Hormones in Women
Understanding estrogen, progesterone, testosterone, and other hormones that influence mood, stress tolerance, and relationships.
← Back to Hormones & TransitionsUnderstanding women's hormonal transitions is key to the Manopause framework. Women's hormonal systems are complex and dynamic. Hormones fluctuate throughout the menstrual cycle, shift during perimenopause and menopause, and interact with stress, sleep, nutrition, and other life factors. These changes are real, scientifically documented, and can significantly affect mood, cognition, stress tolerance, and relationships.
This section provides educational information only. If you're experiencing hormonal symptoms that affect your wellbeing or relationships, consult a healthcare provider (OB-GYN, endocrinologist, or primary care doctor).
Estrogen
What It Does
Estrogen is a primary reproductive hormone that affects multiple body systems. In the brain, estrogen influences neurotransmitters like serotonin, dopamine, and GABA—all crucial for mood regulation.
Effects on Mood & Behavior
- Mood Regulation: Higher estrogen is associated with improved mood, motivation, and emotional resilience.
- Serotonin Production: Estrogen supports serotonin synthesis, affecting mood and stress response.
- Anxiety & Depression: Estrogen decline can contribute to anxiety, depression, and emotional volatility.
- Cognitive Function: Estrogen supports focus, memory, and executive function.
- Pain Sensitivity: Estrogen changes affect perception of physical and emotional pain.
When It Changes
Estrogen fluctuates throughout the menstrual cycle, with peaks during the follicular phase (first half) and a smaller secondary peak during ovulation. During the luteal phase (after ovulation), estrogen drops significantly, which can affect mood.
During perimenopause (typically starting in the 40s), estrogen becomes increasingly erratic and eventually declines. This unpredictability and sustained drop can intensify emotional and physical symptoms.
Progesterone
What It Does
Progesterone is sometimes called the "calming hormone" because it enhances GABA, an inhibitory neurotransmitter that promotes relaxation. It also influences sleep quality and stress response.
Effects on Mood & Behavior
- Calming Effect: Progesterone supports GABA, promoting calm and emotional regulation.
- Sleep Quality: Progesterone promotes deeper sleep and relaxation.
- Anxiety & Irritability: When progesterone drops (especially premenstrually), anxiety and irritability often increase.
- Stress Resilience: Higher progesterone is associated with better stress tolerance.
- Appetite & Energy: Progesterone shifts can affect energy levels and cravings.
When It Changes
Progesterone rises after ovulation and peaks before menstruation. Just before menstruation, it drops sharply, which is why many women experience premenstrual syndrome (PMS): irritability, anxiety, fatigue, and mood dysregulation.
During perimenopause and menopause, progesterone decline reduces the "calming" effect, potentially increasing anxiety and disrupting sleep.
Testosterone in Women
What It Does
Women produce testosterone in smaller amounts than men, but it's still significant for libido, energy, confidence, and muscle mass. It also influences assertiveness and risk-taking behavior.
Effects on Mood & Behavior
- Libido & Sexual Desire: Testosterone peaks around ovulation and is crucial for sexual interest.
- Energy & Confidence: Testosterone contributes to energy, assertiveness, and sense of agency.
- Motivation: Higher testosterone is associated with motivation and goal-directed behavior.
- Stress Response: Testosterone may increase stress reactivity and assertiveness in response to challenge.
When It Changes
Testosterone peaks around ovulation in menstruating women. During and after perimenopause, testosterone gradually declines, which can contribute to reduced libido, lower energy, and decreased sense of assertiveness.
Cortisol (Stress Hormone)
What It Does
Cortisol is released during stress and activates the "fight or flight" response. In healthy amounts, it's adaptive; chronically elevated cortisol damages sleep, mood, and immune function.
Effects on Mood & Behavior
- Alertness & Arousal: Cortisol wakes you up and prepares you for action.
- Anxiety & Hypervigilance: Sustained stress and elevated cortisol increase anxiety and threat perception.
- Sleep Disruption: High cortisol at night prevents deep sleep and recovery.
- Memory & Decision-Making: Chronic stress impairs focus, memory, and executive function.
- Mood & Resilience: Chronically elevated cortisol is associated with depression and reduced stress tolerance.
