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Перепади настрою, тривога й дратівливість: що відбувається

5 хвилин читанняПеревірено спеціалістом VIA-L · 17.10.2026

«Я себе не впізнаю». Зриваєтеся через дрібницю, плачете без причини, тривога накриває на рівному місці, а те, що раніше тішило, стало байдужим. Це не характер зіпсувався. У перехідні роки так буває в дуже багатьох — і цьому є пояснення.

Чому гойдає

Естроген підтримує речовини мозку, що відповідають за настрій і задоволення. У перименопаузі він не просто падає, а гойдається — і розхитує настрій саме амплітуда цих гойдалок. До того ж іде прогестерон, а з ним — природний «заспокійник» мозку. Звідси тривога, дратівливість, спалахи гніву, сльози, відчуття, що витримувати навантаження стало важче.

Дратівливість і гнів часто виражені сильніше за смуток. Це гормональна картина, а не «поганий характер».

І важливе, щоб не лякатися: у більшості жінок це минуща реакція. Зазвичай пік припадає на перименопаузу, а потім усе стихає. Уважнішими варто бути тим, у кого раніше вже були важкі періоди пригніченості.

Як зрозуміти, що саме відбувається

Ключ — у тому, коли буває погано:

Від цього залежить, що допоможе. А розрізнити можна лише щоденником хоча б за два цикли — пам’ять заднім числом усе звалює на «перед місячними». Відмічайте настрій і перший день місячних у VIA-L — за кілька місяців малюнок буде видно.

Що допомагає

Сон. Рваний сон і накопичена втома посилюють гормональні гойдалки настрою. Якщо сон рваний — почніть із нього.

Рух. Найбільш доведений важіль, для багатьох порівнянний за силою з ліками. Близько 150 хвилин на тиждень: ходьба, силові, а м’які практики на кшталт йоги й тай-чі найсильніше знімають тривогу. Силові особливо допомагають жінкам.

Ранкове світло. Яскраве денне світло одразу після підйому помітно піднімає настрій у перименопаузі. Прогулянка при денному світлі — простий щоденний крок.

Повільне дихання. 5–10 хвилин на день із подовженим видихом — близько шести вдихів на хвилину. Діє на тривогу напряму, без «сили волі».

Їжа. Середземноморський стиль, клітковина, ферментовані продукти, білковий сніданок. Магній краще отримувати з їжі — темна зелень, гарбузове насіння, бобові; добавка має сенс, якщо в раціоні його мало.

Що прибрати

Що може запропонувати лікар

Якщо пригніченість чи тривога заважають жити, основа допомоги — психотерапія (зокрема програми саме для менопаузи) і, за потреби, ліки. У перименопаузі, особливо разом із припливами, настрою може допомогти й гормональна терапія — це вирішує лікар.

Коли по допомогу — одразу

Що спробувати цього тижня

На чому ґрунтується

Статтю написано за темами бази знань VIA-L. За ними стоять опубліковані роботи — ось вони:

