Menopause psychology: Not an end, but an opportunity for a new beginning

MEDICENTER TV / ISTANBUL, TURKEY — DEC. 12, 2025

Psychiatrist Dr. Günay Hajiyeva from Üsküdar University NPİSTANBUL Hospital has redefined menopause not as a conclusion, but as an opportunity for women to transition into a more mature, updated, and deeper version of themselves.

Addressing the societal prejudices surrounding this biological process, Dr. Hajiyeva emphasized that while the biological rhythm changes, the woman herself remains the same. However, navigating the hormonal shifts requires understanding the psychological impacts, particularly the increase in anxiety and anger.

The biological trigger of emotional shifts

Menopause is marked by a fundamental reorganization of the hormonal system, specifically the rise in FSH and the drop in estrogen and progesterone. Dr. Hajiyeva highlighted that estrogen is not just a reproductive hormone but a powerful neuromodulator that directly affects the emotional system.

"With the decrease in estrogen, we see increased activation in the limbic system, which manages emotions, while the prefrontal cortex—the part of the brain that brakes and balances us—becomes vulnerable," Dr. Hajiyeva explained. "This mechanism causes women to ask, 'I wasn't like this, what happened?' leading to sudden emotional fluctuations."

Anxiety and the "GABA" imbalance

The most common psychological symptom during this transition is increased anxiety. The drop in estrogen leads to an imbalance in the GABA system, the body's primary reaction-suppressing neurotransmitter.

"This results in impulsivity and an inability to brake emotions," noted Dr. Hajiyeva. "Similarly, fluctuations in serotonin trigger depressive feelings such as hopelessness and reluctance. Cognitive fluctuations, such as focus issues and forgetfulness, are also common."

The "90-Second Rule" for anger management

These emotional changes can strain family relationships, often manifesting as intolerance or reactivity. To cope with sudden emotional outbursts, Dr. Hajiyeva recommends a practical technique known as the "90-Second Rule."

"The process where anger reaches its explosion point in the limbic system lasts an average of 90 seconds," she stated. "When something makes us angry, instead of reacting immediately, we should try to delay the reaction. Taking deep breaths or slowly counting from 1 to 90 helps resolve the explosion in the limbic system and reinforces the feeling that we are in control."

Breathing techniques and sleep hygiene

Sleep disorders, triggered by hot flashes and disrupted melatonin balance, are another major challenge. Experts advise maintaining strict sleep hygiene and using breathing exercises to balance the body's sympathetic (fight-or-flight) and parasympathetic (relaxation) systems.

Dr. Hajiyeva recommends the following breathing technique: "Abdominal muscles should bulge forward; inhale for 4 seconds, hold for 7 seconds, and exhale for 8 seconds. This technique stimulates the vagus nerve, activates the parasympathetic system, and prevents the formation of negative thoughts."

For women finding the process difficult to manage alone, professional support through mindfulness, positive psychotherapy, or Cognitive Behavioral Therapy (CBT) is recommended.

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