Causes, Symptoms & What Helps
Low Mood In Menopause

Low mood is one of the most common, yet least talked about, symptoms during perimenopause and menopause. Many women describe it not as a single episode of sadness but as a background heaviness – like carrying an invisible weight through the day. Understanding why this happens is the first step in finding relief.

What peri-menopause and menopause really mean for your body

• Peri-menopause is the transitional stage before periods stop, usually starting in the mid-40s (though it can begin earlier). Hormone levels fluctuate unpredictably.

• Menopause is diagnosed when periods have stopped for 12 consecutive months, with the average age in the UK being 51.

These stages are natural, but the hormonal shifts can influence both physical and emotional wellbeing.

How hormones shape mood changes

• Oestrogen plays a key role in regulating serotonin and dopamine – the brain’s “feel-good” chemicals.

• When oestrogen levels fall, mood regulation becomes less stable, leading to irritability, anxiety, or tearfulness.

• Progesterone, often called the “calming hormone,” also declines, which can affect sleep and amplify emotional stress.

Spotting the difference: low mood vs clinical depression

• Low mood often feels like lack of motivation, energy dips, or irritability that comes and goes with hormonal shifts.

• Depression is more persistent, with symptoms such as hopelessness, loss of interest in activities, or significant changes in appetite and sleep.

If mood changes are intense or long-lasting, it’s important to seek advice from a GP or menopause specialist.

Even knowing the biology, it can feel overwhelming – like the fogged-up bus window on a rainy morning, where you can just make out the outline of the road but none of the detail. The good news is that low mood during menopause is not inevitable or permanent, and with the right support, most women find it manageable.

Mood changes during menopause rarely travel alone. They’re often tied up with physical shifts that make everything feel more intense. Many women are surprised by how strongly the emotional and physical overlap, sometimes in ways that don’t seem obvious until you step back and connect the dots.

Common patterns in mood and anxiety

• Irritability and sudden frustration, often triggered by small things that previously wouldn’t have mattered.

• Tearfulness or a sense of emotional fragility, like being “closer to the surface” than before.

• Heightened anxiety, sometimes appearing as restlessness, racing thoughts, or a sense of impending worry.

Sleep disruption and its impact on mental health

• Night sweats and hot flushes often wake women in the early hours, leaving them drained the next day.

• Even without sweats, many report insomnia or restless nights – lying awake, staring at the ceiling while the clock ticks louder than usual.

• Poor sleep directly affects mood, creating a cycle where tiredness feeds irritability and anxiety.

Cognitive changes and self-confidence

• Brain fog: forgetting words mid-sentence or walking into a room and wondering why you’re there.

• Short-term memory lapses that can feel unnerving in professional settings.

• These changes can chip away at self-esteem, leading to self-doubt at work or in relationships.

The combination of mood swings, sleep issues, and brain fog can leave women wondering if they’re “losing themselves.” But recognising the connection between hormones, body, and mind is the first step toward breaking the cycle.

When low mood starts interfering with daily life, many women want to know what proven, evidence-based options are available. The reassuring news is that there are several medical and therapeutic approaches that can make a meaningful difference – and most are well-supported by clinical research and NHS guidelines.

Hormone Replacement Therapy (HRT) for mood support

• HRT helps restore declining oestrogen levels, which can improve mood by stabilising serotonin and other brain chemicals.

• Options include tablets, patches, gels, or sprays – chosen based on individual health history and preferences.

• Research from NICE and the British Menopause Society shows HRT can be effective for low mood when symptoms are linked to hormonal changes.

Anti-depressants and when they may be considered

• Selective serotonin re-uptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs) can be prescribed if mood symptoms meet criteria for clinical depression.

• These may also help with hot flushes and sleep issues in some cases.

• They are usually offered when HRT is unsuitable or when depression exists independently of hormonal shifts.

Talking therapies, including CBT

• Cognitive behavioural therapy (CBT) has strong evidence for helping women manage anxiety, low mood, and intrusive thought patterns.

• Therapy provides tools for reframing unhelpful thinking and building coping strategies that last beyond the menopause transition.

• Available on the NHS or privately, CBT is increasingly recommended as part of a holistic menopause care plan.

Treatment is never one-size-fits-all. Some women find relief with HRT, others benefit from therapy, and many combine different approaches to achieve the best outcome. The important step is to start a conversation with a trusted GP or menopause specialist, rather than struggling in silence.

Medical treatments are only one part of the picture. Many women find that small, consistent changes in daily habits can significantly ease low mood and restore a sense of balance. These strategies don’t replace medical care, but they often complement it beautifully – giving you more control over how you feel day to day.

Exercise as a natural mood stabiliser

• Regular movement boosts endorphins, the body’s natural mood enhancers.

• Activities like brisk walking, swimming, or yoga can also reduce stress and support better sleep.

• Even ten minutes of stretching in the morning can shift energy levels, like opening the curtains on a grey day and letting light in.

Nutrition that supports hormonal balance

• Omega-3 rich foods (salmon, walnuts, flaxseed) are linked to better brain health.

• Phytoestrogens in soy, chickpeas, and flax may gently mimic oestrogen’s effects.

• Reducing alcohol and caffeine can improve both mood stability and sleep quality.

Better sleep hygiene for calmer nights

• Keep the bedroom cool, dark, and tech-free to encourage deeper rest.