  1. Cognitive Behavioural Therapeutics for Insomnia Symptoms in the Perimenopause Through to the Early Postmenopausal Period — The Cochrane Database of Systematic Reviews, 2026 doi
  2. Evaluating Tools for Assessing Mental Health Disorders in Perimenopausal Women — International Journal of Gynaecology and Obstetrics: The Official Organ of the International Federation of Gynaecology and Obstetrics, 2026 doi
  3. FIGO Best Practice Recommendations for the Mental Health of Women at Menopausal Age — International Journal of Gynaecology and Obstetrics: The Official Organ of the International Federation of Gynaecology and Obstetrics, 2026 doi
  4. Cognitive-Behavioral, Acceptance-Based, and Mindfulness-Based Interventions for Psychological and Sleep-Related Symptoms During Menopause: A Systematic Review — Acta Psychologica, 2026 doi
  5. Cognitive-Behavioral Interventions for (Peri)menopausal Symptoms: A Scoping Review of Interventions Characteristics and Content — Patient Education and Counseling, 2026 doi
  6. Pathogenesis and Potential Therapies for Perimenopausal Depression: Insights From the Estrogen-Gut Microbiota Axis — Frontiers in Neuroendocrinology, 2026 doi
  7. Depression — Lancet (London, England), 2026 doi
  8. Recent Advances in the Relationship Between Mental Symptoms in Postmenopausal Women and Estrogen Fluctuations — Journal of Psychosomatic Obstetrics and Gynaecology, 2026 doi
  9. Effect of Saffron on Depression, Anxiety and Mood Disorder: A GRADE Assessed Systematic Review and Meta-Analysis of 34 Randomized Controlled Trials — Nutritional Neuroscience, 2026 doi
  10. Reframing menopause and menopause hormone therapy as opportunities for healthy aging — Science, 2026 doi
  11. Integrative Approaches to Perimenopause — The American Journal of Medicine, 2026 doi
  12. Effectiveness of Non-Pharmacological Interventions for Insomnia Related to Natural Menopause: A Meta-Analysis of Randomized Controlled Trials — Maturitas, 2026 doi
Показати всі (113)
  1. A Digital Mindfulness Intervention Improves Sleep Efficiency and Heart Rate Variability in Healthy Adults — Scientific Reports, 2026 doi
  2. Hormonal Modulation With Withania Somnifera: Systematic Review and Meta-Analysis of Randomized-Controlled Trials — Planta Medica, 2026 doi
  3. Nutritional Modulators of Sleep: A Narrative Review of Vitamins, Minerals, Amino Acids, and Their Neurobiological and Chronoepigenetic Mechanisms — Chronobiology International, 2026 doi
  4. Insomnia and women: exploring vulnerability, impact, and intervention — Sleep & Breathing = Schlaf & Atmung, 2026 doi
  5. OSA in Women: Associations With Reproductive Aging and Screening Challenges — Chest, 2026 doi
  6. Pharmacological and Non-Pharmacological Treatments for Chronic Insomnia in Perimenopausal and Postmenopausal Women: A Systematic Review and Meta-Analysis — Sleep Medicine, 2026 doi
  7. An Examination Into the Effects of a Saffron Extract (Affron) on Mood and General Wellbeing in Adults Experiencing Low Mood: A Randomized, Double-Blind, Placebo-Controlled Trial — The Journal of Nutrition, 2025 doi
  8. Role of Circadian Health in Cardiometabolic Health and Disease Risk: A Scientific Statement From the American Heart Association — Circulation, 2025 doi
  9. Effects of different physical activity interventions on depressive symptoms in menopausal women: a systematic review and network meta-analysis — BMC Public Health, 2025 doi
  10. Effects of physical activity on depressive and anxiety symptoms of women in the menopausal transition and menopause: a comprehensive systematic review and meta-analysis of randomized controlled trials — The International Journal of Behavioral Nutrition and Physical Activity, 2025 doi
  11. Therapeutic Efficacy of Botanicals in Psychological Disorders in Menopausal Women: A Systematic and Scoping Review — Frontiers in Pharmacology, 2025 doi
  12. Exercise as a Therapeutic Strategy for Depression in Menopausal Women: A Metaanalysis of Randomized Trials — Frontiers in Psychiatry, 2025 doi
  13. Adrenal Insufficiency in Adults — JAMA, 2025 doi
  14. An Integrative Approach to HPA Axis Dysfunction: From Recognition to Recovery — The American Journal of Medicine, 2025 doi
  15. The Combination of Physical Exercise and Slow-Paced Breathing on Psychophysiological Indices of Emotion Reactivity, Psychosocial Stress Reactivity and Recovery: A Multimodal Investigation — Behaviour Research and Therapy, 2025 doi
  16. Effectiveness of 2 Just-in-Time Adaptive Interventions for Reducing Stress and Stabilizing Cardiac Autonomic Function: Microrandomized Trials — Journal of Medical Internet Research, 2025 doi
