Perimenopause rage: what causes it and how to manage it

Eileen Durward
Ask Eileen

01 August 2022

Today's topic

Today on A.Vogel Talks Menopause, I take a closer look at an often distressing perimenopause symptom – rage.
Feelings of rage and anger can often arise during perimenopause, as well as menopause. It can appear just suddenly out of the blue. You can go totally out of control and then afterwards, you think, "Oh my goodness, what have I done?" The embarrassment and everything else that goes with it can cause a lot of emotional distress, both to you and those around you.
So today, I thought I'd look at the causes and what you can do to try and help yourself.

What causes rage during perimenopause?

This is such an interesting subject and one I find fascinating, but first I need to explain why it can happen. Once you understand this it makes it much easier to accept it as part and parcel or a phase as you go through perimenopause and menopause.

So, we have a gland in the brain called the amygdala, which stores our perceptions and feelings of anger, fear, and sadness. It helps us to control our aggression. It also stores memories of events and emotions that have happened in the past to prepare a response should this same dangerous or awful situation happen again.

During perimenopause and menopause as your oestrogen starts to fluctuate and fall, the control of this gland decreases. It's like a Pandora's Box. Suddenly, it opens up and all these emotions come surging out, and you respond to situations of anger, sadness, and aggression, much quicker and to a much greater degree than you would normally.

The other thing that happens here is that your serotonin can be impacted by falling oestrogen too. Serotonin is a chemical in your brain that helps to keep your mood up. It helps to keep you happy and helps to regulate your emotions. Very often as oestrogen falls, the level of this hormone can decrease too.
So here you are in a situation where you can no longer control your emotions as much as before and your emotions are being released much more quickly. And also, because you've got less serotonin, you are less happy, and your moods can swing quickly.

You can experience a few different types of rage scenarios such as:

Drastic mood swings

You can experience drastic shifts in your mood. You can be low one minute, and then the next minute, anger just surges out of you.

Sudden rage outburst / uncontrollable rage

As I mentioned before, you could be all right one minute and the next minute, you have a sudden outburst of anger towards something or someone

What can also happen, is that emotions experienced in the past can resurface and make your irritation or anger worse. So say, for instance, something happened many, many years ago, maybe somebody upset you. They hurt you verbally. That response is stored in the amygdala. So, when somebody maybe today then says those same words but maybe doesn't mean them in the same way, such as your partner, or your work colleague, or your friend saying to you, "Oh, don't be silly," your brain refers back to that first instance where you were really angry or hurt. You then respond in the same way as how you did in the past, to what's happening in the present, even though it may not have anywhere near the same impact on you or cause the same amount of anger or irritation.

More easily irritated and less patient

You can also become more easily irritated. You can become a lot less patient. You just maybe can't stand people anymore or your tolerance levels are a lot lower than they used to be. You just don't want to be in the same room or the same space as people that you used to be quite happy with.

Other causes/triggers

They can also be other triggers too. Stress, which is a common perimenopause and menopause symptom, can not only cause you to feel more angry and irritated, but it can also make you have less emotional control, leading to increased feelings of anger and rage.

Lack of sleep, which is another common perimenopause and menopause symptom, can also worsen feelings of anger and troubling emotions.

It can also be dehydration and low blood sugars. With these two very often, you may find you experience the same emotions at the same time every day. That's usually a good clue that it's either dehydration or low blood sugar levels causing your rage.

Does this rage continue during menopause and postmenopause?

This is usually a phase. It's just the imbalance between your hormones and maybe your serotonin levels. So, as you go through menopause, as your body learns to adjust, you should find that this phase tails off and disappears.

However, it also depends on all the other triggers I mentioned above such as poor sleep and stress. If these are not resolved, then these feelings could continue longer-term.

What can help manage your perimenopausal rage?

Some simple self-care, lifestyle changes and supplements can help. Here are a few things that I recommend:

Go back to basics: First and foremost, you need to maintain good, basic emotional health and physical stability. You need to address any stress, sort out your sleep problems and make sure you are drinking plenty of water and eating well to avoid the triggers I mention above.

I regularly recommend some simple habits that can make a big difference to your menopause – essentially these are the basics that every menopausal woman should follow. Read my blog 6 good habits every menopausal woman needs to have, to learn all about these and how to adopt them.

Don't suppress it: As women, we like to think we're in control of our emotions. But, if you're in this phase and you try to suppress your feelings, they can build up because that little gland in your brain (the amygdala) is going to continually worry about what's going on. And if you keep suppressing all these irritations and actions from other people or situations that you're in, then it's just going to make it worse at the end of the day.

What you need to do, and I know it's really difficult, is speak and discuss this with family, friends, colleagues, or whoever this is affecting because they haven't a clue what's going on. They might not know that you're in perimenopause. They may not know what's happening to you physically or emotionally. All they are seeing is someone who used to be calm and collected suddenly going off the deep end, and they're seeing somebody that they don't know anymore.
Very often, just talking about it, and explaining that it's your hormones, it's not you and that this is a real physical situation that's going on in your body, can help.

Remember, it's not in your head. You're not going loopy. You're not going out of control. This is a real physical and emotional response to all the hormones that are changing in your body.

Also, don't feel guilty because again, if you start to feel guilty, you are going to put extra pressure on yourself, which is the one thing you don't need at this moment in time.

Find a way to let it out: Exercise is a great way to work out your anger. Things like boxercise, maybe contact sports, or even just getting a tennis racket and a tennis ball and whacking it against the back wall for half an hour can be good. Anything that's going to help to get your aggression and your irritation out of your system is worth it. And exercise also produces feel-good and happy chemicals as well, so it helps boost your mood too.

A helpful herb: If you're looking for herbs, one of the best herbs for low serotonin levels is the herb Hypericum (also known as St. John's Wort). But you do need to make sure that you're not on any prescribed medication, and that would include HRT and any contraceptives that you may be on.

Supportive supplements and therapies: You can look at a magnesium supplement to help to stabilise your nervous system. A good mid-strength vitamin B complex can also be helpful.

Therapies that can be very useful would be things like acupuncture and also Cognitive Behavioral Therapy (CBT).

You can look at the flower essences. I love the flower essences because they work on the emotional side rather than the physical side. So, for this particular situation, I would recommend either Mood Essence, Relaxing Essence, or Female Essence.

When do you need to see your doctor?

If you feel that your rage is getting out of control, if you feel that you are now physically lashing out at people, then you should consider speaking with your doctor about this. I've had women come back and tell me that this is the stage that they have got to which is extremely distressing for them.

If you go to the doctor, they may prescribe antidepressants or medication to help control your mood, but from feedback that we've had from women, very often these may not help because they don't address the hormonal cause.

If you are on HRT and you're having problems controlling your rage, speak to your doctor about swapping brands.

If your periods are tailing off or have stopped, you could look at our Menopause Support tablets for some extra support during perimenopause and menopause.

So, I hope you found this one interesting. If any of you out there have experienced this, what have you done to help yourself? How have you resolved it? Please share your stories with us. They're so helpful for other women going through this.

Until next week, take care.

You may also find these topics helpful:

4 surprising emotional symptoms of menopause

The Mentalpause

5 simple menopausal mood-boosters

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