Perimenopause is the transitional period before menopause.
Most people who go through menopause begin to experience symptoms like brain fog, anxiety, and irritability during perimenopause.
Learning about perimenopause versus menopause can empower you to feel more confident navigating this next stage of life.
Perimenopause refers to the years leading up to menopause. You’re still getting your period, but you may also be experiencing menopausal symptoms like brain fog and irritability.
If you’re in or nearing this stage of life, you may find it helpful to learn about perimenopause vs. menopause. Having this knowledge can empower you to prioritize your mental health throughout the menopausal transition.
Stages of menopause, explained
Menopause is when a person with ovaries goes 12 consecutive months without a period. It’s a singular event, but your body is going through changes well before and after this milestone.
Perimenopause
Many people think they’re "in menopause" when they're actually in the perimenopause stage. Perimenopause typically begins during your mid-40s and lasts for 2–8 years [1]. As your hormone levels begin to fluctuate, you may experience symptoms like irregular periods, hot flashes, and insomnia.
Menopause
The average age to have menopause in the U.S. is 52 [2], but anytime between the ages of 45 and 55 is considered normal. You’ll know you’ve reached menopause when you haven’t had a menstrual period for an entire year. At this point, your ovaries stop releasing eggs, and you can no longer get pregnant.
Postmenopause
Once you reach menopause, you enter postmenopause and remain in this stage for the rest of your life. At this point, your body is producing much lower levels of the hormones estrogen and progesterone.
These changes can increase your risk of health concerns like stroke, osteoporosis, and heart disease. You may find that menopausal symptoms become milder or resolve completely with time.
Signs and symptoms of perimenopause
Irregular periods are usually one of the first signs of perimenopause. You may find that your periods become shorter, heavier, or different from previous cycles.
Some other common symptoms of perimenopause include:
Hot flashes and night sweats
Weight gain
Vaginal dryness
Headaches
Changes in libido
Brain fog
Anger and irritability
Forgetfulness
Mental health effects of perimenopause
Menopause is a natural part of aging, yet many people aren’t prepared for the way it impacts their body and mind [3]. Menopausal symptoms like mood swings are often attributed to typical stressors like work and parenthood.
Once you realize it’s perimenopause, you may begin to worry about what it means for your identity and future. These symptoms and concerns can be more severe if you have a history of depression or poor overall health.
During perimenopause, you may feel more:
Anxious: An increase in anxiety is common during menopause. You may find that you’re more anxious in the morning or having difficulty concentrating throughout the day.
Irritable: Many people feel more tense and on edge during this transitional phase. It’s easy to be overwhelmed or triggered by things that don’t typically bother you.
Emotionally unstable: Perimenopause can feel like an emotional roller coaster, causing mood swings and trouble regulating your emotions.
Hormonal changes may also increase your risk of developing new mental health challenges or worsening symptoms [4] of existing conditions, including:
Supporting your mental health through menopause
You can’t avoid menopause, but you can learn to make the transition feel more manageable. These lifestyle changes and self-care techniques may help you cope with some perimenopause symptoms:
Keep a journal
Journaling is a flexible tool that can be used to make sense of some of the changes happening during this transition. Even just 5 minutes per day can help you slow down, recognize patterns, and process your emotions.
Here are some simple prompts to get you started:
“What am I feeling right now?”
“What went well today?”
“Did anything feel more challenging than usual?”
“What are three things that I appreciate about myself today?”
Consider your lifestyle habits
Make time for the basics, like a healthy diet, regular movement, and quality sleep. Prioritizing a well-balanced diet [8] and mindful movement can help you feel more energized and manage stress and hormone-related mood changes.
If perimenopause is making sleep more difficult, consider how you can improve your sleep hygiene. For example, avoiding caffeine, sugar, and screen time before bed. You may also find it helpful to create a more cool and calming sleep environment — especially if you’re dealing with hot flashes.
Be kind to yourself
Navigating the menopausal transition isn't easy, so remember to be kind to yourself. Everyone's experience is different, so try not to compare yourself to others or judge your own needs.
