Menopause is often talked about in terms of hot flashes, sleep struggles, or irregular periods—but what about the emotional changes that can come with it?
For many women, perimenopause and menopause bring profound shifts not just in the body, but in the mind. It’s not uncommon to feel unlike yourself, to struggle with mood swings, brain fog, or even depression—and it can be confusing or even scary if you don’t realize what’s behind it.
Let’s break down what’s happening, how to recognize changes in mental health during this transition, and what you can do to feel more like you again.
Hormones and Mental Health in Menopause: What’s the Connection?
Perimenopause—the years leading up to menopause—is marked by fluctuating levels of estrogen and progesterone. These hormones don’t just regulate reproduction; they also influence mood, cognition, and emotional balance. Estrogen, in particular, interacts with serotonin and other neurotransmitters in the brain that affect mood.
So when estrogen levels become erratic or start to decline, it’s no surprise that many women report feeling anxious, irritable, tearful, or “off.” You might find yourself snapping at loved ones, crying over commercials, or struggling to focus in ways that feel totally unfamiliar.
Some women even experience new or worsening symptoms of anxiety and depression during this time—sometimes for the first time in their lives.
Signs Your Mental Health Might Be Changing
Mental health symptoms during menopause can show up in different ways for different women. Here are some common signs to watch for:
- Increased anxiety or panic attacks
- Feelings of sadness or hopelessness
- Irritability or sudden mood swings
- Loss of interest in things you used to enjoy
- Difficulty concentrating or memory issues (“brain fog”)
- Changes in sleep patterns
- Fatigue that feels more emotional than physical
- Low self-esteem or increased self-doubt
While some of these may be temporary or mild, others may indicate clinical depression or anxiety and shouldn’t be ignored—especially if they start to interfere with your daily life.
Understanding the Impact of Depression During Menopause
Depression during menopause isn’t just a phase you can push through. Studies have shown that women in perimenopause are at higher risk for depressive symptoms compared to pre- or post-menopause. The combination of hormone changes, life stressors (like aging parents, kids leaving home, or career shifts), and sleep disruption can all contribute to feeling overwhelmed.
Unchecked depression can affect everything—from relationships to your physical health. That’s why it’s important to take it seriously and know that you’re not alone, and there is help.
Treatment Options: You Have Choices
The good news? There are many ways to support your mental health during menopause—some natural, some medical, and many that can be combined to fit your needs.
1. Talk Therapy
Cognitive behavioral therapy (CBT) and other forms of counseling can be incredibly effective in treating menopausal anxiety or depression. Therapy gives you tools to manage mood changes, reduce stress, and reframe negative thinking patterns.
2. Lifestyle Changes
- Exercise: Regular movement boosts endorphins and improves mood.
- Sleep hygiene: Create a calming routine to help regulate disrupted sleep.
- Nutrition: A balanced diet can stabilize energy and mood.
- Mindfulness & meditation: Practicing present-moment awareness can lower anxiety levels.
3. Medications
SSRIs or SNRIs can help manage more severe depression or anxiety.
4. Support Networks
Sometimes, just talking with other women going through the same thing can be a lifeline. Online groups, menopause support communities, or local wellness workshops can provide comfort and connection.
Essential Survey
Dr. Juliana Hauser, in conjunction with FemmePharma, is conducting an important survey about mental health in perimenopause and menopause. Dr. Juliana Hauser leads conversations about taboo topics like sex and sexuality, menopause, intimacy, relationships, and more both publicly and privately through her practice. She has a PhD in Counseling Education and has a TEDx talk about her work with personal agency. She’s seeking 1,000 participants to fill out a 15-20 minute survey, completely online and anonymous and will publicly share the results this summer so long as she reaches this goal of participation. This survey is for women ages 35-90 who are in perimenopause, menopause, or who are younger if they have experienced surgical menopause.
Please follow this link to find out more and participate in the survey:
Dr. Hauser Survey on Perimenopause and Menopause Mental Health
It’s Okay to Ask for Help
Menopause isn’t just a biological milestone—it’s an emotional one, too. If you’ve been feeling off, overwhelmed, or down, don’t be afraid to ask for help. Your mental health matters, and getting support isn’t a weakness—it’s a smart and necessary step toward thriving in this next chapter of life.
Remember: this is a season, not a sentence. With the right tools and support, you can feel balanced, whole, and empowered through menopause and beyond.
If you or someone you love is struggling with depression or suicidal thoughts, don’t wait—reach out. In the U.S., you can contact the 988 Suicide & Crisis Lifeline by calling or texting 988, 24/7.