Pinkishe Foundation
31/10/2026
Dr. Shehla Jamal
You used to be the calm one. Then, somewhere in your 40s, something shifted. You snap over small things. You cry at a television advertisement. A worry sits in your chest for hours, for no clear reason. None of it feels like you.
Many women in this phase are told it is stress, or that they are too sensitive. Sometimes that is part of it. But often there is another cause that nobody names: perimenopause, the years of changing hormones before your periods stop for good.
Oestrogen does more than run your periods. It also acts on the brain, including on chemicals such as serotonin that help keep mood steady. In perimenopause, oestrogen does not fall smoothly. It rises and dips from month to month. Your mood can rise and dip with it.
Sleep plays a big part too. Night sweats and early waking are common in perimenopause. Weeks of broken sleep make anyone more anxious, tearful and short tempered. Busy years, with work, children and ageing parents, add to the load.
None of this is weakness. It is a real change in your body, and it can be helped.
Strong feelings in women are often brushed off as drama. So women keep going and blame themselves. Families may not understand at first. Partners can take it personally. Children get confused.
Sometimes the link to perimenopause is missed in the clinic too. If your doctor does not raise it, ask. Mention any changes in your periods, your sleep and hot flushes, as well as your mood.
Saying "this may be perimenopause", to yourself or someone close, can ease a lot of the confusion. You can stop blaming yourself.
Perimenopause is usually recognised from your age, your periods and your symptoms. Blood tests can help rule out other causes, such as thyroid problems or anaemia. Keep a simple note of your periods, sleep and mood for a month or two and take it with you.
Treatments help many women in this phase. Hormone therapy (HRT) can ease mood changes linked to perimenopause, as well as hot flushes and poor sleep. A talking therapy called CBT helps with low mood and anxiety. If you have depression, medicines and therapy work well. Your doctor can talk you through what suits you.
Keep regular sleep times and a cool, dark room. Move every day, even a brisk walk. Eat regular meals with enough protein and calcium. Cut down on caffeine and alcohol, especially later in the day.
Tell your partner, your closest friend or a sister what is going on. Most people understand more than you expect once they know. Talking to other women in the same phase helps too. Feeling alone makes everything heavier.
If you ever feel hopeless or have thoughts of harming yourself, please talk to someone today. Call Tele-MANAS, the government's free mental health helpline, on 14416 or 1-800-891-4416, at any hour. In an emergency, call 112.
Have a question about menopause or your periods? Call our menstrual helpline on 85888 70999. It answers at any hour.
A simple printable sheet that marks your period days, your fertile window and your ovulation day. We will email it to you now.
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Prefer to work out your dates now? Open the free ovulation calculatorYes, they are common. Changing oestrogen levels affect the brain, and poor sleep adds to it. Irritability, anxiety and low mood are all common in this phase.
They are often strongest in perimenopause, which can last several years. For many women, mood steadies after menopause. Treatment can help in the meantime, so you do not need to wait it out.
There is no single test that confirms it, because hormone levels change from day to day. A doctor usually goes by your age, symptoms and periods, and may test to rule out thyroid problems or anaemia.
For many women, yes, when the low mood is linked to perimenopause. It is not right for everyone. Talk to your doctor about the benefits and risks for you.
If you feel low or hopeless for more than two weeks, if anxiety stops you living your life, or if you have any thoughts of harming yourself, talk to a doctor. For thoughts of self harm, get help the same day.
Mood changes in perimenopause are common and real. They are not a personality flaw. Name what is happening, talk to a doctor, look after your sleep, and let the people close to you in. Help works.
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