Perimenopause Crying Spells: A Guide to Unexpected Tears and Emotional Lability
Sudden crying spells during perimenopause can feel frightening and embarrassing. Learn what causes emotional lability and how to manage it.
When you cry without knowing why
You burst into tears at a television advert. You cry in the car on the way to work over nothing in particular. You feel a wave of grief or sadness that arrives without a clear cause and disappears just as suddenly. Unexpected crying spells during perimenopause are common, and they are often one of the most disorienting aspects of this life stage. Women who have always considered themselves emotionally steady find themselves blindsided by tears they cannot explain, which can be frightening and humiliating, particularly when it happens in professional or social settings. The experience has a name: emotional lability. It refers to rapid, unpredictable shifts in emotional state that are disproportionate to circumstances. It is a neurological and hormonal phenomenon, not a sign that you are fragile or broken.
The hormonal basis of emotional lability
Estrogen plays a central role in regulating serotonin, the neurotransmitter most associated with emotional stability and a sense of wellbeing. As estrogen levels fluctuate and decline during perimenopause, serotonin availability becomes inconsistent. The brain's ability to regulate emotional responses becomes less reliable as a result. Progesterone also contributes. Its calming, anxiolytic properties decline along with estrogen, removing a second layer of emotional buffering. The result is a nervous system that reacts more intensely to stimuli, particularly emotional ones, and recovers more slowly. This is not a psychological weakness. It is a measurable neurological change driven by hormonal shifts. Knowing this matters because it removes the blame from your character and places it accurately on a physiological process.
Distinguishing crying spells from depression
Emotional lability and depression are different things, though they can coexist and can be easy to confuse. Crying spells associated with emotional lability tend to pass relatively quickly, often within minutes, and may not be accompanied by sustained low mood, hopelessness, or loss of interest in life. Depression involves a more persistent low mood that lasts for weeks rather than minutes or hours, and typically includes a cluster of other symptoms such as fatigue, loss of pleasure, sleep changes, and difficulty concentrating. If your crying spells are part of a broader pattern of sustained low mood, worthlessness, or withdrawal from your life, it is important to speak to your GP. Both conditions are treatable, but they sometimes require different approaches. A daily symptom log can help clarify the pattern before your appointment.
What tends to trigger crying spells
While crying spells can appear to come from nowhere, they often have soft triggers. Fatigue is a major one. A night of poor sleep significantly lowers the emotional threshold, meaning that things that would ordinarily feel manageable become overwhelming. Accumulating stress without adequate release, feeling unheard or unsupported, and exposure to emotionally loaded content such as news, films, or conversations about loss are common catalysts. Hormonal phases matter too. Many women notice that crying spells cluster in the days before a period or during phases when sleep has been particularly disrupted. Tracking symptoms in PeriPlan alongside your mood can reveal these patterns clearly, turning a bewildering experience into a predictable one.
Practical ways to manage in the moment
When a crying spell begins in a setting where you cannot freely express it, gentle physical pressure such as pressing your tongue to the roof of your mouth or pressing your thumb and forefinger together can help interrupt the physiological reflex. Slow breathing, especially extending the exhale, activates the parasympathetic nervous system and can reduce the intensity. Giving yourself permission to excuse yourself briefly rather than pushing through in a state of distress is also valuable. On days when you feel emotionally close to the surface, protecting your energy is a reasonable and sensible choice. Reducing optional exposure to emotionally triggering content, building in rest, and asking for lighter interactions from the people around you are practical accommodations, not failures.
Treatment options that help
For women whose crying spells are significantly affecting quality of life, there are effective treatment options. HRT can stabilise estrogen levels and restore more predictable serotonin availability, which often brings a marked reduction in emotional lability. Many women report noticing this benefit within the first few weeks of starting HRT. If HRT is not appropriate or preferred, SSRIs and SNRIs can help by directly supporting serotonin and noradrenaline regulation. Psychological support, particularly through CBT or mindfulness-based cognitive therapy, provides tools for building emotional regulation skills and reducing the distress that the unpredictability itself can generate. Exercise, particularly regular aerobic activity, continues to be one of the most robust mood-stabilising interventions available and is worth prioritising even on the days it feels hardest.
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