Mood swings

Perimenopause Mood Swings – How to Stop Feeling Out of Control

I’ve always fancied myself a relatively calm, rational, level-headed woman. My temper has a long, slow fuse, I’m not easily offended and for years I navigated myself peacefully around conflicts as they arose. I was in control of my emotions. Even if someone pissed me off, I was able to take a few breaths, vent to a girlfriend or my husband and get on with life. But when perimenopause hit, my mood swings became out of control. 

Birth control and a whole new set of emotions

There was, however, one period in my mid-20s when this wasn’t the case. A time of my life when out of nowhere I experienced major sudden shifts in mood. In the blink of an eye, I could move from extreme happiness to feeling sad, low mood and persistent irritability and then back to happiness again. Interestingly, these bizarre mood swings coincided with me starting the birth control pill for the first time.

birth control pills can help with perimenopause mood swings.

For a few weeks, I suffered mild depression and had trouble sleeping and sometimes felt these intense shifts in my mind and body that I started to wonder if I might have bipolar disorder.

It was a scary and confusing time because as I was flying high or raging or crying uncontrollably, I was still able to connect with my rational brain and I knew that this wasn’t normal for me. I knew that something in my body or brain was out of whack, I wasn’t in the driver’s seat anymore and felt out of control.

Being a smart, intuitive woman, it took very little time to connect the dots and I just knew my mood swings had something to do with hormonal changes from my birth control pills. I stopped taking the pill cold turkey and within a week I was feeling like my old self. Phew! I never ever want to go through that again!

In control of my hormones

And for decades, I didn’t. I went back to being a calm, cool, collected woman. Of course, I got irritated and sometimes downright angry with my husband, someone at work or the incompetent driver going 90 in the fast lane on the 401 –  I am human after all –  but those were a flash in the pan and I always felt in control.

Losing control again

And then around the time I turned 39, it all changed again. I went back to having these extreme mood swings – emotional ups coupled with extreme sadness and such incredible rage – that were completely out of my control.

Not only that, but rational Michelle was still by my side as the pendulum swung from one outrageous mood to another, whispering in my ear that my behavior was unreasonable, senseless, and bordering on insane.

I panicked. Holy shit! What is even happening right now? I wasn’t on any form of birth control, so this time I couldn’t blame my extreme mood swings on hormone changes. Instead, I found myself wondering if I had actually lost my mind.

Cyclical hormonal patterns

I went to my doctor who helped me to identify that these mood swings were happening in a regular monthly pattern and that they were indeed related to hormonal changes. Phew! That’s a relief, but now what? My doctor’s solutions included birth control (Hell No!) or antidepressants (also not something that felt right for me, although I know it is a great solution for many people).

Instead, I started working with a Naturopathic Doctor and a Mental Health Professional. Together these incredible women helped me to right my course and get my mood swings back under control.

They taught me so many incredible things, but the first and absolutely most important thing I learned was that I was in perimenopause. Peri-what? Menopause? No way. I’m way too young for that. There’s absolutely no way! So my Naturopath very kindly calmed me down and explained it all to me.

What is perimenopause?

She explained that Perimenopause is the time, usually about six to eight years, leading up to the last period. This time leading up to menopause is when we face that long list of potential symptoms all related to fluctuating, and overall dropping, levels of hormones in our body.

Why does menopause cause mood swings?

We identified that my estrogen and progesterone levels were fluctuating throughout the month, resulting in a roller coaster of emotions. My Naturopath explained that as my hormones dropped and surged, so did my moods. Understanding this made me feel better – I wasn’t crazy after all.

What are perimenopause mood swings like?

For me personally, I experienced a range of negative emotions including sadness, anger, fear, anxiety and absolute RAGE!. Some days these emotions would hit out of the blue and other times my mood swings were more cyclical in nature. I was up one moment, down the next.

I was having trouble sleeping, was easily agitated, and had difficulty handling stress. As you can imagine, these symptoms made it challenging to deal with the stresses of daily life, let alone deal with a four year old boy who was constantly testing the waters as he learned about the world.

I still feel a deep sense of guilt when I think about some of my emotional outbursts in response to regular four year old behaviour. There were many times that my temper tantrums were worse than his and many days that my husband would come home from work to find us both inconsolable with tears.

Again, rational Michelle knew that my lovely boy didn’t deserve these crazy, erratic mood swings, but in the heat of a hormone shift, there was just no controlling it.