  17. Chrononutrition Interventions for Mental Health: Addressing Atypical Depression, Ultra-Processed Food Use Disorder, and Circadian Dysregulation — Frontiers in Psychiatry, 2025 doi
  18. Elinzanetant for the Treatment of Vasomotor Symptoms Associated With Menopause: A Phase 3 Randomized Clinical Trial — JAMA Internal Medicine, 2025 doi
  19. Fezolinetant and Elinzanetant Therapy for Menopausal Women Experiencing Vasomotor Symptoms: A Systematic Review and Meta-Analysis — Obstetrics and Gynecology, 2025 doi
  20. Menopause and Movement: Exercise for Better Sleep and Psychological Well-Being-a Systematic Review — Menopause (New York, N.Y.), 2025 doi
  21. Omega-3 Fatty Acids and Sleep: Recent Advances in Understanding Effects and Mechanisms — Current Opinion in Clinical Nutrition and Metabolic Care, 2025 doi
  22. The Effectiveness of Psychosocial Interventions on Non-Physiological Symptoms of Menopause: A Systematic Review and Meta-Analysis — Journal of Affective Disorders, 2024 doi
  23. The Risk of Depression in the Menopausal Stages: A Systematic Review and Meta-Analysis — Journal of Affective Disorders, 2024 doi
  24. Neuroendocrine Mechanisms of Mood Disorders During Menopause Transition: A Narrative Review and Future Perspectives — Maturitas, 2024 doi
  25. Promoting Good Mental Health Over the Menopause Transition — Lancet (London, England), 2024 doi
  26. Efficacy and Safety of N-3 Fatty Acids Supplementation on Depression: A Systematic Review and Dose-Response Meta-Analysis of Randomised Controlled Trials — The British Journal of Nutrition, 2024 doi
  27. Effects of Mind-Body Exercise on Perimenopausal and Postmenopausal Women: A Systematic Review and Meta-Analysis — Menopause (New York, N.Y.), 2024 doi
  28. "Not feeling like myself" in perimenopause - what does it mean? Observations from the Women Living Better survey — Menopause, 2024 doi
  29. Effectiveness of a Saffron and Withania Supplement on Mood in Women With Mild‐to‐Moderate Anxiety During the COVID‐19 Lockdown — Depression and Anxiety, 2024 doi
  30. Effects of Exercise on Depression and Anxiety in Postmenopausal Women: A Pairwise and Network Meta-Analysis of Randomized Controlled Trials — BMC Public Health, 2024 doi
  31. Shoden Promotes Relief From Stress and Anxiety: A Randomized, Double-Blind, Placebo-Controlled Study on Healthy Subjects With High Stress Levels — Heliyon, 2024 doi
  32. Hypopituitarism — Lancet (London, England), 2024 doi
  33. European Society of Endocrinology and Endocrine Society Joint Clinical Guideline: Diagnosis and Therapy of Glucocorticoid-Induced Adrenal Insufficiency — The Journal of Clinical Endocrinology and Metabolism, 2024 doi
  34. Performance of Dehydroepiandrosterone Sulfate and Baseline Cortisol in Assessing Adrenal Insufficiency — The Journal of Clinical Endocrinology and Metabolism, 2024 doi
  35. Components and Delivery Formats of Cognitive Behavioral Therapy for Chronic Insomnia in Adults — JAMA Psychiatry, 2024 doi
  36. Network Meta-Analysis Examining Efficacy of Components of Cognitive Behavioural Therapy for Insomnia — Clinical Psychology Review, 2024 doi
  37. Stimulus control for insomnia: A systematic review and meta-analysis — J Sleep Res, 2024 doi
  38. Social jetlag and obesity: A systematic review and meta-analysis — Obes Rev, 2024 doi
  39. Premenstrual Disorders, Timing of Menopause, and Severity of Vasomotor Symptoms — JAMA Network Open, 2023 doi
  40. The Role of Magnesium in Sleep Health: A Systematic Review of Available Literature — Biological Trace Element Research, 2023 doi
  41. Effects of Long-Chain Omega-3 Polyunsaturated Fatty Acids on Reducing Anxiety and/or Depression in Adults; A Systematic Review and Meta-Analysis of Randomised Controlled Trials — Prostaglandins, Leukotrienes, and Essential Fatty Acids, 2023 doi
  42. Efficacy of B-Vitamins and Vitamin D Therapy in Improving Depressive and Anxiety Disorders: A Systematic Review of Randomized Controlled Trials — Nutritional Neuroscience, 2023 doi
  43. Effects of Nutritional Interventions on the Severity of Depressive and Anxiety Symptoms of Women in the Menopausal Transition and Menopause: A Systematic Review, Meta-Analysis, and Meta-Regression — Menopause (New York, N.Y.), 2023 doi
  44. The Therapeutic Impact of Plant-Based and Nutritional Supplements on Anxiety, Depressive Symptoms and Sleep Quality Among Adults and Elderly: A Systematic Review of the Literature — International Journal of Environmental Research and Public Health, 2023 doi
