How Perimenopause Affects Your Mental Health

If your mood fluctuations feel less like your usual stress and anxiety and more like the beginnings of a villain origin story (and you’re also experiencing symptoms like insomnia and feeling warmer than usual), it could be the beginning stages of perimenopause.

This is what doctors call the transition to menopause, which is the end of a person’s reproductive years and technically marked by 12 consecutive months without a period, with the full transition taking anywhere from two to eight years, according to the Office on Women’s Health (OWH).

Perimenopause usually begins after the age of 40 (though it can start earlier), the variabilities of which — both in ovarian function and hormone levels — can leave you feeling out of sorts.

“It’s generally a confusing time that catches many of us by surprise, in large part because of how wildly unpredictable symptoms of perimenopause can be,” Dr. Anna Barbieri, New York-based OB-GYN and founding physician at Elektra Health, told HuffPost. “Hormonal changes, and the way symptoms show up, are anything but linear.”

For some, periods can still be regular in the early stages of perimenopause, making it easy to brush off mood-related symptoms (anxiety, irritability, crying spells) as being caused by things like stress, sleep deprivation or burnout.

But start adding signs of cognitive decline to the mix — drawing a blank as to what someone just told you, forgetting what you walked into a room to do — and these ongoing mental blips can trigger understandable waves of panic and fear as to what exactly is going on with that mind of yours.

The possible links between perimenopause and mental health

In our 20s and 30s (pre-menopause), there’s a predictable ebb and flow to our hormones — ditto post-menopause, a time when our hormones are low, but steady.

The perimenopausal period is marked by one long hormonal fluctuation, with levels of estrogen and progesterone (typically referred to as “female” hormones) varying quite a bit. Testosterone — a “male” hormone that’s produced at lower levels in people assigned female at birth — takes a slow dip as well.

Bottom line: “Your hormones are a rollercoaster, and the rest of you is along for the ride,” Barbieri said.