• Going to bed and waking at consistent times helps reset body rhythms.

• A warm shower before bed can signal to your body it’s time to wind down – almost like dimming the lights in a theatre before the show starts.

Stress management techniques that fit real life

• Short mindfulness exercises or breathing drills can calm the nervous system in minutes.

• Journaling before bed can ease mental clutter and reduce middle-of-the-night wakeups.

• The key is consistency, not perfection – even small practices repeated regularly build resilience.

Lifestyle strategies may sound simple, but over time they create a strong foundation for both mental and physical wellbeing. They’re also empowering: things you can do right now, without waiting for an appointment or prescription.

For some women, curiosity naturally extends beyond medical and lifestyle changes into complementary therapies. While the evidence base is mixed, many report that these approaches bring comfort, relaxation, and an added sense of control during a time that can otherwise feel unpredictable.

Herbal and natural remedies that may help mood

• St John’s Wort has been studied for mild to moderate depression, but it can interact with common medications, including HRT and the contraceptive pill – so always check with a GP first.

• Black cohosh and red clover are popular for hot flushes, and some women find they indirectly improve sleep and mood.

• Magnesium supplements may support relaxation and ease anxiety symptoms in certain cases.

Acupuncture, massage, and mindfulness practices

• Acupuncture has some promising evidence for reducing hot flushes and improving sleep, though results vary.

• Massage therapy can lower stress hormones and encourage better rest – many women describe it as a reset button for both body and mind.

• Mindfulness and meditation, even in short daily practices, can improve emotional resilience by calming the nervous system.

Safety and realistic expectations

• Complementary therapies are not regulated as tightly as prescription treatments, so quality and safety can differ.

• What works for one woman may not work for another, so an open, experimental mindset is helpful.

• Always combine these approaches with medical advice rather than using them as stand-alone replacements for proven treatments.

Think of these therapies as supportive extras – the soft throw blanket on top of your bedding. They won’t replace the structure of medical or lifestyle foundations, but they may add warmth and comfort to the overall picture.

Menopause has traditionally been something women endured quietly, but that silence often makes the emotional toll worse. Low mood feels heavier when you’re carrying it alone, and support from others can be as important as medical treatment. Opening up – whether at home, with friends, or in the workplace – can help shift the experience from isolating to manageable.

Talking with partners, friends, and family

• Explaining mood changes honestly helps others understand it’s not “just stress” or a bad day.

• Using everyday comparisons (“it feels like constant jet lag” or “like I’m wearing a heavy coat I can’t take off”) can make the experience more relatable.

• If conversations are difficult, written notes or shared articles can be a gentle starting point.

Menopause in the workplace

• Surveys show nearly 6 in 10 women say menopause affects their work, often through concentration problems, fatigue, or confidence dips.

• UK employers are increasingly adopting menopause-friendly policies, offering adjustments like flexible hours, temperature control, or quiet spaces.

• Line managers may not always know what support is needed, so starting the conversation can pave the way for practical changes.

Why solidarity matters

• Sharing experiences reduces shame and highlights that low mood during menopause is common, not a personal failing.

• Peer groups, both in person and online, provide validation and coping strategies from women going through the same stage.

• Knowing you’re not the only one can transform how manageable the challenges feel.

Support systems won’t erase symptoms, but they make them lighter to carry. Much like leaning against a friend’s shoulder on a crowded bus, the journey feels less overwhelming when it’s not yours alone.

Menopause can feel like a long stretch of uncertainty, but it’s also a stage that can be managed with the right mix of medical support, lifestyle adjustments, and social understanding. The aim isn’t to “get through it” silently but to create a toolkit that helps you feel steady, confident, and more yourself again.

Knowing when to seek professional help

• Persistent low mood, loss of interest in activities, or feelings of hopelessness may signal clinical depression rather than temporary hormone-related dips.

• If thoughts of self-harm or suicidal feelings ever arise, urgent medical help should be sought immediately – this is never “just menopause.”

• GPs and menopause specialists can help assess whether HRT, antidepressants, or a referral for therapy would be appropriate.

Building a personalised toolkit

• Combine medical care (such as HRT or therapy) with daily strategies like exercise, better sleep routines, and balanced nutrition.

• Lean on social support – whether a friend, colleague, or online community – to make the journey less isolating.

• Keep track of symptoms in a journal or app to notice patterns and measure progress.

Moving forward is less about “fixing” everything at once and more about layering small, sustainable supports. Think of it like gradually adding cushions to a hard wooden chair – each one makes the seat more bearable until you can finally sit in comfort again.

Menopause and peri-menopause can feel like unfamiliar terrain, especially when low mood and anxiety appear alongside physical changes. But understanding the role of hormones, recognising the connection between body and mind, and knowing what support is available can transform the experience from something endured in silence to something managed with confidence.

What matters most is choice. For some women, that may mean medical treatments like HRT or CBT; for others, it could be small but powerful lifestyle shifts, from better sleep routines to daily movement. And for many, it’s a blend of approaches – supported by open conversations with friends, family, and employers – that makes the biggest difference.

If you’ve recognised yourself in these words, consider taking the next gentle step. That might be booking a consultation with a trusted specialist, downloading a resource to trial at home, or simply sharing what you’ve read with someone close. Whichever path you choose, remember: this stage does not define you, and support is closer than it often feels.