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Ask an expert: what is menopause rage and how can I beat it?

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Written byAmy Bonifas

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Reviewed byDr Emma Ross

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From helping to identify your triggers to realistic coping mechanisms, women's health expert Dr Emma Ross shares her advice for managing menopausal rage and anger

Summary

1What is menopause rage?

Anger, rage or increased irritability are common symptoms during perimenopause and menopause, according to Dr Emma...

2Why can it happen?

For those who have experienced the menstrual cycle, a little anger and irritability might be nothing new...

3Chaotically changing hormones

During perimenopause, your hormones – particularly oestrogen and progesterone – start to fluctuate...

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We all lose our temper at times. But if you’ve been feeling angrier than usual or exploding at your partner, friends or colleagues in a way that doesn’t feel like ‘you’, there might be more to it.

Increased anger, irritability and – yes – that deep inner rage are all potential signs of perimenopause, thanks to your body’s changing hormones.

Here, we ask women’s health expert, scientist and co-founder of The Well HQ, Dr Emma Ross, how to tell the difference between standard anger and menopause-driven rage, as well as her tips for feeling more in control.

What is menopause rage?

Anger, rage or increased irritability are common symptoms during perimenopause and menopause, according to Dr Emma. “It’s often one of the first symptoms of perimenopause, where you might go from feeling calm to experiencing moments of uncontrollable anger.” 

"You might feel like you’re not in control of your emotions"

Unlike low-level stress, frustration or anxiety, menopause rage tends to be a sharp burst of intense anger. “Some people describe it like a red mist, where you can’t keep it in or you can’t stop yourself from reacting that way,” explains Dr Emma. You might not feel like yourself or like you’re not as in control of your emotions,” she explains.

Why can it happen? What’s going on inside your body?

For those who have experienced the menstrual cycle, a little anger and irritability might be nothing new. “One of the characteristic symptoms of the premenstrual phase (right before your period) can be mood swings,” says Dr Emma.

“And if you think back to puberty, changing moods and feeling angry can be a defining feature of that phase of life, too,” she continues. When you reach menopause, it’s another time of changing hormones as they deviate away from an established, predictable rhythm and become more up and down.

Three potential reasons for ‘menopause rage’

  1. Chaotically changing hormones
    During perimenopause, your hormones – particularly oestrogen and progesterone – start to fluctuate. “Oestrogen can affect serotonin, your ‘good-mood’ hormone, while progesterone is an ‘anti-anxiety’ hormone,” she says. “So, if you have these two hormones fluctuating in your system, this can trigger that switch from feeling fine to feeling really short-tempered.” 
  2. Overall hormonal decline
    “In the background, your overall hormone levels begin lowering,” explains Dr Emma. “You start to lose progesterone quickly, as not all of your cycles will be ovulatory anymore. We know that progesterone has a role in stabilising mood and other functions like blood sugar levels, so it has this compound effect and can cause more mood changes.” 
  3. The stress of (early) mid-life
    During perimenopause, symptoms are often intensified by life's demands, creating a perfect storm of stress and hormonal changes. "You might be juggling peak career responsibilities, financial commitments, or family care, all while carrying a lot of the mental load,” says Dr Emma. This stress, combined with perimenopausal physiology, can trigger mood swings and rage, too.

How do I know if it’s menopause rage or just general anger?

Menopause rage usually feels different to anger or irritations you’ve felt before. To determine whether rage is a sign that you’re entering this stage, take stock of how you’re doing overall.

"What's going on with your menstrual cycle? Is it shorter, longer, heavier, lighter?"

“Think about your age – perimenopause often begins around 40 but it can start earlier (in your 30s) – any other symptoms you might be experiencing. In particular, look at what’s happening in your menstrual cycle, as this is usually one of the first signs. Has it become less regular or shortened? And are your periods heavier or lighter?” says Dr Emma.

There are a few other potential causes of rage, like Premenstrual Dysphoric Disorder (PMDD) or mental health issues like anxiety. “It’s important to have a check-in with yourself rather than just blaming it on menopause,” says Dr Emma. “Your GP is a good first port of call to help you figure things out.” A therapist could also help you get an objective view on your thoughts and feelings.
Lady taking a breather on coral background

What can you do to calm down when rage hits?

Most of the time, the rage build-up can be unpredictable, so it can be hard to manage. “You can’t take away the peaks and troughs of your hormones, but people often find that menopausal rage gets worse when other areas or moments of their life feel unmanageable, so try to look at your background levels of stress.” However, there are some actions you can take.

Dr Emma Ross' calming tips

1. Try some quick box breathing

“Breathing is really powerful,” says Emma. “There's lots of research1 to show that breathwork has almost an immediate effect on your physiology and over time. Try box breathing – where you breathe in for five seconds, hold for five seconds and breathe out for five seconds.” This can really help to ground you in the moment.
 

