Navigating Mental Health Challenges in Perimenopause:

 Understanding, Coping, and Thriving!

Perimenopause is a profound and transformative phase in a woman’s life, but it can also bring unexpected mental health challenges, like anxiety depression, and rage.

These emotions can feel heavy and isolating, often leaving many women wondering,

What’s wrong with me? But here’s the truth: it’s not all in your head—it’s in your hormones.

The good news?

These challenges are mostly temporary, and with understanding, support, and the right tools, you can navigate this phase with grace and empowerment.

In this blog, I’ve packed in a deep dive into what’s happening in your body over this time, which can least up to 10 years. My hope is not to overwhelm you, but to help you understand that if you’re resonating with any of this, now is the time for self-care, girlfriend.

Now is the time to set boundaries and prioritize YOU. You kind of have to, and trust me, it will make all the difference. xx Coryn

Common Reflections from Women Navigating Perimenopause

Here are some things I often hear from clients during this time:

• I don’t feel like myself.

• I don’t have the confidence I used to have.

• I feel so flat.

• I can’t think straight.

• I no longer feel okay about the world.

• I have no patience for my loved ones.

• I wake in the morning with a knot in my stomach.

• I keep replaying the same scenario over and over in my head.

• I’ve lost my joy.

Why Mental Health Shifts in Perimenopause

Perimenopause, the transition leading up to menopause, is marked by fluctuating levels of hormones that directly impact mood and brain function. Here are a few key players.

• Estrogen: This hormone regulates serotonin, the "feel-good" neurotransmitter. When estrogen levels dip unpredictably, it can lead to feelings of sadness, irritability, and anxiety.

• Progesterone: Known as the “calming hormone,” progesterone also declines during this time. Without its stabilising effects, you might feel more sensitive to stress or prone to insomnia.

• Testosterone and DHEA: Testosterone and DHEA are androgens that also decline during perimenopause. They play a significant role in mood, energy, and libido. As these hormones dip, it can contribute to feelings of apathy, low motivation, or fatigue.

  Low androgen levels can lead to a lack of drive, decreased energy, and a feeling of being "stuck."

•  Oxytocin ("The Love Hormone"): Estrogen regulates oxytocin, the hormone responsible for feelings of love, connection, and bonding. When estrogen fluctuates, it can affect how nurturing or connected we feel, which can influence relationships and emotional well-being.

  Many women experience a sense of isolation or emotional disconnection during perimenopause. This is linked to the ebb and flow of oxytocin, which affects how we bond with others and feel supported.

• Grief and Perimenopause: Perimenopause is not just a hormonal shift; it’s a profound emotional transition that asks us to face layers of grief. There’s the quiet ache of letting go—the loss of the ability to conceive and carry life, the bittersweet awareness of aging, and the tender mourning of who we once were. For some of us, this journey becomes an invitation to surrender into what is to come, to embrace the wisdom that already resides within us. These feelings, often tucked away, are part of the sacred process of moving from one life season to the next. Grief, when honoured, holds powerful wisdom that can guide us toward deeper self-compassion and clarity.

By creating space to acknowledge and feel these emotions, we allow the raw beauty of this passage to unfold, paving the way for the strength, wisdom, and reclamation that comes with stepping into the next phase of womanhood.

The Role of Neurotransmitters in Mood

Our brains are intricately connected to our hormonal health, with estrogen playing a key role in regulating neurotransmitters—the chemical messengers that influence how we feel. Estrogen receptor sites are located throughout the brain, particularly in areas responsible for mood and cognition. When estrogen levels decline during perimenopause, this directly impacts our "feel-good" neurotransmitters, such as serotonin and dopamine. The natural boost to mood and emotional resilience provided by higher estrogen levels diminishes, making it harder to feel "okay" without external support. This hormonal shift can leave you feeling less confident, more anxious, or emotionally flat, even when life circumstances remain unchanged.

GABA (Gamma-Aminobutyric Acid)

Progesterone plays a crucial role in boosting GABA, a calming neurotransmitter that helps us relax. As progesterone declines, GABA activity may decrease, leaving us feeling restless, irritable, or anxious.

This is why many women report feeling “on edge,” particularly in the evenings when they’re trying to wind down. The inability to relax or settle into sleep is a common struggle during this phase.

Serotonin Transport and Receptor Sensitivity

Estrogen doesn’t just influence the production of serotonin (our "feel-good" neurotransmitter), it also regulates how well serotonin signals are received by our brain. As estrogen levels fluctuate, serotonin efficiency can decline, making it harder for us to maintain a balanced mood.

