Menstrual cycle and menopause may impact anger and irritability in women

Menstrual cycle and menopause may impact anger and irritability in women | Image Credit: © elnariz - © elnariz - stock.adobe.com.

Feelings such as anger, irritability, and a lack of control may be influenced by menstrual cycle age and reproductive age among women, according to a recent study published in Menopause, the journal of The Menopause Society.¹

Emotional effects of menopause

Menopause has been linked to multiple adverse physical and emotional effects. This includes a significant amount of data evaluating characteristics of depression among menopausal women, but less research has been performed about emotions such as anxiety, anger, and irritability.¹

Investigators conducted the study to determine how symptoms of emotional arousal change based on women’s menstrual cycle phases and reproductive age.² Participants included women in the Seattle Midlife Women’s Health Study (SMWHS) in late reproductive stages 1 or 2 (LRS1, LRS2) or early menopausal transition (EMT).

Symptom tracking and measurement methods

These women reported symptom severity on a scale of 1 to 4 for a full menstrual cycle within the first year of SMWHS. Higher scores indicated increased severity and were recorded in a health diary for anxiety and anger symptoms.²

Anxiety symptoms included anxiety, out of control, tension, nervousness, panic, and palpitations, while anger symptoms included anger, hostility, impatience, and irritability. Mean severity scores were calculated for each symptom.

Cycle phases on each symptom were assessed using a 2-way mixed analysis of variance (ANOVA), alongside reproductive aging stages. Symptoms for LRS1, LRS2, and EMT were assessed, as well as LRS2 vs EMT.²

Staging criteria from menstrual calendars and responses about specific menstrual cycle changes were used to determine the stages of reproductive aging. Regularly occurring menstrual cycles also indicated LRS2, while EMT was determined by the presence of irregular menstrual cycles with a difference of over 7 days in consecutive cycles.²

Cycle phase impacts anger and irritability

There were 301 women aged a mean of 41.1 years included in the final analysis, 65 of whom were in LRS1, 172 in LRS2, and 64 in EMT. Additionally, 70% were partnered, 86% employed, and 78.7% White. A mean of 15.75 years of education was reported among the study population, alongside a mean income of $37,000 from 1990 to 1992.²

Anger severity and irritability severity were the only symptoms significantly impacted by the cycle phases, both presenting with higher premenses severity vs postmenses severity. Additionally, none of the 10 emotional arousal symptoms were influenced by the reproductive aging stage.²

The 2-way mixed ANOVA allowed for additional analysis on how these 10 symptoms are impacted by menstrual cycle phase and by LRS2 and EMT stages. This analysis included 236 women with similar characteristics to the overall study population.²

Further insights and feeling out of control

In the ANOVA, the same 2 symptoms of anger and irritability experienced significant shifts, with higher premenses severity vs postmenses severity. Participants reported significantly higher symptom severity during EMT vs LRS2 for both anger and irritability.²

Feeling out of control was also impacted by cycle phase and reproductive aging stage during the 2-group analysis. This symptom was significantly more severe during premenses vs postmenses. However, no significant effects were reported for the remaining 10 arousal symptoms.²

Conclusions and future recommendations

These results indicated changes in emotional arousal symptom severity from menstrual cycle phases and stages of reproductive aging. Investigators recommended further analyses include measures from late menopausal transition and postmenopause.²

“The findings of this study highlight what women have been telling us for years—that they experience anger and irritability and feel out of control just before their menstrual cycles and that this is more pronounced in the menopause transition,” said Stephanie Faubion, MD, MBA, medical director for The Menopause Society.¹

References

1. Women’s menstrual cycle phase and reproductive stage effect levels of irritability and anger. The Menopause Society. May 28, 2025. Accessed June 2, 2025. https://menopause.org/press-releases/womens-menstrual-cycle-phase-and-reproductive-stage-effect-levels-of-irritability-and-anger.
2. Woods NF, Mitchell ES. Effects of menstrual cycle phases and reproductive aging stages on arousal symptoms: observations from the Seattle Midlife Women’s Health Study. Menopause. 2025. doi:10.1097/GME.0000000000002570