Perimenopause and Mental Health: What Every Woman Deserves to Know

Written By Heather Thompson

What Is Perimenopause?

Perimenopause is the transitional phase leading up to menopause, often beginning in a woman’s late 30s or 40s. During this time, hormone levels—especially estrogen and progesterone—fluctuate significantly. While many people associate perimenopause with physical symptoms like hot flashes or disrupted sleep, the emotional and psychological impact is just as real and often overlooked.

Common Mental Health Symptoms of Perimenopause

Many women are surprised by how intense the emotional changes can feel. Common mental health symptoms during perimenopause include:

  • Increased anxiety or panic attacks

  • Mood swings or irritability

  • Depression or feelings of hopelessness

  • Brain fog and difficulty concentrating

  • Sleep disturbances that worsen emotional regulation

  • Heightened emotional sensitivity

For women with a history of trauma, anxiety, or depression, perimenopause can intensify symptoms that were previously manageable.

Why Perimenopause Can Feel So Overwhelming

Hormonal changes don’t happen in a vacuum. Perimenopause often coincides with major life stressors—career demands, caregiving for children or aging parents, relationship changes, or identity shifts. Many women tell themselves they should “just push through,” which can lead to burnout and self-blame.

The truth is: nothing is wrong with you. Your nervous system and hormones are working overtime.

How Therapy Can Help During Perimenopause

Therapy provides a supportive space to make sense of what your body and mind are experiencing. Working with a therapist who understands women’s mental health can help you:

  • Reduce anxiety and emotional overwhelm

  • Develop tools to regulate your nervous system

  • Process identity changes and grief around aging

  • Improve communication in relationships

  • Reconnect with your sense of self and confidence

A holistic, trauma-informed approach can be especially helpful during this stage of life.

You’re Not Alone in This Transition

Perimenopause can feel isolating, but support makes a meaningful difference. You deserve care that honors both your emotional and physical experience.

Call to Action:
If you’re navigating perimenopause and noticing changes in your mental health, therapy can help. I offer individual therapy for women in Washington State, both in-person and virtual. Schedule a complimentary 15-minute consultation to see if we’re a good fit.

*Medical & Mental Health Disclaimer*

The information provided in this blog is for educational and informational purposes only and is not intended as a substitute for professional mental health care, medical advice, diagnosis, or treatment. Reading this content does not establish a therapeutic relationship between you and Mar & Sol Mental Health Services, PLLC or its clinicians.

If you are experiencing distressing symptoms, a mental health crisis, or believe you may need immediate support, please contact a licensed healthcare provider, call 911, or reach out to your local crisis line. Always seek the advice of a qualified medical or mental health professional with any questions you may have regarding your physical or emotional health.

Heather Thompson