Can Perimenopause Cause Anxiety? Hormone Changes and Mental Health
You're not imagining it.
The simple trip to the grocery store feels difficult. The sudden wave of anxiety that hits you in the middle of a meeting. The 3 AM wake-up with a racing heart and a mind that won't stop spinning. The feeling that you're somehow not yourself anymore; that the person who used to handle everything with ease has been replaced by someone who feels overwhelmed by a grocery list.
If you're a woman in your late 30s to early 50s and these experiences sound familiar, you may be going through something that millions of women experience but very few are told to expect: the mental health effects of perimenopause and menopause.
This isn't burnout. It isn't "just stress." And it isn't something you need to push through alone.
At our practice in Boulder, we see women every day who arrive confused, frustrated, and sometimes frightened by symptoms that seem to come out of nowhere. Many have already been to other providers and been told their labs are "normal," or been handed a prescription for an antidepressant without anyone asking about their menstrual cycle, their sleep, or their hormonal history.
This article is designed to be a comprehensive guide to the mental health and brain-related symptoms of perimenopause and menopause: from anxiety and panic to brain fog, sleep disruption, depression, irritability, and beyond. These symptoms can really disrupt your life. Just as rows of gaudy cereal boxes vie for your attention in the grocery aisle, these symptoms can bombard your day, disrupt your focus and impair your ability to function normally.
A creative play on cereal boxes illustrating the overwhelming mental-health symptoms caused by perimenopause
Hormone Changes Can Cause Mental Health Changes
Can Perimenopause Cause Anxiety?
The short answer: yes, absolutely.
Perimenopause is defined as the transitional years leading up to your final menstrual period. It typically begins in the mid-to-late 40s, though it can start earlier [5]. During this time, your ovaries begin producing estrogen and progesterone in increasingly erratic patterns. It's not a smooth, gradual decline. It's more like a roller coaster with dramatic spikes and drops that can change from week to week, even day to day [4].
This matters for your brain because estrogen is not just a reproductive hormone. It plays a central role in regulating some of the most important chemical messengers in your nervous system, including serotonin, dopamine, norepinephrine, and GABA (gamma-aminobutyric acid). These are the same neurotransmitters targeted by medications used to treat anxiety and depression [2].
When estrogen levels swing wildly, or drop suddenly, these neurotransmitter systems can become destabilized. Serotonin production may decrease. GABA, which normally acts as your brain's natural calming system, may become less effective. The result can feel like anxiety that appears out of nowhere, even in women who have never experienced it before [2].
Research has also shown that these hormonal fluctuations can alter the function of the HPA axis: the body's central stress-response system involving the hypothalamus, pituitary gland, and adrenal glands. When estrogen levels shift rapidly, the HPA axis can become dysregulated, making you more sensitive to stress and more likely to experience an exaggerated cortisol response. In other words, the same stressor that you handled easily a few years ago may now feel overwhelming, not because you've changed, but because your hormonal environment has [3].
Longitudinal studies, including the landmark Study of Women's Health Across the Nation (SWAN), have found that midlife women are more likely to experience anxiety symptoms during the menopausal transition (a phase of perimenopause), with symptoms peaking during late perimenopause. The risk of major depressive episodes during perimenopause is two to five times higher compared to the premenopausal years [1].
For many women, this anxiety is new-onset, meaning they have no prior history of anxiety disorders. This is one of the most important and under-recognized aspects of perimenopausal mental health. You don't need a "history of anxiety" for perimenopause to exacerbate it [1].
Why Anxiety Often Appears Before Hot Flashes
Here's something that surprises many women, and many doctors: anxiety, mood changes, and sleep disruption can be among the very first signs of perimenopause, appearing months or even years before the hot flashes and night sweats that most people associate with menopause.
A large-scale analysis of over 145,000 symptom logs from women across the menopausal transition found that fatigue, headache, anxiety, and brain fog were common across all stages of premenopause, perimenopause, and menopause. Critically, the study found that hot flashes had no predictive power for any symptom except night sweats. This means that waiting for hot flashes to "confirm" perimenopause can mean missing years of treatable symptoms [6].
This is why so many women in their early-to-mid 40s end up in their doctor's office describing anxiety, insomnia, or feeling "off". And then they often leave with a diagnosis of generalized anxiety disorder or stress, without anyone connecting the dots to their reproductive hormones.
The hormonal changes of early perimenopause (particularly the increasing variability of estrogen and the decline of progesterone as ovulatory cycles become less frequent) can directly affect mood and anxiety through the neurotransmitter and stress-response pathways described above [4]. You don't need to be having irregular periods yet for these changes to be underway.
