Do hormones cause anger and rage?

This is a time when hormones are shifting—which can create an array of symptoms. Almost 70% of women report irritability during the early stages of perimenopause, says Donna Klassen, LCSW, Co-Founder, Let’s Talk Menopause, a nonprofit that demystifies menopause anger.

“Serotonin, a neurotransmitter that helps regulate mood and impulse control, drops as estrogen declines, resulting in increased anxiety and decreased ability to curb your compulsions. Progesterone, the calming hormone, also begins to dissipate in perimenopause,” she says. “Add to this the fact that more than 50% of perimenopausal women experience significant sleep issues. It’s the perfect storm of feeling at one’s wit's end.”

That lack of sleep doesn’t help. “Declining or fluctuating estrogen can cause sleep disturbance, which definitely leads to irritability,” explains Sheryl A. Kingsberg, PhD, a psychologist, professor at Case Western Reserve University School of Medicine, and chief of the OBGYN Division of Behavioral Medicine at University Hospitals Cleveland Medical Center.

"You’re losing the natural hormonal filter that you normally have. Some things you may say in conversation at work, or at home to people that you really care about, come out a little bit quicker than you might of anticipated— and that is part of this transition, says Kourtney Sims, M.D., a board-certified integrative gynecologist based in Houston, TX, certified member of the North American Menopause Society, and Phenology’s Chief Medical Advisor.

That’s something Lekeisha, 49, of West Palm Beach, can relate to. “Since the change started, I have been that person who is up in the middle of the night for a while. I have given up trying to go back to sleep. I put on Netflix and go with it,” she explains. “But my patience is just not there anymore. I flare at my family, coworkers, and complete strangers over minor things. Like my Starbucks order taking too long. It’s like, ‘Who even am I anymore?’”

What other menopause symptoms contribute to anger?

Insomnia is, as perimenopause issues go, a biggie, but other issues add to the situation. Vasomotor symptoms (hot flashes and night sweats) and mild cognitive changes (temporary brain fog, short term memory/word recall) also cause impatience and annoyance,” explains Dr. Kingsberg, PhD.

When you are dealing with these symptoms, you may be quick to anger, feel easily overwhelmed, or weepy. “It can be extremely frustrating to not be able to control your emotions,” says Klassen. “Making a tough time worse, is that women also feel ashamed and guilty, compounding the distress. And we so often hear that women feel alone during the menopause transition, that they did not feel adequately informed or prepared (unlike with pregnancy when women are amply supplied with books and resources to know what to expect at every step).”

"When you notice that it’s kind of getting a little out of control, it’s gone too far, usually if you do a self-temperature check and ask yourself, ‘How am I doing in those arenas? Am I taking enough time for myself? Am I getting enough rest? Have I gone to my doctor to talk about what’s going on? Have I tried to avail myself of solutions? Am I making space for this transition in my life?’" says Dr. Kourtney. "If you’re not checking those boxes, often times you’ll notice that symptoms are worse."