Navigating mental health during perimenopause

Perimenopause is the transitional phase before menopause that can last anywhere from a few  months to several years. It comes with a range of changes driven by fluctuating hormone levels as well as metabolic changes that impact many areas of health and wellbeing. 

With over 30 symptoms impacting almost all areas of the body, it’s no surprise that some women feel anxious and overwhelmed as they navigate this phase of life. That’s why it’s more important than ever to prioritise looking after mental wellbeing during perimenopause and beyond. 

How perimenopause affects your mental health

When it comes to perimenopause, mental health can take a bit of a hit. First, hormonal changes can lead to mental health symptoms such as anxiety and mood changes. On top of that, major bodily changes can lead to overwhelm and confusion. Together, these impacts can greatly affect a woman’s quality of life.  

The term perimenopause comes from the Greek words ‘peri’ meaning‘around’, and ‘menopause’, which refers to a woman’s last menstrual period. So in essence, it is defined as the period of time around menopause. While menopause officially starts 12 consecutive months after a woman's last period, the official start point of perimenopause is a bit harder to define. What is known, is that during this phase, levels of key female hormones oestrogen and progesterone fluctuate rapidly, which means symptoms can regularly change.  This can lead to distress, making it hard to manage changes while maintaining a good quality of life.

How do I know it’s related to perimenopause?

One of the most challenging aspects of perimenopause is that it’s not easy to diagnose.. Blood tests can often be unreliable because hormone levels fluctuate and will likely show different results depending on the day and time the test was completed. 

The most effective way for a doctor to identify perimenopause is using a symptom assessment and diary, which can help to piece together a picture showing a variety of symptoms of perimenopause. The Jean Hailes website has a handy symptom checklist that can be completed and taken along to a doctor's visit. It may even be useful to document symptoms in a diary so the doctor can assess how symptoms have changed or persisted over time. 

In any case, anyone experiencing mental health symptoms such as anxiety, low or changed mood, unmanageable stress levels, trouble sleeping or the like should always seek medical advice as soon as possible. 

Common mental health symptoms 

While the common symptoms of perimenopause are known as hot flushes, night sweats, mood changes, low libido and more, these are not the only things that happen in this stage of life. For example, 4 in 10 women also report symptoms such as difficulty concentrating, or memory loss, and these symptoms may occur on and off for years. 

Common mental health symptoms  during perimenopause are:

• Irritability or hostility
• Decreased self-esteem
• Feeling tearful or moody 
• Low energy 
• Anxiety
• Trouble sleeping 
• Less interest in sex 
• Problems with memory
• Difficulty concentrating 

It also appears that women with perimenopause are at a higher risk of depression. . But because many of these symptoms overlap with those caused by hormonal changes, getting a diagnosis can be tricky and sometimes delayed. It’s important to discuss any such symptoms with a doctor to establish the possible cause and best treatments.

Managing your mental wellbeing during perimenopause

In some cases, medications may be prescribed for women in perimenopause with mental health concerns. 

There are also several ways to support mental wellbeing with simple lifestyle habits, including: c 

• Eating more wholefoods and minimising your intake of processed foods
• Moving your body regularly with exercise 
• Limiting alcohol intake
• Breathing exercises
• Journalling
• Talking to someone about your feelings
• Spending time in nature 
• Joining support groups

The bottom line:

Mental health symptoms are not uncommon during perimenopause. In fact, most women in this stage of life will likely experience one or more of these symptoms over time. If you’re experiencing low mood or changes to your mood, please speak to your healthcare professional to find the best treatment options for you.

Find a Psychologist via the Australian Psychological Society for in-person or online consultations. 

If you need urgent mental health support, please present to your local emergency department or call 000. Crisis support is also available via LifeLine 24/7 on 13 11 14.

Reviewed by the Healthylife health experts February 2025.