If you're in your late 30s or 40s and experiencing new or worsening anxiety, it's worth considering whether hormonal changes could be playing a role, even if everything else in your life seems "fine."
Brain Fog and Cognitive Overload
"I can't find the word I'm looking for." "I walked into a room and forgot why." "I feel like I can't hold multiple things in my head anymore."
If these sound familiar, you're not alone. Cognitive complaints (commonly described as "brain fog") are among the most frequently reported and most distressing symptoms of the menopausal transition. They typically involve difficulties with:
Verbal memory — trouble recalling words, names, or details of recent conversations
Attention and concentration — difficulty staying focused, especially when multitasking
Executive function — challenges with planning, organizing, and managing complex tasks
Processing speed — feeling mentally "slower" than usual
The SWAN study found that reported forgetfulness was significantly higher in postmenopausal women (41%) compared to premenopausal women (31%) [17]. A recent systematic review and meta-analysis of 26 studies involving over 9,400 women confirmed that perimenopausal women exhibit poorer cognitive outcomes than premenopausal women, with a moderate effect size [10].
The good news: current evidence indicates that menopause-related cognitive changes are typically mild, variable, and distinct from dementia. While it's natural to worry that brain fog might signal something more serious, research suggests these changes are generally a time-limited phenomenon related to the hormonal transition, not a sign of early Alzheimer's disease or other neurodegenerative conditions [10].
That said, the experience is very real and can significantly affect daily functioning, work performance, and self-confidence.
ADHD in Perimenopause
For women with attention-deficit/hyperactivity disorder (whether previously diagnosed or not), perimenopause can be a particularly challenging time. Research shows that ADHD symptoms frequently worsen during the menopausal transition, with increased inattention, emotional dysregulation, and heightened anxiety. A population-based cohort study found that women with ADHD had significantly higher rates of severe perimenopausal symptoms compared to women without ADHD (54% vs. 30%), and these symptoms appeared at an earlier age [11].
Perimenopause can also unmask previously undiagnosed ADHD. Many women who were able to compensate for mild ADHD symptoms earlier in life find that the loss of estrogen's supportive effects on dopamine and executive function tips the balance, making symptoms suddenly noticeable and impairing. If you've always been "a little scattered" but are now finding it impossible to function, this is worth exploring with a knowledgeable provider [11].
Depression, Irritability, and Emotional Sensitivity
Depression during the menopausal transition is well-documented. Large prospective studies have consistently shown that the risk of clinically significant depressive symptoms increases during perimenopause and menopause, with the risk of a major depressive episode rising two- to fourfold compared to the premenopausal years [1]. A recent meta-analysis of over 100 studies involving more than 1.1 million women found that approximately one in three perimenopausal women experiences depressive symptoms [12].
But depression during perimenopause doesn't always look like "classic" depression. Many women describe it more as:
Irritability — a short fuse, snapping at loved ones, feeling easily frustrated by things that never used to bother you
Emotional sensitivity — crying more easily, feeling deeply wounded by minor comments, emotional reactions that feel disproportionate to the situation
Loss of motivation or pleasure — not wanting to do things you used to enjoy, feeling flat or disconnected
Overwhelm — a sense that everything is too much, that you can't keep up, that the demands of daily life have become unmanageable
These symptoms are driven by the same hormonal mechanisms that underlie perimenopausal anxiety: disrupted serotonin and norepinephrine signaling, altered GABA function, and HPA axis dysregulation [2, 3]. Estrogen variability (particularly the unpredictable swings of perimenopause) appears to be more strongly associated with mood disturbance than low estrogen levels alone. Research has shown that greater estradiol variability and the absence of ovulatory progesterone levels are independently associated with higher levels of depressive symptoms [4].
Women who have a history of depression, premenstrual mood sensitivity, or postpartum depression may be especially vulnerable, as these conditions suggest an underlying sensitivity to hormonal fluctuations. However, perimenopause can also trigger a first-ever episode of depression in women with no prior history [1].
Why Sleep Problems Make Everything Worse
Sleep disturbance is one of the most common and most disruptive symptoms of the menopausal transition. Research shows that between 40% and 69% of women experience significant sleep problems during perimenopause, with up to 40% meeting diagnostic criteria for insomnia disorder [14].
The most common complaint is waking up during the night (often around 2 or 3 AM) and being unable to fall back asleep. Sometimes this is triggered by night sweats, but often it isn't. Many women experience fragmented sleep without any obvious vasomotor trigger, which can be confusing and frustrating.
