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Menopause, often called the "change of life," is a natural phase in a woman’s life marked not only by the end of her menstrual cycle but also by a big scary wave of physical and emotional changes. Among these, mood fluctuations are some of the most profound and perplexing. This week, we look at these menopausal mood swings, to arm you with an understanding and strategies to tame what I affectionately call the "Menopause Monster."

The transition into menopause is anything but straightforward. As estrogen and progesterone levels ebb and flow, they bring about not just the much talked about hot flashes and night sweats but also major mood changes. Women may experience more anxiety, irritability, sadness, or even depression. This emotional roller coaster is not just ‘in your head;’ these extreme mood variations are deeply rooted in the physical changes happening within your body.

Understanding the Beast

To tame the Menopause Monster, you first need to understand it. Estrogen, a key player in regulating mood and emotion, decreases during menopause. This hormone has a complex interaction with serotonin, a neurotransmitter that contributes to feelings of well-being and happiness. As estrogen levels decline, so too can serotonin, leading to mood swings or a drop in mood. At this point, women are often put on a Selective Serotonin Reuptake Inhibitor (SSRI) by their physician. Some common examples of SSRIs, include Escitalopram (Cipralex), Fuoxetine (Prozac) and Sertraline (Lustral).

Unfortunately, these medications can leave a woman feeling more tired and with low to no emotion. SSRIs are not without their side effects. These side effects can include dry mouth, nervousness, dizziness, decreased sex drive, and inability to sleep. This is counter-productive, given that women in this stage of their life may already be suffering with these symptoms.

Menopause can also be a period of significant life reflection and change. Children may leave home, relationships may change, and there may be a growing sense of one’s own mortality; death is closer than it was before. These life changes, combined with sleep disturbances caused by night sweats, can make the Menopause Monster seem even less tameable. Women feel a lack of control and a lack of confidence in reclaiming their selves. Many patients express to me that they don’t even recognize themselves anymore.

Strategies for Taming the Monster

Educate Yourself and Others: Understanding that mood swings are a normal part of menopause can be empowering. Sharing this knowledge with family and friends can foster a support system that empathizes with what you’re going through.

Seek Balance Through Lifestyle: Diet, exercise, and sleep play pivotal roles in managing mood swings. Nutrient-rich foods, regular physical activity, and adequate sleep can enhance your physical well-being and, by extension, your mood.

Mindfulness and Stress Reduction: Techniques such as yoga, meditation, and deep-breathing exercises can mitigate stress and promote a sense of calm and control.

Connect with Others: Joining a support group or connecting with friends who are going through similar experiences can provide comfort and advice on managing symptoms.

Consider Professional Help: For some, the mood changes during menopause can be severe. It’s important to recognize when you might need professional support. Therapists or counselors specialized in menopausal changes can offer strategies and, if necessary, medication to help stabilize mood swings.

I know that these strategies are difficult, especially when you are feeling tired; unhappy; and unmotivated. This is the time to explore Hormonal and Non-Hormonal Therapies. Treatments like bio-identical hormone replacement therapy (BHRT) can be effective for most women to manage mood swings and other symptoms.

No woman should have to navigate menopause alone. At Happy Hormones East, we specialize in providing personalized care that addresses not only the physical symptoms of menopause but the emotional changes as well. Our approach is comprehensive, compassionate, and informed by the latest in hormonal health research.

If you’re tired of battling the Menopause Monster alone, we invite you to reach out. Together, we can explore treatments and strategies tailored to your unique situation, helping you reclaim your balance and embrace this new chapter of life with confidence and joy.

Remember, menopause is not an end but a beginning. With the right support and knowledge, you can tame the Menopause Monster and emerge stronger than ever. To book an appointment with Happy Hormones East and start your journey to balance, visit our website or call us directly.

Your best days are ahead.

If you have topics that you would like to see covered in my column, please email me at Always happy to hear from readers.

Happy Hormones East launches their state-of-the-art website this week, visit us at


Tammy O’Rourke is a Nurse Practitioner with a Ph.D. in Nursing. She spent the first 20 years of her career in primary care. About seven years ago she started having symptoms of several hormonal imbalances, for which her doctor prescribed medications to address anxiety, depression, and sleep issues. These medications left her feeling numb, more tired, and angry at a system that wasn’t addressing the root cause. Tammy was in perimenopause, that 8–10-year period before menopause that leaves women feeling tired, out of control, moody, lacking in self-confidence, and unwell.

She made the move to invest in her health and discovered bio-identical hormone replacement therapy, which helped significantly with her symptoms. So much so that she decided to learn more about hormones. She became certified in the United States through World Link Medical and she has been helping men and women with their hormone problems for more than four years. Tammy is passionate about her hormone practice and continues to help women and men across the country.

She recently relocated to Cape Breton Island with her husband, who grew up in The Pier.


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