What if hormone replacement therapy does not relieve menopausal mood changes?

Hormone changes can overlap with poor sleep, hot flushes, relationship strain, work pressure, grief, anxiety or depression. HRT may help some menopause-related symptoms without resolving a separate mental health condition. A persistent change in mood is not a personal failure and deserves proper care.

Describe whether you feel irritable, tearful, anxious, numb, unusually energetic or unable to enjoy things. Tell the clinician about appetite, sleep, concentration, panic, alcohol and any previous mental health treatment so the assessment is specific.

Book an appointment with your HRT prescriber or primary care clinician. Bring a record of mood, sleep, cycle or bleeding changes, flushes and medicine doses. Ask about talking therapy, practical stress support, sleep treatment or medication for depression or anxiety when appropriate.

Keep regular contact with trusted people, protect rest and choose manageable activity. Do not change HRT or prescribed mood medicines without advice. If treatment has made you feel unusually agitated, impulsive or unable to sleep, report this promptly.

Get urgent help if you may harm yourself or someone else, cannot stay safe, hear or see things others do not, or feel detached from reality. Contact emergency services or a crisis service and ask someone trusted to stay with you. Prompt assessment is also needed when mood changes sharply or daily functioning deteriorates.

Ask whether your symptoms fit a menopause pattern, whether sleep or another condition is contributing, which talking therapies are available, and how HRT and any mood treatment can be monitored together.