There are several reasons this happens:
Hormonal changes directly affect sleep architecture — Research has shown that lower estradiol levels and higher FSH levels (both hallmarks of the menopausal transition) are independently associated with more nighttime awakenings, even after accounting for night sweats and mood symptoms. This suggests that the changing hormonal environment itself disrupts sleep continuity [7].
Night sweats fragment sleep — Women with moderate to severe vasomotor symptoms are nearly three times as likely to report frequent nighttime awakenings. The severity of vasomotor symptoms also predicts both the development and persistence of insomnia [8].
Stress reactivity increases — Declining hormone levels can increase sympathetic nervous system arousal and heighten pre-sleep anxiety, creating a cycle where worry about not sleeping makes it even harder to fall asleep [3].
Here's why this matters so much for mental health: sleep disruption and mood disturbance have a bidirectional relationship. Poor sleep increases the risk of depression two- to threefold during perimenopause, and depression in turn worsens sleep [9]. A large pooled analysis of longitudinal data from over 20,000 women found that sleep disturbance largely accounted for the association between vasomotor symptoms and depressed mood. In other words, when night sweats cause depression, they often do so by destroying sleep first [9].
This is why addressing sleep is often one of the most impactful first steps in managing perimenopausal mental health symptoms. When sleep improves, mood, anxiety, and cognitive function often follow.
Why Perimenopause Is Often Misdiagnosed as Stress or Burnout
One of the most frustrating aspects of perimenopausal mental health symptoms is how often they are attributed to something else entirely. Women are told they're "just stressed," that they need to "practice more self-care," or that their symptoms are a natural consequence of a busy life with work, kids, aging parents, and too many responsibilities.
There are several reasons why:
The timing is misleading — Perimenopause typically occurs during a life stage that is genuinely demanding. Women in their 40s and early 50s often are juggling careers, parenting, caregiving for aging parents, relationship changes, and financial pressures. It's easy, for both patients and providers, to attribute new anxiety, insomnia, or cognitive difficulties to these external stressors rather than to an underlying hormonal shift [1].
The symptoms overlap — Anxiety, insomnia, difficulty concentrating, irritability, and fatigue are symptoms of perimenopause, but they're also symptoms of generalized anxiety disorder, depression, burnout, thyroid disease, and ADHD. Without a provider who thinks to ask about menstrual cycle changes, vasomotor symptoms, or hormonal history, the connection to perimenopause can be missed entirely [6].
Lab tests can be misleading — Many women are told their hormone levels are "normal" based on a single blood draw. But during perimenopause, hormone levels fluctuate dramatically, sometimes from week to week or even day to day. A single measurement of FSH or estradiol can easily fall within the "normal" range even when the overall hormonal environment is highly unstable. Major medical guidelines, including those from JAMA and the Choosing Wisely campaign, advise against using FSH levels to diagnose the menopausal transition in women in their 40s for exactly this reason. Perimenopause is a clinical diagnosis based on age, symptoms, and menstrual cycle changes, not a lab test [5].
Medical training gaps persist — Many healthcare providers receive limited training in menopause medicine. A qualitative study of women with perimenopausal anxiety found that participants reported a general lack of awareness about perimenopause from both their own knowledge and their providers’. This lack of awareness exacerbated uncertainty, anxiety, and the feeling of losing control [1].
The result is that many women spend months or years being treated for the wrong condition, or not being treated at all, before someone finally connects their symptoms to the menopausal transition.
What Can Help?
The most important thing to understand about managing perimenopausal mental health symptoms is that there is no single solution that works for everyone. The best approach is individualized, taking into account your specific symptoms, their severity, your medical history, your preferences, and the full context of your life [13]. Here are the evidence-based options:
Sleep Optimization
Because sleep disruption is so central to perimenopausal mood and cognitive symptoms, addressing sleep is often the highest-yield first step. Cognitive behavioral therapy for insomnia (CBT-I) is considered a first-line treatment; it is effective, durable, and specifically recommended for menopausal insomnia by multiple guidelines [14]. CBT-I addresses the thoughts and behaviors that perpetuate insomnia and has been shown to produce lasting improvements without medication [8].
Basic sleep hygiene practices also matter: consistent sleep and wake times, a cool and dark bedroom, limiting caffeine and alcohol (especially in the afternoon and evening), and reducing screen exposure before bed.
