Perimenopause and Mental Health: What You Should Know
Perimenopause is a natural part of life for all women. Yet many people feel surprised when it arrives (& rightfully so)! We often hear others talk about hot flashes, night sweats, or sleep problems. What usually gets less attention is the impact on thinking and emotional well-being. Many people describe this time as foggy, frustrating, or even confusing. The good news is that information and support can make a big difference.
Why These Changes Happen
There is no single reason why thinking feels different during perimenopause. Hormones rise and fall. Sleep often becomes lighter or more broken. Mood can shift. Stress sometimes increases. Vasomotor symptoms like hot flashes also play a role. When these factors stack up, your brain might feel overloaded. The result can look like slower thinking, trouble concentrating, or forgetfulness.
Researchers have also learned that issues like thyroid problems, vitamin deficiencies, depression, and medication effects can look similar to cognitive changes in perimenopause. This means it is very important to check in with a clinician if you notice changes that worry you.
When to Seek Medical Support
If you feel like something is off, it is always okay to ask for help. Many experts recommend talking with your doctor about cognitive testing and hormonal or endocrine screening. A good assessment should include your menstrual cycle history, sleep quality, mental health, and any medical conditions that might contribute to symptoms. This type of care is considered the gold standard because it helps identify what is actually going on instead of making assumptions.
If early screening shows signs of cognitive change, a more detailed assessment may be helpful. It can look for issues that are fixable, such as thyroid imbalances, low iron, poor sleep, or the effects of certain medications. Finding these causes early can prevent small problems from growing.
Supporting Your Mental Health During the Transition
Many people feel isolated or discouraged during perimenopause. Society often sends the message that menopause automatically brings emotional decline, but modern research tells a different story. Most people do not develop mental health disorders during this time. What helps the most is good information, early support, and attention to daily habits.
Here are some ways to support yourself that have evidence behind them.
Learn about what is typical and what is not
Accurate information reduces fear and helps you understand what is normal. Knowing what to expect can make symptoms feel less alarming.
Challenge negative beliefs about aging
Menopause is often framed as a loss. In reality, many people grow in confidence, emotional clarity, and self-acceptance during the transition. Shifting your perspective can help reduce distress.
Focus on things you can change
Sleep quality, stress levels, physical activity, and social support all influence how you feel. Even small improvements in these areas often help your thinking feel sharper again. Physical activity can be especially helpful because it lifts mood, supports sleep, and improves cognitive health.
Build a strong support system
Talking with friends, connecting with peers going through similar changes, or reaching out to a therapist can help you feel grounded and understood.
Check in with yourself regularly
Pay attention to patterns. Maybe the fog feels worse when you have not slept well, when stress is high, or when symptoms flare. Tracking these patterns helps you respond with more care and intention.
The Bigger Picture
Perimenopause is not a sign that your mind is failing. It is a period of change, and change can feel uncomfortable. Many people find that their thinking improves again once hormones settle. Others feel clearer and more centred after getting proper treatment for sleep, mood, or medical issues.By learning about the transition, understanding the changes, and seeking support, you can move through this stage with more confidence and less fear. You deserve to feel informed and guided, not confused or alone. If you ever feel unsure about what you are experiencing, reach out to a healthcare provider. You know yourself best, and your concerns deserve to be heard!