Perimenopause & Your Mind

Perimenopause - the transition years before menopause - can significantly affect mental health. Fluctuating oestrogen and progesterone are associated with disruptions to mood, sleep, and stress resilience. Anxiety, low mood, irritability, brain fog, and tearfulness are commonly reported, yet are often misattributed to stress or overlooked entirely.

Research consistently links perimenopause with increased vulnerability to depression and anxiety, particularly for women with a history of PMS or prior mental health difficulties. If this sounds familiar, know that what you're experiencing is recognised, valid, and treatable.

How psychology can help

Cognitive Behaviour Therapy (CBT): is a well-supported treatment for anxiety and depression, helping to identify unhelpful thought patterns and build practical coping strategies.

Acceptance and Commitment Therapy (ACT): supports psychological flexibility — useful when navigating identity changes and uncertainty during this life stage.

CBT for Insomnia (CBT-I): targets sleep difficulties, which commonly worsen mood, concentration, and emotional regulation during perimenopause.

Behavioural activation: Re-engaging with valued activities supports mood and sense of self — particularly helpful when low energy and withdrawal become a pattern.

A psychologist can offer a space to make sense of what you're experiencing and develop skills to manage it. For medical aspects of perimenopause - such as hormonal treatments - your GP or gynaecologist is the right person to speak with. A collaborative approach across both often works best.

Written by Dr Maala Lal (Founder of Sydney Psychology Group & Clinical Psychologist)