Mood changes in perimenopause and menopause

Written by the Progyny Editorial Team. Reviewed by the Progyny Clinical Team — July 2026.

Peri/menopause (perimenopause and menopause) can cause more than physical symptoms. The changes during this phase can disrupt mood and emotional well-being as well.

If you’ve noticed any changes to your mood, please know you have support. Let’s talk more about why peri/menopause can affect your emotions and how to find help.

What causes mood changes during peri/menopause?

During perimenopause, your body begins to produce less estrogen and progesterone. And there can be dramatic shifts along the way — some days your hormones may be up, the next day they’re down. Much like in puberty, these fluctuations can affect your mood.

Peri/menopause may also cause other symptoms that affect how we feel, like physical discomfort, poor sleep, and low libido. Plus, midlife can be a time of stress and uncertainty as we juggle career, family, caregiving, and more.

What mood changes can I expect?

Like all peri/menopause symptoms, there’s a wide range of experiences. And, not everyone has mood changes.

But for about 2 out of 5 people, peri/menopause can cause symptoms like mood swings and irritability. This is similar to premenstrual syndrome (PMS), except the mood changes can happen any time.

Peri/menopause may also lead to anxiety or depression. You may have a higher risk for intense mood changes if you’ve previously had:

• Anxiety or depression
• Premenstrual dysphoric disorder (PMDD, a severe form of PMS)
• Postpartum depression
• Depression at puberty

Talk to your healthcare provider if you think you may have anxiety or depression. They can offer support and work with you on a treatment plan to help you feel better.

How can I help my mood?

Coping strategies and lifestyle behaviors can help with mild mood changes. For symptoms that get in the way of day-to-day life and last more than 2 weeks, speak with your provider.

Treating anxiety and depression

Therapy and medicines are effective treatments for anxiety and depression.

• Professional talk therapy may help you find relief and improve quality of life. For example, cognitive behavioral therapy has been shown to help change patterns of thinking and behaviors.
• Antidepressant medicines work by increasing neurotransmitters in your brain. Neurotransmitters are chemical messengers that help regulate mood, among other things.
• Antianxiety medicines often work by supporting the neurochemistry of your brain. They may help calm over-activity in the brain or block the response to adrenaline.

Menopause hormone therapy (MHT) may help with feelings of depression and anxiety during perimenopause. And if symptoms like hot flashes and night sweats are worsening your mood, MHT may help those symptoms.

There is not as much data supporting the use of MHT for mood after menopause. MHT is not right for everyone, so ask your provider what’s recommended for you.

Lifestyle changes

Relieving stress and caring for yourself can help you cope and feel better day-to-day. Here are a few ideas.

• Physical activity: Gentle to moderate physical activity may help your mood. Try to work up to 30 minutes a day, 5 days a week when you can – and any amount helps.
• Mind-body techniques: Deep breathing, meditation, tai chi, and yoga can help calm your mind. A program called mindfulness-based stress reduction (MBSR) may help lower the risk of depression returning if you’ve had it before.
• Journaling: Writing about your feelings can help you process them. A gratitude journal has been shown to help with physical and emotional well-being.
• Social support: Share how you’re doing with family or friends. It’s OK to ask for help and be specific about what you need.
• Quality sleep: It helps to have a relaxing bedtime routine, go to bed and wake up at the same time every day, and keep your room cool. Tell your provider if night sweats are disturbing your sleep. If you’re struggling with insomnia, seek out cognitive behavioral therapy for insomnia (CBT-I), the gold standard treatment.
• Balanced eating: Emotional well-being is linked with physical health. The Mediterranean eating style is a great approach for many people.

Your healthcare team is here for you

Your team is here to help you identify a plan to feel better. For help getting ready for a provider visit, reach out to your Progyny Care Advocate. We’re here to listen, provide support, and help you get the care you need.

Explore related: 

• Perimenopause: what you need to know 

• Brain fog in perimenopause and menopause 

• Menopause hormone therapy: Is it right for me? 

Disclaimer: The information provided by Progyny is for educational purposes only and is not medical advice. Always consult a qualified healthcare provider for medical guidance.