2. Look at a landscape

We’ve all heard that immersing ourselves in nature can help reduce our cortisol levels.2 “But new research3 suggests just looking at a horizon or landscape – even a cityscape – can really affect stress levels,” says Emma. “This might be because the eye is so closely connected to the brain that it's like a short circuit into how we feel.” Next time you’re at your computer getting really cross, step over to a window or go upstairs and spend a calming moment taking in the view.
 

3. Ask for a time out

If you feel the rage coming on when you’re with someone, don’t be afraid to step away. This might be difficult to do or articulate in the moment, so Emma suggests practicing when you’re calmer. “Think of a phrase you’re comfortable with, like ‘I’m not feeling quite right at the moment,’ or ‘I just need a bit of space from this conversation,’” she says.
 

What about coping mechanisms for rage in the long term?

Aside from considering therapy, Emma has a few different suggestions for managing rage during perimenopause and beyond.

  1. Be intentional with your de-stress time
    “Whether it’s moving your body, doing meditation or listening to a certain type of music for 20 minutes a day, try to be explicit and set aside the time,” says Emma. It could be one of the vital tools in your toolbox to help you mitigate stressful or rageful moments. 
  2. Embrace the ‘tend and befriend effect’
    While the fight-or-flight response is well-known for managing stress, researchers at the University of California4 have identified another physiological response in women called 'tend-and-befriend.’ This approach involves nurturing activities for self-protection (tending) and creating social connections (befriending) to process stress – which also triggers the release of oxytocin, a hormone linked with feelings of trust and happiness. “Lean into your social network, talk to family members or join an online community,” recommends Emma. 
  3. Prioritise your wellbeing
    “Around 90% of your ‘good-mood’ hormone serotonin is made in your gut,” says Emma.5 So, it makes sense that taking care of it can support your overall wellbeing and help stabilise your mood and fend off rageful moments. Try eating a diet that’s high in fibre, a range of colourful fruit and veg and reducing ultra-processed foods that are often high in salt or fat. Also, remember to take proper lunch breaks and chew slower.

How can you channel your anger into something more positive?

“We’re human, we’ll be rageful sometimes,” says Emma. “And you might feel ashamed or annoyed at yourself. But it’s also a great opportunity during midlife to stop and reflect on the ways you manage stress – do you carve out enough time to look after yourself? Are you kind enough to yourself?”

"Setting new goals can be stablising and motivating"

You can also channel this anger into self-compassion. “This is a really amazing skill, and you can learn it through things like journalling and talking to yourself like you would a friend,” she says. “Committing to new goals can be stabilising and motivating – when other areas of your life might not be so,” says Emma.

Need support during menopause?

While this can be an overwhelming time, there’s support and information to help you feel more like yourself, like speaking to your doctor about medications like HRT. They can also advise on other options available and help you figure out what’s right for you.

“For some women, HRT can be helpful for lots of menopausal symptoms, rage included,” says Emma. “Ultimately, it replaces declining hormones and provides some stability. It can also be helpful for things like tiredness or joint pain that can make you feel more frustrated.” Speak to your GP who can help you figure out what’s right for you.

Once you've spoken to your GP, you can also check out our women’s health support hub or our friendly advisors in store.

Disclaimer

The advice in this article is for information only and some of the information reflects the opinion of Dr Emma Ross and should not replace medical care. Please check with your GP or healthcare professional before trying any supplements, treatments or remedies. Food supplements must not be used as a substitute for a varied and balanced diet and a healthy lifestyle.
 

Sources

  1. Fincham GW, Strauss C, Montero-Marin J, Cavanagh K. Effect of Breathwork on Stress and Mental health: a meta-analysis of randomised-controlled Trials. Scientific Reports [Internet]. 2023 Jan 9;13(1). Available from: https://www.nature.com/articles/s41598-022-27247-y
  2. Jimenez MP. Associations between Nature Exposure and Health: a Review of the Evidence. International Journal of Environmental Research and Public Health [Internet]. 2021 Apr 30;18(9):4790. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8125471/ 
  3. Wapner J. Vision and Breathing May Be the Secrets to Surviving 2020 [Internet]. Scientific American. 2020. Available from: https://www.scientificamerican.com/article/vision-and-breathing-may-be-the-secrets-to-surviving-2020/ 
  4. Se T, Lc K, Bp L, Tl G, Ra G, Ja U. Biobehavioral Responses to Stress in Females: Tend-And-Befriend, Not Fight-Or-Flight [Internet]. Psychological review. 2000. Available from: https://pubmed.ncbi.nlm.nih.gov/10941275/ 
  5. Appleton J. The Gut-Brain Axis: Influence of Microbiota on Mood and Mental Health. Integrative Medicine: A Clinician’s Journal [Internet]. 2018 Aug 1;17(4):28–32. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6469458/
 

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