Part 4: Navigating the Stormy Weather of Menopause

Part IV: Mood Swings

Like so many women in the prime of their lives, Cheryl Miller was too busy with life’s responsibilities to pay attention to perimenopause’s first signals.

Perimenopause literally means the time “around” menopause and is a term used to describe the beginning of the estrogen decline leading to menopause. However, many women use the term “perimenopause” to describe the time when they first begin to notice menopausal symptoms.

With the help of Heather Pugmire, MD, an obstetrician-gynecologist (OB/GYN) at the Bingham Memorial Women’s Center, it’s time to decode the signals of perimenopause—that transitional phase before periods end for good. Understand the symptoms and practical strategies for surviving sleepless nights.


Signal: Dark moods and widely scattered emotions.

Storm advisory: Cheryl called it “PMS on steroids” or ?simply “hell week”—the week before her period when she felt fragile and furious.

“The mood swings and rages where I’d lose complete control were probably what freaked me out the most,” she recalls. “I would scream so loud that I would lose my voice and start shaking. It was just rage. Absolute rage. And then I would swing over to depression. And the depression would be so dark and heavy that I would start crying, and I’d cry for two or three days at a time. And then it was like a switch would go off and it would pass, and then I’d feel completely normal.”

How to weather it: Dr. Pugmire compares the moodiness and irritability that many women feel during perimenopause to premenstrual syndrome or postpartum depression.

“It’s good if women can realize it’s a phase; it’s not going to last forever,” she says. Cheryl’s symptoms were severe and most women won’t hit these extremes.

Emotional health during this pivotal time of life requires a healthy balance between self-nurturing and the obligations of work and caring for others. “It’s an important time to get enough sleep and exercise,” says Dr. Pugmire. “Stay active and engaged and get out of the house to do things that you find rewarding and enjoyable.”

When lifestyle changes aren’t enough, hormone drugs, such as oral contraceptives or estrogen therapy, may help stabilize moods. Other women may benefit from selective serotonin reuptake inhibitors (SSRIs), such as Prozac, Zoloft or Celexa. The important thing to realize, says Dr. Pugmire, is that the need for hormones or SSRIs is temporary.

Part 1 – Irregular Periods

Part 2 – Hot Flashes

Part 3 – Sleep Disruption

Part 5 – Sunny Skies Ahead

About Heather Pugmire, MD

Dr. Pugmire is an obstetrician-gynecologist (OB/GYN) at the Bingham Memorial Women’s Center. As an OB/GYN, Dr. Pugmire is qualified to care for all of women’s healthcare needs. She also understands the challenges facing today’s women, and encourages patients to be open with her so she can provide the best care for them.Dr. Pugmire is always welcoming new patients, and to schedule a consultation, please call 782-3900.

If you enjoyed this article, you may like our other articles: Part 1Part 2Part 3

Return to Health Matters for Women, March 2015 Edition

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