During perimenopause, fluctuating hormone levels can both worsen pre-existing mental health conditions and contribute to the development of new psychological and cognitive symptoms, including:
- Low mood
- Anxiety
- Panic attacks
- Irritability
- Mood swings
- Brain fog
- Poor concentration
- Loss of confidence
- Feeling overwhelmed
Women with a history of hormone-sensitive conditions—such as postnatal depression or anxiety, premenstrual syndrome (PMS), or premenstrual dysphoric disorder (PMDD)—may be particularly susceptible to worsening symptoms during perimenopause.
However, these symptoms are not limited to women with a previous mental health history. Many women who have never experienced anxiety, depression, or significant mood changes before can develop psychological and cognitive symptoms for the first time during the menopause transition.
It can be an incredibly confusing and distressing experience. Many women tell me they feel as though they are “losing themselves” or “losing their mind,” without realising that fluctuating hormones may be contributing to how they feel. This is especially true when symptoms occur in the absence of the more widely recognised signs of menopause, such as hot flushes or night sweats.
It’s also important to remember that perimenopause can begin much earlier than many people expect—sometimes in the mid-to-late thirties or early forties. If you’re in this age group and have developed new psychological or cognitive symptoms, hormonal changes may be one factor worth considering as part of a comprehensive medical assessment.
The good news is that you do not have to struggle alone. Effective support and treatment are available, but the first step is recognising what may be happening.
If this resonates with you, or someone you care about, please seek advice from your GP or a British Menopause Society-registered menopause specialist. You deserve to be listened to, taken seriously, and supported.