This hormonal shift often leads to increased mood challenges, including feelings of irritability, sadness, or even depression.

These hormonal shifts can create a perfect storm for emotional upheaval.

The Role of the Adrenals and Chronic Stress

As we enter perimenopause, the body begins to transition its hormone production. When our ovaries start producing less estrogen and progesterone, our adrenal glands step in to take over the production of some of these hormones, including estrogen. However, if we've been under chronic, long-term stress—whether physical, emotional, or mental—the adrenals are already under pressure.

Impact on Mental Health

Chronic stress can lead to adrenal fatigue or burnout, where the adrenals struggle to keep up with the body's demands for stress hormones like cortisol, as well as their new role in hormone production. When this happens, the production of estrogen, progesterone, and other hormones can become irregular, which can make mental health symptoms—such as anxiety, mood swings, irritability, and fatigue—worse. This is because, instead of balancing and supporting the body, the adrenals are overwhelmed, leading to further hormonal imbalances that can intensify the emotional rollercoaster of perimenopause.

Oh and there are more

 Brain Inflammation and Cognitive Function

Declining estrogen levels have been associated with increased inflammation in the brain, which can manifest as brain fog, memory lapses, or slower cognitive processing. This can leave us feeling frustrated and mentally exhausted.

Women often describe feeling like they’re not quite as sharp as they used to be. This can lead to a dip in self-confidence, as cognitive clarity seems harder to grasp.

 Thyroid Health and Mental Well-Being

Hormonal shifts during perimenopause can also impact thyroid function, leading to symptoms of hypothyroidism (sluggish thyroid). This can manifest as fatigue, depression, and a general sense of sluggishness, making mental well-being even more challenging.

If mental health symptoms persist, it’s important to have thyroid levels checked. Even subtle thyroid dysfunction can significantly impact mood and energy levels during perimenopause.

 Gut-Brain Axis

The gut and brain are in constant communication, and the balance of our hormones directly impacts this relationship. Changes in estrogen and progesterone can disrupt the gut microbiome, leading to issues like "leaky gut." When the gut is compromised, it can send stress signals to the brain, affecting mental health.

Many women notice increased anxiety, low mood, or digestive issues during perimenopause, which can feel like a vicious cycle of discomfort and emotional instability.

 Vitamin D and Brain Health

Vitamin D is vital for brain health and serotonin production, and hormonal fluctuations during perimenopause can exacerbate vitamin D deficiencies. Low vitamin D levels have been linked to worsened mood, fatigue, and even depression.

If you're feeling down, sluggish, or unmotivated, it might be worth checking your vitamin D levels, as a deficiency can worsen mental health symptoms.

 Sleep Disruption

One of the most common complaints during perimenopause is sleep disruption, often due to night sweats or insomnia. Unfortunately, poor sleep can further affect mental health, exacerbating feelings of anxiety, depression, or irritability.

To combat sleep disturbances, it’s important to develop a bedtime routine, so your body can start to wind down. Creating a calming evening ritual, is a good place to start.

Statistics Speak Loudly

Studies show that women are 2–4 times more likely to experience depression during perimenopause compared to premenopausal years. Nearly 25% of perimenopausal women report new or worsening anxiety symptoms.

The key takeaway? You’re not alone, and this phase is well-documented.

The Silver Lining: It’s Temporary

While hormone levels are unpredictable during perimenopause, they stabilise once you transition into menopause. Many women find that anxiety and depressive symptoms dissipate as their bodies adjust to a new hormonal baseline.

Knowing this can be a beacon of hope when emotions feel unmanageable.

Practical Tools to Support Mental Health

• Breathing Exercises: Practices like box breathing or extended exhalations can calm the mind and reduce overwhelm.

• Qigong: Gentle, flowing movements paired with breathwork can ground and soothe your nervous system.

• Meditation: Even five minutes of mindful breathing can reduce stress hormones and foster peace.

• Somatic Practices: Move trapped energy through the body to release tension and create feel-good hormones.

• Say no more often: Quite often we have taken the role of putting everyone else first and its time for boundaries and what we need.

• Ask for Help: Hey I get it, it can be hard to ask for help when you feel like this, belive I know. but remember people love you and it can be really helpful to let people know how you are feeling and that you need some support.

• Find your Joy!: Remember what you used to love doing and go out there and do it.

  
  

• Friends and Community: Hang out with people that make you laugh and inspire you.

• Walking in Nature: It has to be one of my favorites, nature is medicine.

