Perimenopause and Your Mental Health

Are you more irritated than usual? Foggy? Forgetting simple words? Sleeping less no matter what you try? Gaining weight with no change in diet or habits? Your primary care physician or gynecologist says your labs are normal. Nothing shows up on tests. Are you over 35? It might be perimenopause.

What do we know about Perimenopause?

Medicine is only starting to fully understand how much perimenopause can affect every part of a woman’s life. For some women, these symptoms can be intense enough to interrupt everyday life and make you feel like you are not yourself anymore. Though perimenopause can feel different for everyone, it can also have some very similar symptoms between women. Here is a non-exhaustive list of the most common symptoms women notice in perimenopause:

• Mood swings

• Poor sleep

• Anxiety and muscle tension

• Emotional outbursts (Feeling angry over relatively minor obstacles.)

• Depression

• Frequent crying, easily moved to tears

• Low motivation

• Trouble focusing and feeling overwhelmed

• Forgetting words

• Memory lapses (“Why did I walk into this room?”)

• Night sweats

• Weight gain, without change in diet or appetite

• Constant fatigue

• Dry skin

• Thinning hair

• Change in sex drive

For years, we didn't even have a name for these symptoms. And when women's symptoms don't have a name, medicine tends to label them anxiety, depression, or worse, a personality disorder. What could be happening is a hormone shift that can begin anywhere from age 35 to 50. That's perimenopause.

What is Perimenopause?

Perimenopause is the body moving towards menopause, which is when our bodies stop having periods (menstruating) and we are no longer able to become pregnant or have children. The three main hormones responsible for perimenopause symptoms are estrogen, progesterone, and even testosterone. Surprisingly, perimenopause isn't a slow, predictable decline in estrogen, progesterone, and testosterone until menopause hits. It's chaotic — hormones fluctuate rather than dropping in a steady, expected decline. That makes it hard to diagnose with blood work alone. Every woman’s body responds differently to changing hormone levels. You can have a full slate of perimenopause symptoms while your labs read "normal." Normal labs don't mean your symptoms should be dismissed. What may be a “normal” estrogen level on lab work could be a very low level for your body. Every case needs an individual look and a treatment plan built around the person, not the bloodwork.

What can psychiatry do for Perimenopause?

Here at the Inner Mosaic, we evaluate each woman holistically. We strive to understand the symptoms that are most important to each person and give them a supportive treatment plan tailored to their needs. For example, sleep issues, anxiety, and fatigue are typical issues associated with perimenopause. We can use supplements, behavioral changes, and medications to help make these issues more manageable. Our goal is to help you feel capable of tackling your life as it comes by controlling the symptoms that make you feel like you can’t.

Some women require hormone replacement therapy (HRT) to make their perimenopause symptoms manageable. At the Inner Mosaic, we get excited to help you navigate and improve yourself, in whatever form that comes in. We can work with you to help alleviate symptoms whether you choose to take hormones for perimenopause or not.

At the Inner Mosaic, we help women navigate perimenopause with respectful, individualized mental health care.

Perimenopause isn't quick or easy — but you don't have to go through it alone. We're here for you, every step of the way.