Exercise and Movement
Physical activity is one of the most consistently supported interventions for perimenopausal depression and anxiety. A comprehensive meta-analysis of 21 randomized controlled trials found that physical activity significantly reduced both depressive symptoms and anxiety symptoms in menopausal women. Low-to-moderate intensity exercise (including walking, yoga, swimming, and resistance training) was effective. Mind-body exercises such as yoga and tai chi may be particularly beneficial, and resistance training has also shown strong antidepressant effects [15].
The key is consistency rather than intensity. Even 30 minutes of moderate activity most days of the week can make a meaningful difference in mood, sleep, and cognitive function.
Cognitive Behavioral Therapy (CBT)
CBT is a proven, first-line treatment for depression and anxiety at any life stage, and it is specifically recommended by the UK's National Institute for Health and Care Excellence (NICE) for depressed mood during menopause [1]. CBT is also effective for managing vasomotor symptoms and sleep disturbance [14]. It can help you develop practical strategies for managing the thought patterns and behaviors that amplify anxiety, low mood, and insomnia.
Hormone Replacement Therapy (HRT)
HRT (also known as Menopausal hormone therapy MHT) can be an important part of the treatment picture for some women, particularly those with bothersome vasomotor symptoms. Research shows that MHT improves concurrent depressive symptoms in women with troublesome hot flashes and night sweats, and it can significantly improve sleep quality [16].
However, it's important to understand that MHT is not currently approved as a standalone treatment for depression or anxiety by regulatory agencies in the US or Europe, and the evidence for its effectiveness as a primary mood treatment is mixed. Some studies have shown benefit (particularly with transdermal estradiol in perimenopausal women) while others have not. A recent meta-analysis found that hormone therapy was associated with a small but statistically significant reduction in depressive symptoms in perimenopausal women, though the magnitude of the effect was modest [16].
The decision to use hormone therapy should be individualized, weighing the potential benefits for your specific symptom profile against the risks, and made in partnership with a knowledgeable provider.
Antidepressant Medications
For moderate to severe depression or anxiety during perimenopause, antidepressant medications (particularly selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs)) remain a first-line treatment option with proven efficacy in midlife women [1]. Some of these medications, such as escitalopram and venlafaxine, may offer the additional benefit of reducing vasomotor symptoms.
Antidepressants are not a sign of failure. They are a well-studied, effective tool that can provide meaningful relief, especially when symptoms are significantly affecting your ability to function, work, or maintain relationships.
Mindfulness and Stress Reduction
Mindfulness-based stress reduction (MBSR) has shown promise in preventing depressive symptoms during the menopausal transition. In one randomized controlled trial, MBSR effectively prevented the development of depressive symptoms while promoting higher levels of resilience and lower levels of stress and anxiety: benefits that were particularly evident in women with a history of depression or recent stressful life events [1, 18].
An Individualized Approach
The International Federation of Gynecology and Obstetrics (FIGO) recommends that treatment for menopausal mental health symptoms should be individualized and may include lifestyle changes, cognitive-behavioral therapy, and hormone therapy, with the specific approach tailored to each woman's needs, history, and preferences [13].
This is exactly the philosophy we practice in Boulder. There is no one-size-fits-all protocol. The right approach for you depends on your unique situation, and finding it starts with a thorough evaluation and a provider who listens.
You Deserve to Be Heard
If you've read this far and found yourself nodding along, know this: what you're experiencing is real, it's common, and it's treatable. You are not losing your mind. You are not weak. You are going through a profound biological transition that affects your brain, your mood, your sleep, and your ability to think clearly. And you deserve care that recognizes that.
Radiant Health for Women specializes in exactly this kind of nuanced, individualized menopause care. We listen. We look at the full picture. And we work with you to find an approach that fits your life, your body, and your goals.
If you're ready to feel like yourself again, we're here to help. Book a free discovery call to learn more.
Frequently Asked Questions
Can perimenopause cause panic attacks?
Yes. The hormonal fluctuations of perimenopause can increase sympathetic nervous system activation and alter neurotransmitter balance in ways that lower the threshold for panic-like symptoms [2]. Symptoms of menopause (such as a sudden racing heart, sweating, and rapid breathing) can also overlap with and mimic panic attacks, making it difficult to distinguish between the two. If you're experiencing new-onset panic symptoms in your 40s, it's important to consider perimenopause as a contributing factor.
Why do I wake up at 3 AM during menopause?
