Mood and Hormones

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Your Mood and Hormones Over 40

Introduction

Women over 40 are often surprised to learn that despite having a consistent menstrual period, hormone changes that lead towards menopause begin¹. These hormone changes can lead to a worsening of old symptoms such as PMS, but can also bring new symptoms such as insomnia, hot flashes, cycle changes and low mood1. Mood changes over 40 are caused by wide fluctuations in hormone production as the body has to work harder over time to produce an egg each month. The definition of perimenopause includes cycle length changes of greater than 7 days in either direction of your regular cycle, which is a small insight into the changes going on under the surface with hormone levels². As estrogen and progesterone are produced less consistently, some months may have higher than average production and some months may have lower than average production.

Signs and Symptoms

Estrogen is a necessary hormone for positive mental health in women, and the fluctuating levels experienced in perimenopause can cause new onset of low mood or a worsening of it in women who were already at risk³. Lab testing for hormone levels during perimenopause is challenging because the fluctuation of hormone levels happens daily, which means relying on a woman’s recount of her experience and a history taking of both hormonal symptoms, cycle changes and how she is feeling⁴ is important when diagnosing for low mood.

Causes and Prevalence

The hormone changes at perimenopause are part of a natural progression of aging, but the symptoms that some women experience are significant and deserve attention and support. Upwards of 20% of women at 40 years of age have enough hormone changes to be classified as perimenopausal, and the incidence increases every year before 50⁵. Despite these changes, very few women are assessed by their practitioner for symptoms of low mood⁶, leaving many women to feel their circumstances are causing their low mood, not an internal hormone change. With 40% of perimenopausal women reporting low mood as one of their most significant symptoms, this is an area that women need resources and solutions to better support their health⁷. The risk factors that increase the likelihood of having low mood during perimenopause include a higher body weight, social determinants of health such as income and education and stressful life events around the time of menopause⁸. Having other symptoms related to perimenopause such as hot flashes and insomnia also increase the risk of having low mood⁸.

Diet (foods that make the condition better or worse)

Women can support themselves during this time by focusing on nutrition and nutrients that have been shown to improve mood and other symptoms of perimenopause. Women who eat more fruit⁹ and who include soy in their diet have lower risks of persistent sadness, and the addition of soy in the diet of women who are struggling may help reduce her symptoms¹⁰,¹¹. Women also increase their alcohol intake during perimenopause, which may have a negative impact on her mood and overall health¹².

Lifestyle

The most important message for women over 40 is to help them understand the changes that are happening in their body so that they can connect their symptoms with their changing hormones. Many women believe that menopause begins at 50 with a loss of their period, which leaves them feeling confused in their 40s when their bodies change, and they continue to have a menstrual cycle. Tracking your symptoms and speaking with your health care provider about your hormonal health, a healthy diet and the inclusion of nutrients known to support mental health can help you feel more in control of your perimenopausal years and lead a happy and fulfilled life. Women who engage in regular exercise¹³, have higher self compassion^14,15 and focus on stress reduction have a better experience through perimenopause.

Exercise has a significant role in supporting mental health and overall wellbeing in perimenopause with women who engage in regular physical activity (that includes sweating and being breathless a few times per week) having better overall mood and wellbeing¹⁶. Guidelines that make recommendations for exercise in low mood include women in the perimenopause transition as people who may benefit from regular exercise in combination with other supports to help mood symptoms¹⁷.

Nutraceuticals:

Melatonin is a nutrient that may support the symptoms of perimenopause, especially if there is an overlap between low mood and disturbed sleep. Melatonin secretion during perimenopause is different than in other times of a woman’s life¹⁸, and this disruption may be contributing to both the mood and sleep challenges women face at this time. Research suggests that the addition of melatonin in poor sleepers may support their ability to sleep, and may support symptoms overall in perimenopause, including mood¹⁹.

Saffron is a herb that is gaining interest as research has shown positive results with its use in various in health conditions^{20 - 22}. Saffron has been studied in women in post menopause for low mood and hot flashes and was found to be a safe and effective herbal treatment for these symptoms^23,24.

Herbs that support the stress response such as Rhodiola and Ashwagandha can also be considered in this stage of life. Rhodiola improves energy and an overall sense of wellbeing^25,26. Ashwagandha improves a sense of stress and anxious feelings ^27,28 which may support women during this stressful time to feel more like themselves.

References

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