Menopause & perimenopause
The “bitch factor” — irritability in perimenopause
by Dixie J. Mills, MD
A good friend of mine called recently to talk about an issue she was having in her relationship. She was in tears, not because of anything her partner had done, but because of her own behavior. Irritable, cranky, crabby, and bitchy were the words she used to describe herself. She felt unhappy and out of sorts because feeling irritable was not her “normal” state and she was embarrassed about it. She’d fallen into a nasty pattern of verbally attacking her partner and nothing seemed to help the situation. She felt guilty and wanted to be able to control her outbursts, but she couldn’t seem to stop herself — what she really wanted was to just be alone!
What’s funny (but not amusing) about my friend’s problem is that she’s not alone, not by a long shot. Irritability and mood swings are unpleasant but common symptoms of perimenopause and hormonal imbalance. And for some women with a history of premenstrual syndrome (PMS), it may become increasingly pronounced over the years.
If this sounds familiar, there are some effective ways to bring yourself back from the edge, especially if you take steps to rebalance your hormones.
Herbal Equilibrium for balance
Our herbal formula is specifically designed for balancing hormones and easing symptoms associated with hormonal imbalance, like irritability. Learn more about Herbal Equilibrium and our Personal Program.
Connecting hormones to crankiness
Certain hormonal fluctuations, such as a drop-off of progesterone levels, both premenstrually as well as in perimenopause, can certainly be linked to heightened irritability. Research suggests that there are brain changes during a woman’s luteal phase (the latter part) of her menstrual cycle that could predispose her to hear fewer positive words during the premenstrual week. In other words, hormonal changes may make you more vulnerable to interpret whatever you’re hearing as more negative, or more likely to be set off by hot-button words, phrases, or events!
The second half of the monthly cycle can also seem “darker” for some women. They may have less energy, less resilience in the face of stress, or react with greater irritability. In addition, chronically high stress and poor nutrition can amplify the effects of changing estrogen and progesterone levels in perimenopause and menopause, as well as the delicate balance-ratio between them.
Many integrative health practitioners see PMS as exposing how a woman feels all the time. She is able to manage her crankiness most of the month, until physiological changes begin to occur just before her period. Like perimenopause, these physiological changes are like a door swinging open on all her pent-up frustration, so it’s suddenly released and able to run wild.
When this happens, try to be kind to yourself and don’t berate yourself. This gentle acceptance can help you carve out a space — an opening to explore your life and, perhaps, what’s not working so well right then. (Hint: Maybe it’s time to pay more attention to YOU.)
The “whiplash effect” of irritability
A small shift in perception can help prevent an outburst
I’ve heard irritability described as “bees buzzing in my head.” When you hear those bees, try to keep yourself from flying off the handle by redirecting your focus. Here are some of my favorite ideas:
- Find a favorite funny image. Envision everyone in their underwear, or picture a Chihuahua wearing a sweater…and maybe a hat too.
- Sing your favorite song. When you feel yourself simmering and about to boil over, sing a song you know well, out loud if possible. The sound vibrations and vocalizing sometimes can “reset” your mood.
- Breathe. Stop whatever you are doing and take 5 deep, measured breaths (5 counts in, 5 counts out) or simply focus on counting your breaths. This really works to help calm you temporarily.
- Go outside right away. The instant change of scenery and fresh air are wonderful tonics for irritability.
- Find a “venting partner.” Make an arrangement with a friend who is also struggling with perimenopausal irritability. (Unfortunately, there should be no shortage of women to choose from!) When you feel unbearably annoyed, call your friend and “vent” for a few minutes. Return the favor whenever necessary.
Many women are surprised that their irritability is often rooted in the physical changes that occur during perimenopause. Even a woman who is normally calm and patient may hit perimenopause and be shocked to find herself morphing into a shrew and furiously questioning the intelligence of an unsuspecting store clerk — perhaps very loudly.
Like my friend, other women tell me that when they snap at family members, co-workers, or even complete strangers, they feel instant regret. Eruptions of crankiness can cause negative fallout — guilt, remorse, and magical thinking when you believe you can rewind the clock and take it all back.
