Menopause, Perimenopause, and Mental Health
When most people hear the word menopause, they immediately think of hot flashes, night sweats, and mood swings. And yes—those are very real. But what often gets left out of the conversation is the profound effect this transition can have on a woman’s mental health and relationships.
In my office, I’ve sat with countless women who whisper things like, “I feel like I’m losing my mind… am I going crazy?” Suddenly, they’re questioning everything—careers, partnerships, even their sense of self. It’s not just about biology; it’s about the ripple effect these hormonal shifts can have on every corner of life.
What’s Really Happening in Perimenopause and Menopause
Menopause typically arrives in the late 40s or early 50s, but the lead-up—perimenopause—can begin up to 10 years earlier. Officially, menopause is defined as one year without a period, but the symptoms can start much sooner.
And while there’s no single blood test that gives a definitive answer, your body’s collection of symptoms tells a story worth listening to.
Common symptoms include:
Hot flashes and night sweats
Mood swings and irritability
Brain fog, memory lapses, and indecisiveness
Sexual changes
Bladder problems
Shifts in body fat distribution (hello, back fat!)
Trouble sleeping—arguably the most disruptive of all
But that’s not the full picture. Many women also experience joint pain, heart palpitations, itchy skin, dry eyes, constipation, or dizziness. On their own, these symptoms can be frustrating; together, they can feel overwhelming.
More Than Just Hormones
The hormonal rollercoaster is real. Declining estrogen affects nearly every system in the body, so it makes sense that the impact can be widespread—and different for each woman.
For those who’ve struggled with PMS or PMDD in the past, symptoms during perimenopause often hit harder. Anxiety, depression, irritability, and feelings of dread can creep in. Add to this the external stressors of midlife—teenagers at home, aging parents, career shifts, family pressures—and it’s no wonder so many women feel like they’re at a breaking point.
And here’s the truth: for too long, women have been told to just “deal with it.” Thankfully, that narrative is changing.
Why Mental Health Support Matters
Mental health isn’t a side note here—it’s central. The irritability, sadness, brain fog, and sleep loss aren’t weaknesses; they’re symptoms. And just like hot flashes or joint pain, they deserve validation and support.
Therapy can play a huge role in this stage of life. It offers:
Education about what’s happening in your body and mind
Strategies to cope with symptoms and improve daily functioning
Preparation for meaningful conversations with your doctor
Empowerment to advocate for your mental health and wellbeing
Sleep: Your Secret Weapon
If there’s one area to prioritize, it’s sleep. Quality rest is the foundation of mental and physical health—and the first thing to go haywire during perimenopause. Here are my top therapist-approved tips:
Wear an eye mask – Even the tiniest bit of light can disrupt sleep.
Do a brain dump – Write out all the worries swirling in your head before bed.
Sip chamomile tea – (Check with your doctor or pharmacist first.)
Learn CBT strategies – Cognitive-behavioral tools can retrain your brain for healthier sleep patterns.
Stepping Into Your Power
Perimenopause and menopause are not just endings—they’re transitions. With the right support, they can become seasons of self-discovery and growth. Therapy can help you release shame, challenge limiting beliefs, and reconnect with your resilience.
This stage doesn’t mean losing yourself. It can mean stepping into your most powerful, confident, and wise season of life.
If you’re navigating perimenopause or menopause and wondering if therapy might help, I encourage you to reach out. You don’t have to do this alone. Connect here
