Menopause Rage is Real. Here’s How to Handle the Anger

It’s no surprise that the menopause transition can leave you on edge. After all, you’re managing all sorts of weird and uncomfortable new mental and physical symptoms and likely not getting enough sleep. If you feel ready to blow your top over even the tiniest annoyances, you’re not alone. Menopause rage is a completely real—and normal—experience for many women. One study found as many as 70 percent of people in perimenopause listed irritability as their “primary mood complaint.” ¹

“Think of menopause as emotional turbulence on an otherwise smooth flight,” says Australia-based psychologist Veronica West, M.P.H. “Hormone shifts, especially the drop in estrogen, can throw your mood regulation out the window.”

When your body starts producing less estrogen, often in your late 40s, you may begin to feel anxious, depressed, and angry, West explains. But don’t worry: You won’t be on this emotional roller coaster forever. And in the meantime, health professionals say there are effective ways to bring your boiling menopause rage down to a gentle simmer.

About the Experts

Alyssa Dweck, M.D., FACOG, is a New York gynecologist who specializes in menopause and female sexual health issues.

Veronica West, M.P.H., is a psychologist in Australia who specializes in treating mental health during all stages of life. West is also the lead content creator at My Thriving Mind, which provides tools and worksheets for therapists.

Bruce Dorr, M.D., is a gynecologist who specializes in female pelvic medicine at all ages and regularly works with clients going through the menopause transition.

What Menopause Rage Looks Like

Menopause rage hits everyone differently, whether you cry excessively at the drop of a hat or sometimes need to punch a pillow.

Menopause rage symptoms may include:

• Getting easily annoyed or irritable
• Mood swings
• Sudden outbursts—verbal or physical
• Excessive crying

Menopause rage is a complex social behavior caused by hormonal changes and situational factors—and importantly, it’s not your fault.

How long does menopause rage last?

How long menopause rage will last depends on a variety of hormonal and environmental factors. Women can experience feelings of anger at any point in the menopause transition. Your menopause rage may fizzle out by the time perimenopause ends, or it might persist through menopause and beyond.

Some factors impacting how long menopause rage might last include:

• how much sleep you’re getting
• how much stress you’re experiencing
• whether you’re able to receive HRT
• overall mental health ²
• social support systems, including family ^{3 4}

Rest assured that menopause rage does not have to be permanent, and that managing temporary irritability can go a long way.

Menopause Rage, Hormonal Fluctuations, and Other Causes

The primary cause of menopause rage is hormonal fluctuations, which directly impact mood through a variety of systems:

• Estrogen: Declining estrogen levels during perimenopause can cause menopause rage due to the hormone’s role in mood regulation. Estrogen influences the production and function of neurotransmitters in the body, including the “feel-good” chemicals oxytocin, serotonin, and dopamine.⁵
• Oxytocin: Known as the bonding or love hormone, oxytocin can alleviate tension and make you feel less stressed and irritable. ^{6 7} Declining oxytocin levels during menopause can directly impact your anger levels and heighten challenging emotional situations.
• Progesterone: Declining progesterone levels might contribute to menopause rage due to the hormone’s role in regulating gamma-aminobutyric acid (GABA), a neurotransmitter that helps quiet overactive nerve cells in the brain. Progesterone and GABA’s impact on cognitive regions like the hippocampus, hypothalamus, and amygdala might support women in managing their mood and anxiety. ⁸
• Serotonin: Decreased serotonin levels can result in mood changes like menopause rage, specifically symptoms like depression, frustration and tension. ^{9 10} If you’ve heard loved ones talk about using antidepressants to treat menopause symptoms, this is why. Selective serotonin reuptake inhibitors (SSRIs) can help your body make up for declining serotonin levels, easing mood swings and reducing anger. ¹¹
• Dopamine: Research suggests low dopamine levels can make you feel more reactive and aggressive when provoked. ¹²

But hormones aren’t the only reason why menopause rage can happen. “Mood swings during perimenopause and menopause are real and have multiple causes,” says gynecologist Alyssa Dweck, M.D.

