Perimenopause: Mental Health and Wellbeing
Perimenopause isn’t just about hot flushes and irregular cycles. The hormonal changes of this stage can have a huge impact on your mental health and emotional wellbeing. While it can be confronting, the good news is that with the right knowledge and support, this can also be a time of growth, healing and self-discovery.
Perimenopause as a Window of Risk
For many women and AFAB people, perimenopause is when mental health concerns can re-emerge or flare up. Past experiences of anxiety, body image struggles, eating disorders, mood disorders, or trauma can resurface. For others, this may be the first time they encounter depression, anxiety, or significant mood changes.
Hormonal shifts during the menopause transition affect neurotransmitters that regulate mood, which is why symptoms like mood swings, irritability, sleep problems, anxiety and depression can become more noticeable.
The Impact of Trauma
There’s a strong link between earlier trauma, Adverse Childhood Experiences (ACEs), and a greater risk of depression in the perimenopausal years. If old wounds or untended trauma are resurfacing, it’s not a personal failing—it’s your body and mind flagging that you may need extra support. Working with a menopause-informed mental health professional can help you process these experiences safely and begin to feel more grounded.
The Role of Sleep
Sleep is one of the pillars of mental health, yet perimenopause can wreak havoc on it. Night sweats, hormonal changes and restless nights often leave women exhausted. Poor sleep makes it harder to manage stress, cope with daily demands, and regulate mood. That’s why prioritising rest isn’t indulgent, it’s essential for mental wellbeing during this stage.
Mental and Emotional Wellbeing
Common Mental Health and Emotional Challenges
It’s important to be aware of the many ways perimenopause can affect mental health. These may include:
Mood swings and irritability
Lower stress tolerance
Loss of motivation and confidence
Withdrawal from social connections
Body image concerns
Feeling like you have less to give
A sense of “not feeling like yourself”
Because perimenopause often coincides with midlife pressures like career, caring for children or ageing parents, relationship stress, it’s easy to misinterpret symptoms as burnout or overwhelm. Many women describe it as a profound feeling of 'having less to give' or 'not just feeling like myself'. And there is often a strong pull to turn inward and prioritise themselves, similar to the developmental push for independence in adolescence.
Many individuals report feeling the urge to prioritise their own needs, time, and resources, an echo of the drive for independence characteristic of adolescence.
Perimenopause as a Window of Opportunity
Perimenopause isn’t just a biological event, it’s a psychological and emotional rite of passage. Many women begin to reflect on identity, values, purpose, and how they want to live the next stage of life. This transition invites you to pause, review, and ask: What’s sustainable for me? What needs to change?
After perhaps decades of focussing on external pursuits and the care of others, perimenopause offers a perfectly timed invitation to do a life review, urging individuals to evaluate their current path, habits, and relationships and consider the sustainability of their roles and expectations of themselves.
If perimenopause was seen as a rite of passage with physical, emotional and mental shifts similar to those experienced at puberty, pregnancy and post-partum, we could perhaps see the perfection of mother nature forcing us to turn inward for the unfolding of our midlife metamorphosis that is purposeful and necessary.
Self-Care Strategy
Embracing a holistic view of mental health and well-being, which encompasses physical health, mental resilience, self-awareness and compassion, emotional regulation, and social connectivity is essential.
So your self-care strategy might include:
Building self-awareness and self-compassion
Learning nervous system regulation strategies
Exploring body-based therapies such as yoga therapy, somatic psychotherapy or EMDR
Strengthening social connections and seeking supportive communities
Prioritising rest and balanced routines
Professional Support
If symptoms are interfering with your work, relationships, or ability to enjoy life, it’s important to seek help. A menopause-informed mental health or medical professional can guide you through tailored treatment.
For some women, Hormone Therapy (HT) not only eases physical symptoms but also improves mood and stress resilience. In fact, HT is now the recommended first-line treatment for peri/menopausal depression. However, there is so much going on for midlife women well beyond the neuroendocrine event of peri/menopause. Identity shifts, changes in values and what feels purposeful, relationship strain, ageing parents or parents becoming unwell or passing away, teens and young adults facing their own stressors and/or leaving home, financial strain and career pressure (to name a few).
While these are 'normal' and 'typical' events of midlife, they are still painful. While HT helps give you the 'bandwidth' to cope, there are many instances when psychological therapy is going to provide the most support and pathway forward.
Crisis Support
In Australia, you can access crisis support for acute mental health symptoms through the following services:
Lifeline 13 11 14
Suicide Call Back Service 1300 658 467 or Call 000 for an Ambulance.
You Don’t Have to Navigate This Alone
Perimenopause can feel overwhelming, but it doesn’t have to be something you “just get through.” With the right support, this can be a time to not only manage symptoms but also reconnect with yourself and create a stronger foundation for the years ahead.
All About Her Centre for Menopause is a collective of health professionals for Australian women whose lives are impacted by menopause, and education and training for the psychologists and health professionals who support them.
We exist to ensure that perimenopausal, menopausal and postmenopausal women feel understood, seen and supported at every step along the way.
*All About Her - The Centre for Menopause acknowledges that all people born with ovaries and who live long enough will experience the menopause transition. This includes cisgender women, transgender men, non-binary individuals, and any other individual with ovaries. We use the terms
individuals/people to be inclusive of the many who do not identify as women, but who will nonetheless experience this significant life stage.
Disclaimer: The information presented is for general understanding only and should not substitute professional medical advice. If you are concerned about your health, talk to your doctor or healthcare team for personalised guidance.
© All About Her Centre 2024