If you had a rough night, choose to take a nap or an earlier bedtime the next day. If you’re feeling bad about how symptoms are changing your body, remind yourself that you’re strong and capable.
Focus on what’s next
Like any major life change, perimenopause presents an opportunity for reflection and growth. As you navigate this new phase in life, make a point to embrace your strengths and identify what’s causing you stress. Setting specific and realistic mental health goals can help you focus on a future that feels right to you.
Seek professional support
If menopausal symptoms are impacting your daily functioning or quality of life, remember that support is available. Working with a psychiatrist or therapist can help you find the right approach to manage anxiety, cope with change, and begin to feel like yourself again.
The care you need, when you need it
Learn how Rula can support your mental health journey
Knowing that the menopausal transition may be affecting your mood can help you make sense of changes that otherwise feel confusing. Instead of blaming yourself for feeling different, you can start thinking about what you need and whether it’s time to reach out for support.
Brandy Chalmers, LPC
Clinical reviewer
Find care with Rula
Growing older can be challenging, especially when it involves such significant mental, emotional, and physical changes. If you’re finding it difficult to cope with perimenopause symptoms, know that support is available.
Working with a therapist can help you identify and treat challenges like anxiety, mood swings, and trouble sleeping. With the right support, you can navigate this new phase of your life with self-awareness and hope.
At Rula, we’re here to help you feel better. Rula makes it easy to find a licensed therapist or psychiatric provider who takes your insurance. That way, you don’t have to choose between great care and a price you can afford.
Rula patients pay about $15 per session with insurance, and 93% say they feel better after getting care through Rula. We have 21,000+ providers, and appointments are available as soon as tomorrow. We’re here to help you take the next step — wherever you are in your mental health journey.
References
- Menopause basics https://womenshealth.gov/menopause/menopause-basics
- What Is Menopause? https://www.nia.nih.gov/health/menopause/what-menopause
- An online survey of perimenopausal women to determine their attitudes and knowledge of the menopause https://pmc.ncbi.nlm.nih.gov/articles/PMC9244939/
- Severe mental illness and the perimenopause https://pmc.ncbi.nlm.nih.gov/articles/PMC11669460/
- Does menopause elevate the risk for developing depression and anxiety? Results from a systematic review https://journals.sagepub.com/doi/10.1177/10398562231165439
- OBSESSIVE–COMPULSIVE DISORDER AND FEMALE REPRODUCTIVE CYCLE EVENTS: RESULTS FROM THE OCD AND REPRODUCTION COLLABORATIVE STUDY https://onlinelibrary.wiley.com/doi/abs/10.1002/da.22234
- Symptom severity of bipolar disorder during the menopausal transition https://pmc.ncbi.nlm.nih.gov/articles/PMC4546121/
- The Importance of Nutrition in Menopause and Perimenopause—A Review https://pmc.ncbi.nlm.nih.gov/articles/PMC10780928/#sec6-nutrients-16-00027
Alex Bachert
Alex Bachert is a freelance copywriter and mental health advocate. Since earning her masters degree in public health, she has focused her career on creating informative content that empowers people to prioritize their health and well-being. Alex has partnered with organizations like Ro, WellTheory, and Firsthand, and her work has been recognized by the Digital Health Association.
When she’s not writing about mental health, Alex is usually playing pickleball, meeting with her local board of health, or enjoying time with her three kids.
Brandy Chalmers, LPC
Having faced challenges like childhood abuse, neglect, and the loss of her father to suicide, Brandy Chalmers is deeply passionate about providing compassionate care. She is a Licensed Professional Counselor, Nationally Certified Counselor, and Registered Play Therapist with a Master’s Degree in Clinical Counseling and Marriage and Family Therapy.
Brandy also teaches at a university, sharing her expertise with future mental health professionals. With over a decade of experience in settings like inpatient care and private practice, she specializes in helping clients with perfectionism, trauma, personality disorders, eating disorders, and life changes.
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