Menopause rage: why you’re feeling so angry

It’s no secret that hormonal changes during menopause can cause irritability and mood swings – but for many women that doesn't come close to describing the full-blown rage they can feel at this time.

Menopause rage may mean sudden, unexplained bursts of extreme anger that in hindsight seem shocking and leave you asking ‘where did that come from?’

On the other hand, the trigger for your anger may be justified but you may feel you would previously have been able to keep your feelings ‘under control’.

Either way, it can be incredibly disconcerting, with some women reporting associated fear, shame or a sense that ‘I don’t feel like myself’.

If you’re experiencing regular menopause rage, it’s important to know that there are reasons for it, that it generally improves, and that there are treatments that can help in the meantime.

What causes menopause rage?

This time of life can be more stressful than ever. Many women are juggling increased job pressure, bringing up children and perhaps also having to care for ageing parents. It would be no surprise if that contributed to feeling on edge and reacting more aggressively to certain situations.

But there’s a lot more to menopause anger than simply increased stress. Changing levels of reproductive hormones like oestrogen are the defining factor in what most women experience as menopause rage. It’s these hormonal shifts that can make you feel ‘out of control’ and as if you don’t recognise yourself.

Menopausal rage is particularly common during perimenopause, the time leading up to menopause when your hormone levels are in the greatest state of flux. Combined with increased stress, this can create a perfect storm for anger and rage.

In fact, clinical studies looking specifically at this have shown that the more your oestrogen levels fluctuate, the more anger and hostility you’ll tend to feel in response to stressful events.

The good news – backed by a study from The Menopause Society – is that as you enter the later stages of the menopause transition, you're likely to see reduced anger levels and get better at managing those feelings.

That’s not to say that postmenopausal women don’t experience hormonal rage – in some situations, stable but low levels of oestrogen at this time can also play a part in bursts of anger.

To understand all of these impacts better, let’s look at the effects that changing oestrogen levels can have on hormones that influence your mood.

Cortisol

Known as the ‘stress hormone’, cortisol triggers physiological changes in your body that produce a ‘fight-or-flight’ response – with anger and aggression being the ‘fight’ side of that equation.

Research has found that spikes in oestrogen during perimenopause predict both increases in cortisol levels and in emotional responses like anger.

Serotonin

Changing levels of the ‘feel-good’ hormone serotonin influence areas of your brain involved in aggression and anger.

Studies have shown that dips in oestrogen can lower your levels of serotonin, as well as reducing its effectiveness and how long it remains in your brain.

Insulin

Oestrogen helps maintain your sensitivity to insulin, the hormone that keeps your blood sugar levels stable. As you approach menopause, and oestrogen levels start to settle at a lower point, your blood sugar control gets worse. This increases the chance of more extreme blood sugar spikes and ‘crashes’ in the hours after you eat.

These blood sugar crashes – known medically as reactive hypoglycaemia – can in turn lead to mood swings. If you notice that you’re prone to ‘hangry’ reactions a few hours after eating – such as mid-morning or mid-afternoon – this could be why.

The good news is, adjusting your diet may help with this. We’ll look at this later in the article.

Menopause and anger towards your husband or partner

If you’re experiencing menopause anger, it’s not uncommon for your husband or partner to be the main focus of these feelings.

For some women, this anger is justified – they feel they’ve simply reached their limit when it comes to what they view as their husband’s unreasonable behaviours.

Others may verbally attack their husband in a burst of rage but later regret the things they’ve said to someone they generally feel is a kind and supportive partner.

There are many reasons why your husband can be the main focus of your anger:

• As someone you feel safe and comfortable with, your husband can be the person you’re most willing to be emotionally open with – and that can include sharing feelings of anger.
• That same closeness can mean you expect them of all people to empathise with what you’re going through – if that’s not the case, it can be particularly hurtful or aggravating.
• Since you live together in close proximity, your husband is one of the people you see most often and whose own habits and behaviours are most likely to affect you.
• It can feel unfair if your husband seems less affected than you by getting older – especially since they don’t have to deal with the many potential symptoms of the menopause transition.

If you feel menopause is having a negative impact on your relationship and would like help to improve things, there are therapists who specialise in couples counselling in this area.

How long does menopause rage last?

As we’ve seen, menopause rage is most common during perimenopause and is closely related to the hormonal fluctuations that happen during this time.

Although the timing and length of perimenopause can vary significantly from woman to woman, it generally begins in your 40s or 50s and continues for around 4 to 8 years.

Thankfully, that doesn’t mean you’ll experience menopause anger all this time, or to the same degree. Symptoms like this tend to peak during the early stages of perimenopause when hormone levels are fluctuating most widely and will generally start to improve and even disappear as the menopause transition continues.

Ways to treat menopause rage

HRT, lifestyle changes and mindfulness practices could all help you manage your anger while your hormones are in a state of flux.

Hormone replacement therapy (HRT)

Hormone replacement therapy helps to balance levels of reproductive hormones like oestrogen and progesterone during the menopause transition. It can be an effective treatment for perimenopause symptoms including mood swings and anger.

There are different ways to take HRT – tablets, gels or patches – as well as different combinations of hormones, and different timings. Your GP can help you find a method and treatment cycle that works best for you.

Choosing the right foods

If your anger or mood swings tend to happen two to four hours after you’ve eaten, blood sugar dips, known as reactive hypoglycaemia, may be a contributing factor.

These severe dips or crashes happen following initial spikes in your blood sugar, and are more likely after you eat foods that are high in easily accessible carbohydrates. That means white bread, rice or pasta, potatoes, sugary drinks – including fruit juices – breakfast cereals, biscuits, cakes and sweets.

As well as anger, you may also experience low energy, anxiety or dizziness, and have cravings for more sweet foods.

Try swapping refined white carbs for wholegrain versions – or, even better, replacing them with beans, vegetables or healthy proteins like fish, eggs or plain yoghurt. Trade sugary snacks for whole fruit, nuts or high-cocoa dark chocolate.

These alternatives release energy more gradually, keeping your blood sugar levels stable.

Other things that may help

• Regular exercise: Studies have shown that regular aerobic exercise like brisk walking, running, cycling or swimming can significantly reduce irritability and mood swings in menopausal women.
• Improved sleep routine: Poor sleep can lead to increased stress and irritability. These tips for improving your bedtime routine could increase your chances of getting a good night’s sleep.
• Probiotics: The strains of friendly bacteria found in Better Gut probiotics help maintain the balance of your gut estrobolome, which processes oestrogen. They’ve been shown to improve menopause symptoms including mood swings and poor sleep.
• Cognitive behavioural therapy (CBT): The Menopause Charity says the talking therapy CBT can help with mood swings and anger. You may be able to get CBT on the NHS.
• Mindfulness: Mindfulness practices like meditation, breathing exercises and yoga can improve emotional balance and reduce levels of the stress hormone cortisol.

Summary

Changing oestrogen levels during the menopause transition can contribute to increased feelings of rage, in part due to the effects oestrogen has on mood-regulating hormones like cortisol and serotonin.

Bursts of rage or anger in response to stressful situations are particularly common during the early stages of perimenopause, when oestrogen levels are fluctuating most widely. These symptoms tend to become less severe as you approach menopause.

Hormone replacement therapy can be an effective treatment for menopausal mood swings and anger.

Low oestrogen later in the menopause transition can increase your risk of blood sugar crashes after you eat – known as reactive hypoglycaemia – which is another cause of severe mood swings for some women.

You can reduce these responses by swapping refined carbohydrates for foods higher in fibre and protein.