasingly unappealing — even painful.