How It Interacts
During perimenopause and menopause, the body's stress response can become dysregulated. Lower estrogen and progesterone mean the brain is less buffered against stress, so cortisol spikes more easily and stays elevated longer. Additionally, poor sleep (due to hot flashes or hormonal shifts) further elevates cortisol, creating a cycle of anxiety, irritability, and fatigue.
Thyroid Hormones
What It Does
Thyroid hormones regulate metabolism, energy, temperature, and mood. Women are more prone to thyroid dysfunction than men, especially during perimenopause and after menopause.
Effects on Mood & Behavior
- Energy & Fatigue: Low thyroid hormone causes persistent fatigue and brain fog.
- Mood & Depression: Hypothyroidism is associated with depression and low motivation.
- Anxiety & Irritability: Hyperthyroidism can cause anxiety, irritability, and emotional reactivity.
- Cognition & Memory: Thyroid dysfunction impairs focus, memory, and decision-making.
- Temperature Regulation: Thyroid changes contribute to hot flashes and night sweats (during perimenopause).
When It Changes
Thyroid function naturally declines with age, and autoimmune thyroid disease is more common in women. During perimenopause and menopause, thyroid changes can coincide with hormonal shifts, magnifying fatigue, mood dysregulation, and cognitive symptoms.
Important: If you're experiencing persistent fatigue, depression, or cognitive symptoms, ask your doctor to check thyroid function (TSH, Free T4, Free T3, and thyroid antibodies).
The Menstrual Cycle: Four Phases
Understanding your menstrual cycle can help you recognize how hormones affect your mood, energy, and stress tolerance throughout the month.
Menstruation (Days 1-5)
Hormones: Estrogen and progesterone are at their lowest.
Typical Experience:
- Physical symptoms: cramping, headaches, fatigue
- Mood: withdrawal, introspection, or emotional sensitivity
- Energy: lower; body prioritizes rest and recovery
- Stress tolerance: may be lower; irritability possible
Follicular Phase (Days 5-13)
Hormones: Estrogen rises steadily; FSH (follicle-stimulating hormone) increases.
Typical Experience:
- Mood: improving; motivation and optimism rise
- Energy: increasing; physical strength and endurance peak
- Stress tolerance: good; more resilience to setbacks
- Social engagement: increased interest in socializing and new activities
Ovulation (Days 13-15)
Hormones: LH surge; testosterone and estrogen peak; brief progesterone rise begins.
Typical Experience:
- Mood: confident, assertive, socially outgoing
- Energy: very high; sexual desire peaks
- Cognition: sharp; good for creative problem-solving
- Risk-taking: slightly increased (normal assertiveness)
Luteal Phase (Days 15-28)
Hormones: Progesterone rises; estrogen drops relative to progesterone.
Typical Experience:
- Mood: more introspective; some anxiety or irritability (especially late luteal)
- Energy: lower; body prioritizes internal processing
- Sleep: may need more rest
- Stress tolerance: may be lower; heightened sensitivity to conflict
- Appetite: may increase, especially for carbs/comfort foods
- Premenstrual symptoms: peak in the last few days (PMS)
Perimenopause & Menopause: The Transition
Perimenopause is the transition phase before menopause, typically lasting 5-10 years. During this time, hormonal shifts are erratic and intense.
Early Perimenopause (40s)
Hormone levels become less predictable. Estrogen and progesterone fluctuate wildly, which can intensify mood swings, anxiety, and physical symptoms. Periods may become irregular but are still present.
Common experiences:
- Unpredictable mood swings and irritability
- Hot flashes and night sweats
- Disrupted sleep (from hot flashes, anxiety, or shifts in sleep architecture)
- Brain fog and difficulty concentrating
- Anxiety and panic attacks
- Heavier or more frequent periods
Late Perimenopause (late 40s-early 50s)
Hormonal shifts are at their most extreme. Long gaps between periods may occur, followed by periods returning. Symptoms often peak.
Common experiences:
- Most severe hot flashes and night sweats
- Persistent anxiety, depression, or emotional flatness
- Significant sleep disruption
- Extreme fatigue and low energy
- Vaginal dryness and reduced libido
- Weight gain and metabolic changes
- Joint and muscle pain
Menopause & Postmenopause (typically 50s-beyond)
Menopause is technically defined as 12 consecutive months without a period. After menopause, estrogen and progesterone remain low. Many symptoms improve, but some persist or emerge.