Early morning awakening is one of the most common sleep complaints during the menopausal transition. It can be caused by night sweats, but it often occurs independently of vasomotor symptoms. Research shows that the hormonal changes of perimenopause (particularly lower estradiol and higher FSH) directly disrupt sleep continuity and increase the number of nighttime awakenings [7]. Increased cortisol and sympathetic nervous system activation in the early morning hours can also make it difficult to fall back asleep [3]. Cognitive behavioral therapy for insomnia (CBT-I) is one of the most effective treatments for this pattern [8].
Can menopause worsen ADHD?
Yes. Research increasingly shows that ADHD symptoms frequently worsen during perimenopause and menopause. Estrogen supports dopamine function in the brain, and as estrogen levels decline and fluctuate, women with ADHD may experience increased inattention, difficulty with executive function, emotional dysregulation, and worsening brain fog. Perimenopause can also unmask previously undiagnosed ADHD in women who were able to compensate earlier in life. A population-based study found that women with ADHD had nearly twice the prevalence of severe perimenopausal symptoms compared to women without ADHD [11].
Can hormone levels look normal during perimenopause?
Yes, and this is one of the most important things to understand. During perimenopause, estrogen and FSH levels fluctuate dramatically, sometimes from one week to the next. A single blood draw can easily catch a "normal" moment in what is actually a highly unstable hormonal environment. This is why major medical guidelines advise against using a single FSH or estradiol measurement to diagnose or rule out perimenopause [5]. The diagnosis is clinical: based on your age, symptoms, and menstrual cycle changes, not based on a lab test.
Why does anxiety suddenly appear in my 40s?
For many women, the hormonal fluctuations of early perimenopause are the trigger. Estrogen helps regulate serotonin, GABA, and the stress-response system [2]. When estrogen levels become erratic (which can happen years before periods become noticeably irregular) these systems can become destabilized, leading to new-onset anxiety even in women with no prior history [4]. The SWAN study found that women with low anxiety before menopause were at risk of increased anxiety symptoms during the menopausal transition [1].
Can HRT help anxiety?
Hormone replacement therapy (also known at menopause hormone therapy MHT) may help anxiety symptoms in some women, particularly when anxiety is accompanied by vasomotor symptoms and sleep disruption. By stabilizing the hormonal environment, MHT can reduce the neurochemical instability that contributes to anxiety [16]. However, the evidence for MHT as a standalone treatment for anxiety is limited, and it is not currently approved for this indication. For many women, the best results come from a combination approach: addressing sleep, using behavioral strategies, and considering hormone therapy as one component of a broader plan [13].
Does menopause affect serotonin?
Yes. Estrogen plays a direct role in regulating serotonin synthesis, receptor sensitivity, and metabolism in the brain [2]. Animal studies have shown that estrogen withdrawal leads to decreased serotonin expression across nearly all brain regions. In humans, the rapid estrogen fluctuations of perimenopause disrupt serotonin and norepinephrine signaling, which can contribute to anxiety, depression, and sleep disturbance. This is one reason why SSRIs, which increase serotonin availability, can be effective for perimenopausal mood symptoms [1].
References
1. Brown, L., Hunter, M. S., Chen, R., Crandall, C. J., Gordon, J. L., Mishra, G. D., Rother, V., Joffe, H., & Hickey, M. (2024). Promoting good mental health over the menopause transition. Lancet, 403(10430), 969–983. https://pubmed.ncbi.nlm.nih.gov/38458216/
2. Fidecicchi, T., Giannini, A., Chedraui, P., Luisi, S., Battipaglia, C., Genazzani, A. R., Genazzani, A. D., & Simoncini, T. (2024). Neuroendocrine mechanisms of mood disorders during menopause transition: A narrative review and future perspectives. Maturitas, 188, 108087. https://pubmed.ncbi.nlm.nih.gov/39111089/
3. Gordon, J. L., Girdler, S. S., & Meltzer-Brody, S. E. (2015). Ovarian hormone fluctuation, neurosteroids, and HPA axis dysregulation in perimenopausal depression: A novel heuristic model. American Journal of Psychiatry, 172(3), 227–236. https://pubmed.ncbi.nlm.nih.gov/25585035/
