Emotional Changes During Menopause

Common Emotional and Psychological Changes

Women may experience fluctuating moods, irritability, and emotional lability during the menopausal transition, according to the National Comprehensive Cancer Network 1, 2
Increased feelings of anxiety and stress are common during menopause, as noted by the National Comprehensive Cancer Network 1
Sleep disturbance, often related to hot flashes/night sweats, can secondarily affect mood and cognitive function, as reported by the National Comprehensive Cancer Network 1, 2
Some women report difficulties with memory and concentration, as stated by the National Comprehensive Cancer Network 1, 2
Decreased libido and changes in sexual response can affect emotional well-being, according to Ca-A Cancer Journal for Clinicians 3, 4

Abrupt onset of menopause can lead to more severe symptoms in younger women due to the abrupt hormonal changes, as noted by the Journal of Clinical Oncology 5

It is essential to differentiate between normal adjustment and clinical disorders, and to assess frequency and severity of symptoms, as recommended by Annals of Oncology 6
Screening for underlying medical causes, such as thyroid disease, is crucial, as stated by the National Comprehensive Cancer Network 7
Evaluating for co-occurring vasomotor symptoms, such as hot flashes and night sweats, is necessary, as reported by Annals of Oncology and Journal of Clinical Oncology 6, 5

Brief psychoeducational support, group therapy, or intensive psychotherapy should be offered to women experiencing significant emotional changes, as recommended by Ca-A Cancer Journal for Clinicians 3, 4
Lifestyle modifications, such as regular exercise, stress reduction techniques, and adequate sleep, can help manage mood symptoms, as noted by the Journal of Clinical Oncology 5
Environmental modifications, like creating cool environments and dressing in layers, can reduce hot flashes that contribute to mood disturbances, as stated by the Journal of Clinical Oncology 5
SNRIs/SSRIs can help manage both vasomotor symptoms and mood disturbances, though they're not FDA-approved specifically for menopausal symptoms, as reported by the Journal of Clinical Oncology 5
Gabapentin can be effective for reducing hot flashes and may help with associated mood symptoms, as noted by the Journal of Clinical Oncology 5
Menopausal hormone therapy (MHT) should be considered carefully, weighing benefits against risks, especially in women with a history of hormone-sensitive cancers, as recommended by the National Comprehensive Cancer Network and Annals of Oncology 8, 9

Cancer survivors may experience menopausal symptoms without meeting the definition of menopause, including those on aromatase inhibitors or with history of chemotherapy, as noted by the National Comprehensive Cancer Network 1
Women who undergo surgical removal of ovaries often experience more abrupt and severe emotional symptoms, as stated by Annals of Oncology 9
Sexual dysfunction often accompanies emotional changes and may require specific interventions, including lubricants, moisturizers, and sexual counseling, as recommended by Ca-A Cancer Journal for Clinicians 3, 4

Persistent depressive symptoms or severe anxiety that significantly impairs daily functioning may require specialist care, as noted by Annals of Oncology 6
Complex cases, such as women with multiple symptoms or comorbid conditions, may benefit from specialist care, as recommended by Annals of Oncology 6