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Feeling angry?This could be a sign of perimenopause

The entire plot of Netflix’s hit show “Beef” is fueled by rage: specifically, a scene between Ali Wong and Steven Yeun’s character An epic road rage incident that escalated quickly. Showing anger on screen – especially that of women – has become more common in recent years (see also Yellow Jackets , I May Will ruin you, and Big Little Lies ). While dramatizing anger for entertainment is a trend, its occurrence — especially among women in menopause or in the menopause transition — is very real. Julie, a 45 year-old marketing executive in Boston, avoids Beef while she regularly browses Netflix. “I was nervous watching the movie because I felt like I was going to see myself on the screen,” said Jolie, who has been dealing with a bout of anger that her ob-gyn attributes to hormones.

Hormones do play an important role. “Due to the drop in estrogen and progesterone levels during perimenopause (the years before menopause) and the menopausal transition, our mental health can suffer,” says Allie Sharma, a psychiatrist and consultant for Evernow Women’s Health. Sharma, M.D. These hormones can directly affect our brain chemicals, including the production and regulation of brain chemicals called neurotransmitters such as serotonin, dopamine, and norepinephrine. These are critical to the overall function of the brain, and mood in particular, says neuroscientist and associate professor of neuroscience Lisa Mosconi, Ph.D. “As these levels become unbalanced, women may experience mood swings, heightened anxiety, depressive symptoms, and heightened irritability or anger,” Mosconi said.

GABA, a Sedation is another effect that diminishes with the loss of estrogen, added Leah Millheiser, MD, clinical professor of obstetrics and gynecology at Stanford University and chief medical officer of Evernow. Hormonal fluctuations can also have devastating effects on the hypothalamic-pituitary-adrenal (HPA) axis. “It’s a very important system that connects the brain, ovaries and adrenal glands and is responsible for the body’s stress response,” Mosconi said. “A change in the HPA axis can make coping with everyday stress more challenging.” It’s like, for example, having someone stop you in the store parking lot.

But beyond the hormonal and chemical changes, there are many situational factors that accompany the forties-fifties years that might make a person want to rage. For example, caring for young children and guiding them through adolescence; also caring for aging parents; ever-increasing professional demands; maintaining long-term relationships (or forming new ones). They can all add fuel to the fire, Mosconi said. Not to mention the physical manifestations of the menopausal transition, such as hot flashes, vaginal dryness, sleep and skin changes, fatigue and insomnia. “Coping with hot flashes throughout the day, a seemingly sudden increase in abdominal weight, and changes in sexual function can all be sources of frustration in general,” says Millheiser. Add to all of the above hormonal and chemical elements and you have a mental health pressure cooker. “These situations, combined with an already overworked HPA axis, can make you feel as though the entire universe is conspiring against you, turning everyday annoyances into anger triggers,” adds Mosconi.




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