  45. Effects of Sleep Fragmentation and Estradiol Decline on Cortisol in a Human Experimental Model of Menopause — The Journal of Clinical Endocrinology and Metabolism, 2023 doi
  46. Changes in Cortisol Awakening Responses (CAR) in Menopausal Women Through Short-Term Marine Healing Retreat Program With Specific Factors Affecting Each CAR Index — PloS One, 2023 doi
  47. Ocimum Tenuiflorum Extract (HOLIXERTM): Possible Effects on Hypothalamic-Pituitary-Adrenal (HPA) Axis in Modulating Stress — PloS One, 2023 doi
  48. GABA-ergic Modulators: New Therapeutic Approaches to Premenstrual Dysphoric Disorder — CNS Drugs, 2023 doi
  49. The Effect of Caffeine on Subsequent Sleep: A Systematic Review and Meta-Analysis — Sleep Medicine Reviews, 2023 doi
  50. Clinical and cost-effectiveness of nurse-delivered sleep restriction therapy for insomnia in primary care (HABIT): a pragmatic, superiority, open-label, randomised controlled trial — Lancet, 2023 doi
  51. Oral Micronized Progesterone for Perimenopausal Night Sweats and Hot Flushes a Phase III Canada-Wide Randomized Placebo-Controlled 4 month Trial — Scientific Reports, 2023 doi
  52. Optimizing Sleep Across the Menopausal Transition — Climacteric : The Journal of the International Menopause Society, 2023 doi
  53. Relationship between daytime napping with the occurrence and development of diabetes: a systematic review and meta-analysis — BMJ Open, 2023 doi
  54. Association of Hormone Therapy With Depression During Menopause in a Cohort of Danish Women — JAMA Network Open, 2022 doi
  55. Mood Disorders and Hormonal Status Across Women's Life: A Narrative Review — Gynecological Endocrinology : The Official Journal of the International Society of Gynecological Endocrinology, 2022 doi
  56. The Effect of a Mediterranean Diet on the Symptoms of Depression in Young Males (The "AMMEND: A Mediterranean Diet in MEN With Depression" Study): A Randomized Controlled Trial — The American Journal of Clinical Nutrition, 2022 doi
  57. Association of Magnesium Intake With Sleep Duration and Sleep Quality: Findings From the CARDIA Study — Sleep, 2022 doi
  58. Behavioral Interventions for Improving Sleep Outcomes in Menopausal Women: A Systematic Review and Meta-Analysis — Menopause (New York, N.Y.), 2022 doi
  59. Human adaptative behavior to Antarctic conditions: A review of physiological aspects — WIREs Mechanisms of Disease, 2022 doi
  60. Modulation of the Hypothalamic-Pituitary-Adrenal (HPA) Axis by Plants and Phytonutrients: A Systematic Review of Human Trials — Nutritional Neuroscience, 2022 doi
  61. Systematic review and meta-analyses on the effects of afternoon napping on cognition — Sleep Med Rev, 2022 doi
  62. A Portrait of Obstructive Sleep Apnea Risk Factors in 27,210 Middle-Aged and Older Adults in the Canadian Longitudinal Study on Aging — Scientific Reports, 2022 doi
  63. Disruption of Sleep Continuity During the Perimenopause: Associations With Female Reproductive Hormone Profiles — The Journal of Clinical Endocrinology and Metabolism, 2022 doi
  64. Omega-3 Fatty Acids for Depression in Adults — The Cochrane Database of Systematic Reviews, 2021 doi
  65. Effect of magnesium and vitamin B6 supplementation on mental health and quality of life in stressed healthy adults: Post‐hoc analysis of a randomised controlled trial — Stress and Health : Journal of the International Society for the Investigation of Stress, 2021 doi
  66. The Role of Estradiol Fluctuation in the Pathophysiology of Perimenopausal Depression: A Hypothesis Paper — Psychoneuroendocrinology, 2021 doi
  67. Biopsychosocial Predictors of Depressive Symptoms in the Perimenopause-Findings From the Swiss Perimenopause Study — Menopause (New York, N.Y.), 2021 doi
  68. Chrono-Nutrition: From Molecular and Neuronal Mechanisms to Human Epidemiology and Timed Feeding Patterns — Journal of Neurochemistry, 2021 doi
  69. Diagnosis and Treatment of Luteal Phase Deficiency: A Committee Opinion — Fertility and Sterility, 2021 doi
  70. Effect of Long-term Supplementation With Marine Omega-3 Fatty Acids vs Placebo on Risk of Depression or Clinically Relevant Depressive Symptoms and on Change in Mood Scores: A Randomized Clinical Trial — JAMA, 2021 doi
  71. Omega-3 Long-Chain Polyunsaturated Fatty Acid and Sleep: A Systematic Review and Meta-Analysis of Randomized Controlled Trials and Longitudinal Studies — Nutrition Reviews, 2021 doi
  72. Sleep During Menopausal Transition: A 10-Year Follow-Up — Sleep, 2021 doi
