Low mood is a common yet little-discussed menopause symptom that can cause havoc in your daily life. Feeling down can mess with your relationships, your performance at work or make getting through the day’s tasks more difficult. It also makes physical menopause symptoms trickier to manage. Read on to find out more about the hormonal changes behind low mood, and the treatments available.
What is low mood?
A low mood can feel slightly different for everyone. It can also affect how you think and act. Common symptoms are:
- Feeling low or sad
- Having low energy
- Feeling crabby or easily irritated
- Lacking motivation
- Being tearful
- Finding it hard to enjoy things you used to love
- Poor sleep
- Eating more or eating less
While these feelings and emotions are a normal part of life, it’s important to keep tabs on them and get help when you need it.
What is the difference between depression and low mood?
It can be a fine line between low mood and depression, and it’s often tricky to decide where one ends and the other begins. The symptoms can be very similar.
In general, low mood is less severe than depression. Low mood may come and go, or may be more easily relieved.
In contrast, the symptoms of depression tend to be worse and harder to shift. Perhaps you feel like there is a dark cloud around you at all times. Maybe you can’t enjoy your successes or passions like you used to. With depression, your mood remains low no matter what you do to cheer yourself up. Thoughts of suicide and self-harm might also creep into the picture if you have depression, rather than just low mood.
Getting help
If you suspect you may be depressed, talk to someone as soon as possible, if you haven’t already. This is particularly important if you have thoughts of harming yourself or others.
How to get help:
- Contact your doctor or NHS 111
- Samaritans Helpline, available 24/7 – call 116123
- Mind
Why does low mood happen at menopause?
Low mood can happen at any age, but hormonal changes during menopause mean that it is more common.
Hormonal changes
Oestrogen levels decrease significantly during menopause. This affects your mood and mental health because your brain and nervous system use oestrogen in several ways.
Oestrogen is thought to protect against depression. It helps neurotransmitters in the brain, such as serotonin and dopamine, work properly. These neurotransmitters help balance your mood, emotions and behaviour.
Life changes
Hormonal changes are not the only reason many people feel low during menopause. Menopause happens at a difficult time of life. It can be hard to balance finances, work pressures, relationships, family transitions and responsibilities caring for family or friends. Any of these or a combination can trigger low mood.
Mixed emotions
For some, menopause can signal a fresh start and new opportunities. For others, it can be a challenge. Menopause can take an emotional toll and make you feel like you’ve lost a part of yourself. Everyone will grapple with menopause in different ways, and acknowledging why you are feeling a certain way is an essential part of managing your low mood.
How to treat low mood at menopause
There are a few ways to treat low mood during menopause. You can try one option at a time or a combination of the following methods. We always recommend trying to improve your lifestyle habits alongside medication or therapy.
Lifestyle change
A broad, balanced approach is the best way to tackle low mood at menopause. A mood-boosting lifestyle includes:
- Drinking less alcohol
- Avoiding recreational drugs
- Having caffeine in moderation
- Getting some exercise
- Improving your sleep routine
- Eating a balanced diet, with less processed foods and more whole foods
Therapy
Lifestyle change is not easy, and it doesn’t always make a difference quickly enough.
Cognitive behavioural therapy (CBT) is also currently recommended for low mood associated with menopause. You can speak to your doctor for advice on how to access this in your area.
General health treatment
Talk to a doctor about any long-term illnesses or discomfort you have as they can affect your mental health. This includes treating menopause symptoms like hot flushes, night sweats and poor sleep, all of which can be relieved by hormone replacement therapy (HRT) in most cases.
Read more about the benefits and risks of HRT.
Medication
Doctors don’t generally prescribe antidepressants for low mood. Antidepressants, such as fluoxetine, sertraline and citalopram, are widely used and generally work well for depression, but we don’t yet have any evidence that they work for less severe symptoms like having low mood alone.
Can HRT help?
Hormone replacement therapy (HRT) is the most effective treatment for many menopause symptoms. It is a great option if your mental health is being affected by hot flushes and night sweats, disturbed sleep or vaginal and urinary symptoms.
HRT is also recommended by NICE as a possible treatment for low mood caused by menopause.
HRT isn’t suitable for everyone. There are non-hormonal treatments available if you can’t or prefer not to take HRT.
When should you see a doctor?
When low mood hangs over you for longer than is normal for you, it can be worrying, but there are lots of different treatments available. See a doctor if your low mood is troubling you, or if it’s causing problems in other ways, for example, at work or in your home life.
You should also seek help if you think you might have depression. Depression can make it feel impossible at times, but your doctor will help you get the treatment you need.
Getting help
If you suspect you may be depressed, talk to someone as soon as possible, if you haven’t already. This is particularly important if you have feelings of harming yourself.
How to get help:
- Contact your doctor or NHS 111
- Samaritans Helpline, available 24/7 – call 116123
- Mind
Final word
Low mood is unfortunately part of menopause for many people, but don’t put up with it if it’s causing problems. Speak to your doctor for advice on the best treatments for your personal circumstances.
Find out more about menopause on our blog or in our symptoms library.
- National Institute for Health and Care Excellence 2019, ‘Menopause: diagnosis and management’ [NICE Guideline 23]
- Herson M, Kulkarni J 2022, ‘Hormonal agents for the treatment of depression associated with the menopause’, Drugs & Aging, vol. 39, no. 8, pp. 607–618
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