Perimenopause and Mental Health: What’s Happening to My Mind?

If you’re in your late 30s or 40s and feeling a little (or a lot) off, you’re not imagining things. Perimenopause, the transitional phase before menopause, can bring a rollercoaster of emotions, unexpected anxiety and even brain fog that often leaves you wondering if you’re losing your mind! Spoiler: You’re not. But your hormones are shifting, and they have a lot to do with how you feel mentally and emotionally.

I first started noticing the first small signs of perimenopause around the age of 38. Back then, it was the odd emotional outburst, anger coming from nowhere and a restless night. Now, at 42, things have definitely ramped up, especially in the lead up to my period – more mood swings, irregular periods, low days, not being able to remember things, waking often in the night and the kind of brain fog that makes even the simplest tasks feel hard work. If this sounds familiar, trust me, you are not alone.

The Hormone-Mood Connection

During perimenopause, oestrogen and progesterone, the two powerhouse hormones that regulate everything from your menstrual cycle to your mood, start wildly fluctuating. One day they’re up, the next day they’re crashing. This unpredictability is what can cause mood swings, irritability and even symptoms of depression or anxiety. If you’ve ever felt like bursting into tears over something trivial, only to feel fine an hour later, you can most definitely blame the hormonal rollercoaster.

Anxiety and Panic Attacks

Many women report experiencing heightened anxiety during perimenopause, even if they’ve never had anxiety before. You might feel more on edge, have trouble relaxing or experience racing thoughts. Some women even have full-blown panic attacks, feeling overwhelmed by fear without a clear reason. This can be incredibly frustrating, especially if you’ve always been someone who could handle stress well.

The Foggy Brain Dilemma

Do you walk into a room and forget why you’re there? Struggle to recall words mid-sentence? Feel like your brain is moving through treacle? Cognitive issues, often called “brain fog,” are common during perimenopause. Oestrogen plays a big role in cognitive function, and as levels fluctuate, you may notice lapses in memory, difficulty concentrating and a general sense of mental exhaustion. Honestly, some days I feel like I’m running on a quarter of my usual brainpower.

Mood Swings and Irritability

One minute you’re fine, the next you’re snapping at your partner, kids or coworkers over something minor. Mood swings during perimenopause can feel like the emotional turbulence of puberty all over again. You might find yourself more sensitive, quicker to anger or struggling to control your emotions. This isn’t just in your head, it’s the direct result of hormonal imbalances that affect neurotransmitters like serotonin and dopamine, which regulate our mood.

Depression and Feeling Low

For some women, perimenopause can bring feelings of sadness, hopelessness or emotional numbness. This isn’t the same as situational sadness; it’s a deeper, persistent low that can feel overwhelming. If you’ve had a history of depression, perimenopause can intensify symptoms. But even if you’ve never struggled with depression before, the hormonal shifts can still trigger changes in mood that feel completely out of character.

Sleep Disturbances and Their Effect on Mental Health

Sleep and mental health go hand in hand, and perimenopause often brings disruptive sleep patterns (don’t I know it!) Hot flushes, night sweats and insomnia can leave you feeling exhausted, which only amplifies mood swings, anxiety and that frustrating brain fog. Poor sleep can make even minor stressors feel monumental and make it harder to manage your emotions.

How to Support Your Mental Health During Perimenopause

While the hormonal shifts of perimenopause can feel overwhelming, there are ways to support your mental health during this time:

• Talk to Your Doctor: If mood changes are significantly impacting your life, speak with a doctor or nurse. Hormone therapy, antidepressants or other treatments such as supplements might be an option for you.
• Prioritise Sleep: Establish a calming bedtime routine, limit caffeine in the afternoon and create a sleep-friendly environment to improve rest.
• Move Your Body: Exercise can help regulate mood and improve brain function. Even a 20-minute walk can do wonders for mental clarity and emotional stability.
• Mindfulness and Relaxation: Practices like meditation, deep breathing and yoga can help calm the nervous system and help to reduce anxiety.
• Support System: Surround yourself with people who understand what you’re going through. Talking to friends, joining support groups or even working with a counsellor can be beneficial.
• Nutrition Matters: Eating a balanced diet rich in omega-3s, protein and healthy fats can support brain function and mood stability.
• Supplements: There are many complete supplements available on the market that are designed to take the edge off of perimenopausal symptoms. Other vitamins you may want to look into include magnesium, iron, vitamin D, calcium and starflower oil.

You’re Not Alone

If perimenopause is making you feel like a stranger in your own body and mind, know that you’re not alone. The emotional and cognitive symptoms are real, but they’re also manageable. Understanding what’s happening can be the first step in regaining control and finding ways to support your mental well-being. Be kind to yourself.