  73. Effects of a Short Daytime Nap on the Cognitive Performance: A Systematic Review and Meta-Analysis — Int J Environ Res Public Health, 2021 doi
  74. Impact of Estradiol Variability and Progesterone on Mood in Perimenopausal Women With Depressive Symptoms — The Journal of Clinical Endocrinology and Metabolism, 2020 doi
  75. Improving Diet for Psychiatric Patients : High Potential Benefits and Evidence for Safety — Journal of Affective Disorders, 2020 doi
  76. The Allopregnanolone to Progesterone Ratio Across the Menstrual Cycle and in Menopause — Psychoneuroendocrinology, 2020 doi
  77. Hormone Therapy for Postmenopausal Women — The New England Journal of Medicine, 2020 doi
  78. Healthy Dietary Indices and Risk of Depressive Outcomes: A Systematic Review and Meta-Analysis of Observational Studies — Molecular Psychiatry, 2019 doi
  79. Efficacy of Omega-3 PUFAs in Depression: A Meta-Analysis — Translational Psychiatry, 2019 doi
  80. Guidelines for the Evaluation and Treatment of Perimenopausal Depression: Summary and Recommendations — Journal of Women's Health (2002), 2019 doi
  81. Management of Depression in Women — Journal of Women's Health (2002), 2019 doi
  82. Effect of Saffron Supplementation on Symptoms of Depression and Anxiety: A Systematic Review and Meta-Analysis — Nutrition Reviews, 2019 doi
  83. Chronotype and Social Jetlag: A (Self-) Critical Review — Biology (Basel), 2019 doi
  84. Efficacy of Transdermal Estradiol and Micronized Progesterone in the Prevention of Depressive Symptoms in the Menopause Transition: A Randomized Clinical Trial — JAMA Psychiatry, 2018 doi
  85. Positive Psychological Well-Being and Cardiovascular Disease: JACC Health Promotion Series — Journal of the American College of Cardiology, 2018 doi
  86. A New Model for Adrenarche: Inhibition of 3β-Hydroxysteroid Dehydrogenase Type 2 by Intra-Adrenal Cortisol — Hormone Research in Paediatrics, 2018 doi
  87. Effects of Mind⁻Body Exercises (Tai Chi/Yoga) on Heart Rate Variability Parameters and Perceived Stress: A Systematic Review With Meta-Analysis of Randomized Controlled Trials — Journal of Clinical Medicine, 2018 doi
  88. Effect of Omega-3 Supplements on Vasomotor Symptoms in Menopausal Women: A Systematic Review and Meta-Analysis — European Journal of Obstetrics, Gynecology, and Reproductive Biology, 2018 doi
  89. Symptoms of menopause — global prevalence, physiology and implications — Endocrinology, 2018 doi
  90. Effects of Pharmacologic and Nonpharmacologic Interventions on Insomnia Symptoms and Self-Reported Sleep Quality in Women With Hot Flashes: A Pooled Analysis of Individual Participant Data From Four MsFLASH Trials — Sleep, 2018 doi
  91. Therapeutic Effects of Phytochemicals and Medicinal Herbs on Depression — BioMed Research International, 2017 doi
  92. Understanding Adaptogenic Activity: Specificity of the Pharmacological Action of Adaptogens and Other Phytochemicals — Annals of the New York Academy of Sciences, 2017 doi
  93. Omega-3 Versus Isoflavones in the Control of Vasomotor Symptoms in Postmenopausal Women — Gynecological Endocrinology : The Official Journal of the International Society of Gynecological Endocrinology, 2017 doi
  94. Altered Diurnal Pattern of Steroid Hormones in Relation to Various Behaviors, External Factors and Pathologies: A Review — Physiology & Behavior, 2016 doi
  95. Ovarian Hormone Fluctuation, Neurosteroids, and HPA Axis Dysregulation in Perimenopausal Depression: A Novel Heuristic Model — The American Journal of Psychiatry, 2015 doi
  96. Duration of menopausal vasomotor symptoms over the menopause transition — JAMA Intern Med, 2015 doi
  97. Pooled Analysis of Six Pharmacologic and Nonpharmacologic Interventions for Vasomotor Symptoms — Obstetrics and Gynecology, 2015 doi
  98. Efficacy of Omega-3 for Vasomotor Symptoms Treatment: A Randomized Controlled Trial — Menopause (New York, N.Y.), 2014 doi
  99. Cortisol Stimulates Secretion of Dehydroepiandrosterone in Human Adrenocortical Cells Through Inhibition of 3betaHSD2 — The Journal of Clinical Endocrinology and Metabolism, 2011 doi
  100. Acute Emotional Stress and Cardiac Arrhythmias — JAMA, 2007 doi
  101. Suppression of the Hypothalamic-Pituitary-Ovarian Axis in Normal Women by Glucocorticoids — Biology of Reproduction, 1993 doi

Доказова сила цих робіт різна: десь великі огляди та мета-аналізи, десь окремі невеликі дослідження. Кроки в статті — прості заходи турботи про себе з низьким ризиком, а не лікування, і підходять не всім.

Це загальні відомості, а не призначення. Обстеження й лікування підбирає лікар.

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