4. Joffe, H., de Wit, A., Coborn, J., Crawford, S., Freeman, M., Wiley, A., Athappilly, G., Kim, S., Sullivan, K. A., Cohen, L. S., & Hall, J. E. (2020). Impact of estradiol variability and progesterone on mood in perimenopausal women with depressive symptoms. Journal of Clinical Endocrinology and Metabolism, 105(3), e642–e650. https://pubmed.ncbi.nlm.nih.gov/31693131/
5. El Khoudary, S. R., Aggarwal, B., Beckie, T. M., et al. (2020). Menopause transition and cardiovascular disease risk: Implications for timing of early prevention: A scientific statement from the American Heart Association. Circulation, 142(25), e506–e532. https://pubmed.ncbi.nlm.nih.gov/33251828/
6. Aras, S. G., Grant, A. D., & Konhilas, J. P. (2025). Clustering of >145,000 symptom logs reveals distinct pre, peri, and menopausal phenotypes. Scientific Reports, 15(1), 640. https://pubmed.ncbi.nlm.nih.gov/39753725/
7. Coborn, J., de Wit, A., Crawford, S., et al. (2022). Disruption of sleep continuity during the perimenopause: Associations with female reproductive hormone profiles. Journal of Clinical Endocrinology and Metabolism, 107(10), e4144–e4153. https://pubmed.ncbi.nlm.nih.gov/35878624/
8. Baker, F. C. (2023). Optimizing sleep across the menopausal transition. Climacteric, 26(3), 198–205. https://pubmed.ncbi.nlm.nih.gov/37011660
9. Caruso, D., Masci, I., Cipollone, G., & Palagini, L. (2019). Insomnia and depressive symptoms during the menopausal transition: Theoretical and therapeutic implications of a self-reinforcing feedback loop. Maturitas, 123, 78–81. https://pubmed.ncbi.nlm.nih.gov/31027682/
10. Bangle, A., Williams, D., Walters, J., & Nguyen, L. (2026). Cognitive functioning in perimenopause: An updated systematic review and meta-analysis. Psychology and Aging, 41(3), 303–318. https://pubmed.ncbi.nlm.nih.gov/41066270/
11. Jakobsdóttir Smári, U., Valdimarsdottir, U. A., Wynchank, D., et al. (2025). Perimenopausal symptoms in women with and without ADHD: A population-based cohort study. European Psychiatry, 68(1), e133. https://pubmed.ncbi.nlm.nih.gov/40903825/
12. Balasubramanian, I., Abhijita, B., Krishnamoorthy, Y., et al. (2026). Prevalence and incidence of depressive, anxiety, and insomnia symptoms in perimenopausal and postmenopausal women: Systematic review and meta-analysis. General Hospital Psychiatry.https://pubmed.ncbi.nlm.nih.gov/41946603/
13. Khadilkar, S., Divakar, H., Benedetto, C., et al. (2026). FIGO best practice recommendations for the mental health of women at menopausal age. International Journal of Gynaecology and Obstetrics, 173(2), 588–601. https://pubmed.ncbi.nlm.nih.gov/41902367/
14. Breitinger-Blatt, D., Lee, J., Ribeiro Pereira, S. I., et al. (2026). Cognitive behavioural therapeutics for insomnia symptoms in the perimenopause through to the early postmenopausal period. Cochrane Database of Systematic Reviews, 4, CD016349. https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD016349/full
15. Yue, H., Yang, Y., Xie, F., et al. (2025). Effects of physical activity on depressive and anxiety symptoms of women in the menopausal transition and menopause: A comprehensive systematic review and meta-analysis. International Journal of Behavioral Nutrition and Physical Activity, 22(1), 13. https://pubmed.ncbi.nlm.nih.gov/39856668/
16. Li, Y., Sun, Y., Bi, Y., et al. (2026). Efficacy and safety of menopausal hormone therapy for depressive symptoms in perimenopausal women: A systematic review and meta-analysis. Journal of Affective Disorders, 409, 121892. https://pubmed.ncbi.nlm.nih.gov/42061517/
17. Greendale, G. A., Huang, M. H., Wight, R. G., Seeman, T., Luetters, C., Avis, N. E., Johnston, J., & Karlamangla, A. S. (2009). Effects of the menopause transition and hormone use on cognitive performance in midlife women. Neurology, 72(21), 1850–1857. https://pubmed.ncbi.nlm.nih.gov/19470968/
18. Gordon, J. L., Rubinow, D. R., Eisenlohr-Moul, T. A., Leserman, J., & Girdler, S. S. (2021). Endocrine and psychosocial moderators of mindfulness-based stress reduction for the prevention of perimenopausal depressive symptoms: A randomized controlled trial. Psychoneuroendocrinology, 131, 105288. https://pubmed.ncbi.nlm.nih.gov/34058560/
This content is for educational purposes only and is not a substitute for personalized medical advice. Consult your healthcare provider for guidance specific to your situation.