Common experiences:
- Hot flashes and night sweats gradually resolve (though some women have them for years)
- Mood stabilizes for many women; depression or anxiety may persist in others
- Sleep may improve, but can remain disrupted
- Reduced libido and vaginal health issues
- Increased risk of osteoporosis, cardiovascular disease, and metabolic syndrome
- Many women report feeling more stable, focused, and liberated once hormone levels stabilize
How These Hormonal Changes Affect Relationships
Understanding hormonal shifts doesn't excuse harm, but it can foster compassion and practical problem-solving in relationships.
Emotional Reactivity & Conflict
Lower stress tolerance and higher anxiety (due to hormonal shifts, poor sleep, and elevated cortisol) can make small conflicts feel catastrophic. A woman may perceive criticism or disappointment more intensely, react faster, and need more recovery time.
Healthy response: "I notice I'm extra reactive right now. Can we table this conversation and revisit it tomorrow when I've had sleep?" Partners can be understanding and patient.
Unhealthy response: Using hormonal shifts as an excuse for blame, contempt, or refusal to take accountability. "You're crazy because of your hormones" is dismissive and harmful.
Reduced Libido & Sexual Desire
Declining testosterone, estrogen, and progesterone—plus fatigue, sleep disruption, and mood changes—can significantly reduce sexual desire. Additionally, vaginal dryness during perimenopause and menopause can make sex painful.
Healthy response: Open conversations about desire, exploration of non-penetrative intimacy, medical consultation (vaginal estrogen, lubricants, etc.).
Unhealthy response: Pressure, coercion, or using reduced libido as grounds for controlling behavior or infidelity.
Withdrawal & Emotional Shutdown
Some women experience emotional numbing or withdrawal during perimenopause. This can feel like depression or disconnection, creating distance in relationships.
Healthy response: Recognition that this may be hormonal, medical consultation, therapy, and patience from both partners.
Unhealthy response: Partners interpreting withdrawal as rejection or using it as justification for controlling behavior.
Sleep Disruption & Its Cascading Effects
Hot flashes, night sweats, and hormonal changes disrupt sleep quality. Sleep deprivation drastically reduces emotional regulation, stress tolerance, and cognitive function—creating a cascade of mood, anxiety, and conflict issues.
Healthy response: Taking sleep seriously—separate bedrooms if needed, addressing hot flashes medically, creating a cool sleep environment, stress management.
Anxiety & Hypervigilance
During perimenopause, anxiety and panic attacks can increase due to hormonal instability, sleep disruption, and elevated cortisol. This can manifest as hypervigilance in relationships—heightened threat perception and worry.
Healthy response: Medical support, therapy, grounding techniques, and reassurance from partners.
Note: If a woman's anxiety manifests as controlling, monitoring, or aggressive behavior toward a partner, that's a separate issue requiring professional support.
Self-Care & Medical Support
If hormonal transitions are affecting your mood, sleep, energy, or relationships, there are evidence-based approaches:
Key Takeaways
- Hormonal transitions are real. Estrogen, progesterone, testosterone, and cortisol shifts have measurable effects on mood, stress tolerance, sleep, and cognition.
- Effects vary widely. Some women experience dramatic mood swings; others notice subtle changes. Individual variation is normal.
- Hormones affect context, not character. Recognizing hormonal factors should increase compassion, not excuse harm.
- Help is available. Medical support, therapy, lifestyle changes, and honest communication can make a significant difference.
- Partner understanding matters. When both partners understand hormonal transitions, they can problem-solve together and reduce unnecessary blame.
Further Learning
Want to learn more about hormones and menopause?
- North American Menopause Society (NAMS) — Evidence-based information for midlife and menopausal women
- Mayo Clinic: Menopause — Medical overview and treatment options
- American College of Obstetricians and Gynecologists (ACOG) — Professional guidelines on menopause care
- Book: "The Hormone Cure" by Sara Gottfried, MD — Practical guide to hormonal balance (consult your doctor before implementing)
← Back to Hormones & Transitions | Explore Hormones in Men →