Life demands in your late 40s and early 50s are likely high: You might be hitting the peak of your career, raising teens, or caring for aging parents—all of which can add stress as you navigate the ups and downs of perimenopause, with its hot flashes, mood swings, poor sleep, and increased anxiety.

Relationship issues and financial stressors can also contribute to your irritability, Dweck suggests. Having an unsupportive partner or lack of a support network can make the menopause transition even more emotionally challenging. ¹³

The impact of your rage could hurt your personal relationships and also affect your job security. “Irritability can [disrupt] work performance,” gynecologist Bruce Dorr, M.D., says.

How to Manage Menopause Anger

Incorporating some lifestyle changes into your weekly routine can help manage your menopause rage.

1. Practice mindfulness

One proven way to reduce menopause rage is regular meditation practice. A 2020 study noted a 42% reduction in irritability among menopausal women who practiced meditation at least once a week for six months. ¹⁴ Grounding yourself in a mindfulness practice can regulate your nervous system and help you think more clearly to better manage your emotions. “Think deep breathing, meditation, or yoga,” suggests West. “Anything that helps you tap into your inner calm and press ‘pause’ on those emotions.”

Mindfulness practices can also help reduce stress, which is critical to managing perimenopause symptoms that can trigger feelings of anger and rage, Dweck says.

2. Exercise regularly

The benefits of exercise for menopause rage are clear—a 2017 study observed a significant reduction in irritability for menopausal women who worked out at least twice a week. ^{15 16}

Regular exercise—ideally about 150 minutes a week, per the CDC—can help you burn off pent-up anger and irritability while triggering the release of more of the feel-good neurotransmitters serotonin, and dopamine. ^{17 18 19}

“Regular exercise is a great mood booster,” West says. “It doesn’t have to be anything extreme. A brisk walk or even dancing around the living room counts.” Any movement that gets your endorphins (AKA your body’s natural painkillers) flowing is a win, she adds.

3. Optimize your sleep

Up to 47% of women in perimenopause and 60% of women in menopause can experience insomnia, and its impact on mood is clear. ²⁰ When you don’t get enough sleep, you are more likely to feel agitated, stressed, and angry. ²¹ “Good sleep works like a ‘reset’ button for your mood, helping you start [your day feeling] fresh,” West says.

To sleep better at night and prevent your next bout of menopause rage, make sure your bedtime routine includes these healthy sleep hygiene habits: dimming the lights, doing a brief meditation, and avoiding screentime one hour before bed and avoiding caffeine after noon.

If night sweats are compromising your sleep, lowering the temperature in your home or dressing your bed in cooling sheets may help you stay comfortable and get more rest.

4. Eat a nutrient-dense diet

The key to calming your menopause rage might start in your gut. Eating a balanced diet fortifies gut bacteria to drive the production of mood-regulating neurotransmitters like serotonin, GABA, and dopamine. ²² To support a healthy gut microbiome and balance your emotional symptoms, try to incorporate pre-biotic foods high in soluble fiber such as asparagus, leeks, and chicory root. ²³

For greater mood benefits, consider adding soy-based foods such as tofu and edamame or a soy isoflavone supplement. Soy is a phytoestrogen, a plant compound that mimics the behavior of estrogen in the body. ^{24 25} Research into phytoestrogens found depression symptoms decreased in women who took a soy isoflavone supplement. ²⁶

On the flip side, eating heavily processed, high-fat foods can intensify feelings of irritability. Sugary foods, for example, can spike your blood glucose (sugar) levels, setting you up for a blood sugar crash. This rapid drop in blood sugar can make you feel agitated, anxious or angry. ²⁷

5. Limit caffeine and alcohol

Too much caffeine can make people jittery and irritable and also compromise sleep (especially when consumed after 3 p.m.), worsening mood-related symptoms. The hormonal fluctuations of menopause can increase sensitivity to caffeine by altering how the brain processes stress and regulates mood. ²⁸ Even moderate caffeine intake may heighten irritability, anxiety, or restlessness, lowering the threshold for menopause rage. ^{29 30} Caffeine is also associated with vasomotor symptoms in menopausal and perimenopausal women, meaning it can increase chances of night sweats and hot flashes. ³¹