I have to remind women that, in so many ways, the transition from perimenopause to menopause and postmenopause is a journey for rediscovering who you truly are — physically, emotionally, and spiritually. So even if you thought you had your irritability issue licked long ago, here it is again, popping back up during midlife. Your grumbling may actually be bringing an important nugget of truth to the surface where you can understand it better, and then deal with it more directly.
Preventing irritable outbursts — and the aftermath
Okay, so you’ve barked at someone close to you and, in addition to feeling irritable, you feel guilty, too: I feel awful that I told my son he smelled like a sweat sock... he’s just a kid! I am a terrible person, aren’t I? This thought pattern about something you have said will trap you, allowing the whole incident to make you feel embarrassed, ashamed, and powerless. This negative cascade can continue for days, if you don’t put a stop to it. Try not to dwell on this one moment in time and allow it to define you.
Be the lotus
In the practice of yoga, posture is extremely important, partly because it can affect your mood. As an exercise, imagine you are a lotus flower — a symbol of transformation in yoga. Stand straight — but not rigidly — and imagine that your spine is the trailing lotus stem. Carry your head like a lotus flower floating gently atop of your spine. As you breathe deeply, feel the energy and air in your “central column” circulating freely and releasing tension.
When you’ve lost it, try these steps:
- Accept the moment for what it is and let yourself feel angry
- Allow time for cooling off
- Forgive yourself and others
The key is compassion, first of all for yourself, but yes, for anyone else you may have hurt. An apology, along with a short explanation for your crankiness, may help you move forward. If you’re embarrassed by how you acted, say you’re sorry and try to talk about it. You and “your victim” may even be able to laugh about it, but the goal is to move on as quickly as possible.
Staying angry and feeling ashamed by your outburst may give the episode more power over you and your immediate future than serves your best interests. Forgiving yourself, through contemplation, emotional work with a therapist or program, or doing whatever you need to do to fully process your feelings — and especially if you can have a little chuckle as soon as possible — can help rinse away any embarrassment and shame, and allow you to come to a place of peace with where you are in life.
Four steps to reduce hormonal imbalance (and your bad moods!)
Know that your perimenopausal crankiness is likely not a permanent condition. But in the meantime, creating the conditions in your body for achieving hormonal balance can help you feel less irritated in general. Here are some ways to help you do that:
- Good nutrition is vitally important for stable moods, hormonal balance, and to meet the energy demands of your body. A high-quality multivitamin like the one we offer in our Personal Program can help to fill in any nutritional gaps.
- Support hormonal balance through perimenopause with an herbal formula that includes herbs to quell irritability. Our Herbal Equilibrium includes Passionflower, which specifically helps with irritability.
- Regular physical activity, including contemplative practices such as yoga, is a key component for maintaining hormonal and emotional balance. Try to leave time for your favorite type of exercise as often as possible. Exercise can single-handedly bring you out of nuclear hissy-fit mode.
- Don’t forget the soothing powers of sleep and rest — a little catnap can do wonders for your state of mind. Regular sleep (we recommend between 7 and 9 hours per night) is also one of the most important factors in reducing our stress hormone cortisol.
Lighten up with loving, laughing compassion for yourself and those around you
Not only is life a bitch, but it is always having puppies.
- Adrienne Gusoff
Humorist and writer
Most of the women I know in perimenopause have a cranky outburst now and again, and while it doesn’t feel good, it is forgivable. And if you take these events as little lessons, you may be able to speak more clearly about what is really bothering you or what you really want. Acknowledge that it feels really crummy when you bitch at someone, and no, it isn’t so funny at the time. But no matter how bad it might seem then, these moments do pass.
My friend broke her pattern of grumpiness by getting away for a solo mini-break. She came back rested and refreshed and says she’s feeling much better, though she is still in the process of making some important changes. So here’s your homework: contemplate, laugh, learn, forgive — and let go. Then move on with your life, making sure to support the hormonal changes you’re going through. It may take some practice, but trust yourself — you’ll get the hang of it.
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