• Move your body: Dance, move, and work out!

• Create rituals: Many of us have lost touch with this sacred practice, yet we are ritualistic beings by nature. Embracing a daily ritual can help anchor you into the present moment.

• Embrace your sexuality: Perimenopause can bring changes to desire and intimacy, but it’s also an opportunity to explore what feels good and right for you. Be gentle with yourself and reconnect in ways that honor your evolving body and needs.

  
  

Nutrition and Lifestyle

• Eat to Support Hormones: Include healthy fats, leafy greens, and protein-rich foods. Don't eat too much and don't starve yourself either! (this is a blog on it's own)

  
  

• Limit Stimulants: Reduce caffeine and alcohol, which can exacerbate anxiety.

Seek Professional Support

Therapy: Cognitive-behavioural therapy (CBT) can be incredibly effective for managing anxiety and depression.

Naturopathic Guidance: Work with a practitioner to explore lifestyle, supplements, or herbal remedies that support mood and hormonal health.

Perimenopause: A Crossroads and an Opportunity

Perimenopause is more than just a phase of fluctuating hormones—it’s a pivotal moment in a woman’s life. While the symptoms can feel overwhelming, this transition also offers a unique opportunity to reassess your health and well-being.

Think of it as an invitation to:

• Reconnect with your body and its needs.

• Address underlying health concerns like gut health, stress, or sleep.

• Embrace practices that nourish your mind, body, and spirit.

You can set the foundation for a vibrant, empowered next chapter by leaning into this crossroads.

Can Hormone Replacement Therapy (HRT) Help?

For many women, Hormone Replacement Therapy (HRT) can be a valuable tool for managing mental health challenges during perimenopause. HRT supplements the hormones your body is no longer producing at the same levels, particularly estrogen and sometimes progesterone.

How HRT Supports Mental Health

• Stabilising Mood: Restoring estrogen levels can improve serotonin production, reducing sadness and irritability.

• Easing Anxiety: Progesterone has a calming effect, helping to alleviate anxiety and promote better sleep.

• Reducing Brain Fog: Many women report better focus and memory with HRT.

Is HRT Right for You?

HRT isn’t a one-size-fits-all solution. It’s important to consider:

• Personal Health History: Women with a history of certain cancers, blood clots, or cardiovascular issues may need alternatives.

• Symptom Severity: If mood swings, anxiety, or depression are significantly impacting your quality of life, HRT might be worth considering.

• Hormone Fluctuation: Regular testing can ensure HRT is tailored to your needs.

• Medical Menopause: HRT may be especially beneficial for women experiencing abrupt hormonal changes due to medical interventions.

When I trained over 20 years ago, HRT wasn’t something I would have recommended. But research has evolved. The risks once associated with HRT have been debunked, and newer formulations are proving to be a good option for some women. Watch this space as more research emerges.

Finding the Right GP

Not all healthcare providers are extensively trained in perimenopause or the complexities of HRT. It’s vital to find a GP who understands hormonal health.

A knowledgeable GP can:

• Help you understand your symptoms and their hormonal causes.

• Provide up-to-date advice on HRT and other treatments.

• Ensure you feel heard and understood.

Ask questions, advocate for yourself, and find a GP who empowers you on this journey.

Meeting yourself again

Perimenopause may bring its challenges, but it’s also an invitation to deepen your self-awareness and care. By understanding the hormonal mechanisms behind mental health shifts, you can release self-blame and embrace tools to support your well-being.

This is a temporary phase, and on the other side lies the wise, grounded energy of menopause—a new chapter filled with potential and possibility.

If you relate to any of this, start small—oh, so small. Make one change a day, or even a week, if that feels more manageable. Reach out and ask for help when you need it. Talk to the people close to you and share what’s going on. Don’t expect them to instinctively know how to support you—be clear about what you need.

And remember, this is your second puberty. Take yourself back to when you were that strong, fierce, free-willed 10-year-old. What would you say to her right now? Would you remind her of her courage, her curiosity, and her boundless sense of possibility? That same essence still lives within you—it hasn’t been lost; it’s only evolved.

Perimenopause, like puberty, is a time of profound transformation, a bridge from one chapter of life to another. While it may feel like you’re losing parts of yourself, you’re also gaining so much: deeper wisdom, a sharper sense of what truly matters, and the freedom to step into the most authentic version of yourself.

You’ve got this. There is light at the end of the rollercoaster.

This is a sacred opportunity to meet yourself again, with all the strength, love, and resilience you’ve gathered along the way.