Mabilis mag-init ang ulo lately? Perimenopause mood, rage and anxiety, explained

If you are thinking about ending your life or harming yourself, you deserve help today, not after the next check-up.

• Go to the nearest hospital emergency room, or ask someone you trust to take you.
• Call the National Center for Mental Health (NCMH) crisis hotline: 1553 (landline, nationwide), 0919-057-1553 (Smart/TNT), or 0917-899-8727 or 0966-351-4518 (Globe/TM). It is free, open 24/7, in English and Filipino.
• Tell one person near you what you are feeling. You do not have to explain everything.

This is a medical emergency, the same as chest pain. It is not drama and it is not "OA".

Estrogen and progesterone affect brain chemicals that steady mood, including serotonin. In perimenopause these hormones rise and fall unpredictably, sometimes within the same month. Many women notice their mood follows that roller coaster.

Then add the rest. Night sweats and 3 am waking leave you running on empty. Hot flashes in a meeting are stressful. Midlife often brings teenagers, aging parents, money pressure and work all at once. Perimenopause is a time when the risk of depressive symptoms goes up, even in women who have never been depressed before (The Menopause Society's 2018 perimenopausal depression guidelines).

Filipinas on Reddit describe "rage, brain fog, feeling na I am not the same person as before" and being "hormonal as in mabilis mag-init ulo". Many were raised to be matiisin and to keep it inside, so they wait years before asking for help. You do not have to.

Mood changes have other causes worth checking, sometimes alongside perimenopause:

• Depression or an anxiety disorder. These can start or return in midlife. If low mood lasts most days for two weeks or more, or you have lost interest in things you used to enjoy, tell a doctor.
• Thyroid problems. An overactive thyroid can cause anxiety, a racing heart and irritability; an underactive one can cause low mood and tiredness. A TSH test costs ₱490 per test (Exact Check). See Perimenopause or thyroid?.
• Anemia. Heavy periods can leave you exhausted and low.
• Medicines. Some blood pressure medicines, steroids and sleeping pills can affect mood. Bring your list.
• Alcohol and caffeine. Both can worsen anxiety and sleep.
• Life events. Grief, burnout and caring for others are real loads on their own.

Prices checked October 2026.

• HRT for low mood linked to menopause: Some evidence. NICE 2024 says to consider HRT for low mood that comes with perimenopause or menopause. It also helps hot flashes and night sweats, which often drive the bad nights behind bad days. Read HRT for menopause.
• CBT: Some evidence. NICE 2024 recommends cognitive behavioural therapy for menopause-related low mood and anxiety, and it also helps sleep and hot flashes. It can be done face to face or online.
• Antidepressants for diagnosed depression or anxiety: Strong evidence for those conditions. If you have depression or an anxiety disorder, SSRIs and similar medicines are a standard, effective option. NICE notes there is no clear evidence that antidepressants help low mood caused by menopause alone in women who do not have depression. Paroxetine is one SSRI sold in the PH, at ₱68.75 per tablet (Watsons), Rx only. SSRIs and SNRIs are also recommended for hot flashes in The Menopause Society 2023 nonhormone statement. See non-hormonal treatments.
• Sleep, movement and less alcohol: Some evidence for general wellbeing. The NHS suggests regular sleep routines, regular exercise, staying within alcohol limits, and relaxing activities such as yoga or meditation for menopause mood changes. Not a replacement for treatment when symptoms are heavy.
• Supplements (ashwagandha, L-theanine, magnesium): Not enough evidence. Popular in PH Reddit threads, but not proven for menopause mood. See our honest supplement guide.

Prices checked October 2026. Rx medicines need a doctor's prescription, and your doctor decides what fits you.

A lot of searches for this topic come from children, not mothers. If Mama has become irritable, tearful or anxious in her late 40s or 50s, perimenopause may be part of it. Ask gently how she is sleeping and feeling, without labelling her moods. Our guide Paano tulungan si Mama has words to use and a gentle link to the symptom checker you can send her.

• Thoughts of suicide or self-harm: emergency care now (see the crisis box above).
• Low mood or anxiety most days for two weeks or more
• Panic attacks, or a racing heart with chest pain or fainting (rule out heart problems; see palpitations)
• Rage that frightens you or the people around you
• Using alcohol or pills to cope

A menopause-literate doctor can look at hormones, mood and sleep together. Our talk to your doctor script helps if you have been told it is "stress lang".