It also might be tempting to wind down after a stressful day with a glass of wine, but that could contribute to menopause rage. Declining estrogen levels in menopause lead to reduced alcohol tolerance, which can strengthen its effects and exacerbate emotional reactivity. ³² Alcohol interferes with REM sleep, resulting in fragmented sleep ³³ that leaves you fatigued. Booze is also a nervous system depressant, which could bring your mood down even more. ³⁴

PERIMENOPAUSE SYMPTOMS

Perimenopause Fatigue Is Real. Here’s What to Do About It

Too Stressed to Sleep? Help for Perimenopause Anxiety and Insomnia

Treatments for Menopause Rage

If your menopause rage starts affecting your life in significant ways, it’s time to see a healthcare provider to review treatment options. Make an appointment with your provider right away if you’re experiencing any of the following:

• It’s affecting your quality of life and relationships.
• Your performance at work is suffering.
• You have sudden or worsening headaches or bouts of confusion or disorientation.
• You have thoughts of self-harm or suicide.
• You’re experiencing hallucinations.

The good news is there are plenty of treatment options available for menopause rage. “As a practicing gynecologist, I consider hormone therapy, non-hormonal drugs, and clinically studied supplements for those having menopause symptoms that interfere with quality of life,” Dweck says.

Counseling and therapy

Helpful therapy options for menopause rage include group therapy, anger management counseling, cognitive behavior therapy, and stress inoculation training (SIT), which helps people, particularly those with PTSD, manage stress. These modalities can provide tools and strategies to manage feelings of anger and aggression in a healthy, constructive way. Some counselors and therapists may also be able to lead you in a guided meditation or mindfulness practice to help quell your menopause rage. ^{35 36}

Seek out providers with experience treating patients going through the menopause transition, “because providers often have very little training in the treatment of perimenopause and menopause or the symptoms that accompany these life stages,” Dorr says.

You can use the Menopause Society practitioner directory to find mental health professionals, physicians, physical therapists, and nurses who are Menopause Society Certified Practitioners worldwide.

Medication options

Almost half of women in menopause with a mental health diagnosis are prescribed anti-depressants such as:

• Selective serotonin reuptake inhibitors (SSRIs) supplement the brain’s production of serotonin, which helps control anger and irritability. ³⁷
• Serotonin and norepinephrine reuptake inhibitors (SNRIs) block the reabsorption of both serotonin and norepinephrine in the brain, which increases levels of these neurotransmitters in the brain, regulating mood and alleviating symptoms of depression and anxiety. ^{38 39}

Dorr cautions that medications like antidepressants can treat symptoms but will not address the underlying cause, which is declining hormones. She also notes that some medications have side effects that could end up amplifying some of your symptoms. “These prescriptions often cause additional problems, such as libido loss, sexual dysfunction, and weight gain,” Dorr says.

Try HRT

Hormone replacement therapy (HRT), also known as menopause hormone therapy (MHT), can help ease perimenopause symptoms—including menopause rage. Research shows that HRT may relieve psychological symptoms of menopause, including rage, depression, and anxiety, while also improving some of the effects of chronic stress on cognitive function. ^{40 41 42}

If you’re already on hormone therapy but still experiencing bursts of anger and irritability, ask your doctor if you need to change your HRT dose. ⁴³

Regardless of the menopause rage treatment you choose, keep in mind that what you’re experiencing is normal. “Menopause is a natural life stage, not a disease,” Dweck says. “Being proactive by educating yourself [about menopause] and maintaining a healthy lifestyle is so important.”

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About the author

Stephanie Anderson Witmer is a freelance journalist and content creator based in Pennsylvania. She's written health and lifestyle stories for Women's Health, Redbook, Prevention, Good Housekeeping, USA Today, Better Homes & Gardens, Giddy, Parade, Yoga Journal, and more.

About the reviewer

Dr. Shelly Chvotzkin, D.O., F.A.C.O.O.G., is a physician board certified in obstetrics and gynecology. She is a member of the American College of Osteopathic Obstetricians and Gynecologists (ACOG), the American Osteopathic Association (AOA), the American Society for Colposcopy and Cervical Pathology (ASCCP) and the Menopause Society (formerly known as the North American Menopause Society or NAMS).