How to reduce mood swings during perimenopause

Because we’re dealing with wildly fluctuating hormones, this is a complex topic to approach. I don’t pretend to be an expert on this subject, but through my work with a naturopath and therapist, I’ve built a great little toolbox of lifestyle changes, supplements, and coping skills, to help me (and hopefully you) deal with my mood swings. Here’s what I’ve learned:

Lifestyle changes:

  • Keep a regular sleep schedule and make sure you’re getting enough sleep every night (7-9 hours).
  • Move your body, preferably outside in nature – regular exercise helps to regulate cortisol levels, important for so many reasons.
  • Eat a healthy diet of whole foods full of fiber, protein, and fat.
  • Spend time with supportive friends and family – this can do wonders for your emotional state.
  • Take time for yourself each day to relax and do something you enjoy – we all deserve a daily dose of self love.

Mental Health Resources:

  • Make use of in-person or online counseling or therapy services.
  • A therapist can help you to understand how to use tools like talk therapy, a mood journal, or meditation – all great mood stabilizers.
  • Join a support group and if you can’t find one, start the conversation with your friends and sisters. I guarantee that many women are struggling with mood swings and are eager to talk about their experiences.

NOTE: If you suffer from clinical depression, major depressive disorder, or suicidal thoughts, it is important you get help from your healthcare provider or a mental health professional immediately.

Supplements for perimenopause mood swings

There are many nutritional supplements available that are believed to support hormonal shifts that lead to mood swings. Some of the ones that I’ve used include:


helps the body cope with stress and can improve sleep quality.   

Omega-3 fatty acids

like as fish oil, can reduce inflammation and improve mood.

B vitamins

are important for energy production and the regulation of hormones.

Vitamin D

helps with mood regulation, sleep cycles, and energy levels.

Herbal remedies

like ashwagandha, chamomile can help to reduce anxiety and induce relaxation.

NOTE: Always consult a Naturopathic Doctor (ND) before taking supplements. They can have potential adverse reactions or side effects, such as headaches, nausea, dizziness, and more. In some cases, there may be an increased risk of bleeding or clotting in women taking blood thinners. Ask them to recommend a reputable brand, because not all supplements are created equal.

Medications for perimenopause mood swings

Although I didn’t go the route of pharmaceuticals (yet), I know many women who rave about the life-changing effects. Here are a few you might consider:

Menopause Hormone Therapy (MHT)

Also known as Hormone replacement therapy (HRT) – is a common treatment for menopausal symptoms. This treatment of estrogen or estrogen plus progestin help with several perimenopause symptoms, including helping to reduce mood swings.

However, as with any form of medication, there are risks associated with MHT depending on your medical history, so it’s important to speak to your doctor about the benefits and risks so you can make the right decision for you.


Your doctor might also prescribe a low-dose antidepressant or Selective Serotonin Reuptake Inhibitors (SSRIs) that can help with mood shifts by targeting the brain’s serotonin levels.

Birth Control or IUDs

Although definitely NOT for me, they can help to regulate hormones and reduce fluctuations during our unpredictable menstrual cycle which can help to reduce mood swings. They can also help to reduce hot flashes and night sweats and make menstrual bleeding more predictable.

Can perimenopause cause mood swings?

Now you know the answer… hell ya it can! Crazy, explosive, mood swings that can leave many women feeling out of control and questioning their mental health.

Armed with this knowledge, however, I was able to take control back from my hormones and get myself back on track. And you can too. I’m happy to report that all is well now – despite turning fifty in a couple of months.

Become the hero of your own health story

I do admit, however, this thing called perimenopause is a wild ride that many women are not prepared for. It’s so much more than physical symptoms like hot flashes and changes to your menstrual period and it’s more than occasional mood swings. It affects our sleep, our motivation, our alertness, our weight and so much more.

The good news is that, whatever your symptoms, you can take control. Taking time to read our stories is a great first step. Sharing our stories with your friends and sisters and starting a conversation with them is another important step to changing the narrative around menopause.

If you still have questions, are experiencing symptoms, or just want to know what to expect, it’s a good idea to talk with your doctor. Don’t have a doctor? Here’s a great resource to help you find a menopause practitioner* to help guide you through the menopause transition and beyond.

Don’t let your raging hormones take control of your life. You are not going crazy. This is perimenopause. And there are solutions to help get you back in the driver’s seat.


*The North American Menopause Society (NAMS) publishes a list of Certified Menopause Practitioners if you need to find a doctor in your area to help you navigate this period of life.