Understanding Perimenopause & Mental Health: What Every Woman Needs to Know

Author: Kiara-Breia Hicks-Lyles CRNP, PMHNP-BC

Introduction

Perimenopause is a natural but often misunderstood phase in a woman’s life. While most expect hot flashes or irregular cycles, many are surprised when emotional and psychological symptoms surface as well. Mood swings, anxiety, irritability, and even depressive symptoms can appear long before menopause itself.This blog offers clarity on what’s happening in the body, why mental health can shift during perimenopause, and how you can find relief.

What Is Perimenopause?

Perimenopause is the transitional period leading up to menopause and can begin as early as the mid-30s to early 40s. During this time, estrogen and progesterone fluctuate dramatically, influencing both physical and mental well-being.

Common symptoms include:

• Irregular menstrual cycles

• Hot flashes and night sweats

• Fatigue

• Sleep disturbances

• Mood changes

• Brain fog or difficulty concentrating

• Increased anxiety or irritability

These symptoms vary widely—some women experience mild shifts, while others find the changes disruptive.

How Hormones Affect Mental Health

Hormones and mood are deeply connected. Estrogen influences serotonin, dopamine, and norepinephrine—neurotransmitters involved in mood regulation. When estrogen levels fluctuate, these neurotransmitters may shift as well.

You may notice:

• New or worsening anxiety

• Emotional sensitivity

• Feelings of sadness

• Lower frustration tolerance

• Decreased motivation

Women with a history of depression, trauma, PMDD, or postpartum mood disorders may experience more intense symptoms.

Why This Transition Feels So Overwhelming

Perimenopause often overlaps with major life roles and responsibilities: raising children, caring for aging parents, building careers, or managing long-term relationships.This emotional load can make hormonal changes feel even heavier.

What You Can Do to Support Your Mental Health

1. Prioritize Sleep

Sleep disturbances are common in perimenopause and can increase anxiety and irritability.Helpful strategies include:

• Keeping a cool sleep environment

• Limiting caffeine later in the day

• Practicing nighttime wind-down routines

• Considering magnesium or other natural supports

2. Move With Intention

Exercise can stabilize mood and improve energy.Great options include:

• Low-impact strength training

• Yoga

• Pilates

• Daily walking

Movement supports hormonal balance and nervous system regulation.

3. Consider Integrative & Supplemental Supports

Under professional guidance, supplements such as:

• Magnesium glycinate

• Evening primrose oil

• Vitamin D

• Omega-3s

can help with mood, energy, and sleep.

4. Explore Therapy or Medication if Needed

Working with a PMHNP or mental health provider can help you determine whether you may benefit from:

• Cognitive behavioral therapy (CBT)

• Trauma-informed approaches

• Mood-stabilizing or antidepressant medication

• Hormonal evaluation with your PCP or gynecologist

There is no one-size-fits-all plan—care should be tailored to your unique experience.

Key Takeaways

• Perimenopause can start earlier than expected.

• Hormonal changes can significantly impact mood and mental health.

• Supportive lifestyle shifts and professional care can bring meaningful relief.

• You’re not “just emotional”—your body is transitioning in real ways.

If you’re experiencing mood changes, anxiety, or emotional overwhelm during perimenopause, OPOM Wellness is here to help. Now accepting new clients in PA & MD. You deserve support that understands the full picture—including your hormones, your story, and your goals.