--- title: 'Understanding Why Your Mood Changes Perimenopause' slug: mood-changes-perimenopause lifeStage: perimenopause category: Mood medicalReviewer: 'Dr Jade Thomas, HCPC Registered Psychologist and BPS Chartered Psychologist' reviewerId: 'https://blog.bloume.com/perimenopause/medical-board.md#dr-jade-thomas' lastUpdated: '2026-07-20' primarySource: 'Symptoms of menopause and perimenopause' --- # Understanding Why Your Mood Changes Perimenopause Mood changes in perimenopause are common and can include anxiety, low mood, irritability, and mood swings. These shifts can start years before your periods stop, and sometimes show up before physical symptoms like hot flushes. Broken sleep can make it all feel sharper. Everyday changes, talking therapies, and treatments you can discuss with a GP can all help. This article covers the broad mood picture of perimenopause and when it is worth seeking professional support. **Q: Can mood changes be an early sign of perimenopause?** A: Yes. Low mood and anxiety can show up before physical symptoms like hot flushes. If you are noticing mood changes and are not sure what is behind them, speaking to your GP is the most reliable way to understand what is happening. Worry that arrives without an obvious cause, tearfulness that catches you off guard, a low mood that sits with you through the day. Mood changes like these are a common part of perimenopause, often showing up as anxiety, irritability, or low mood alongside physical symptoms like hot flushes and irregular periods. Sometimes the mood changes come first, before any physical signs, which can make them harder to place. ## How perimenopause affects mental health The emotional side of perimenopause can start years before your periods stop. It tends to build gradually, which is part of why it can be hard to link to this stage at first. > **INFO**: Low mood and anxiety are often among the first signs of perimenopause, sometimes showing up before physical symptoms like hot flushes. If you are noticing changes and are not sure what is behind them, it is worth raising this with your GP rather than trying to work it out alone. ## What you might notice: anxiety, low mood, and irritability Anxiety is common during perimenopause. It can show up in different ways: a background hum of worry, feeling reluctant to do things you used to manage easily, or, for some, panic attacks. If you are having panic attacks that are severe or frequent, call your GP or NHS 111. Low mood, sadness, and feeling more tearful are common during this stage too. These shifts are different from clinical depression, which is more constant and more severe, and needs separate assessment by a healthcare professional. If your low mood feels persistent, or you think it might be more than the shifts that come with perimenopause, speak to your GP. Irritability and mood swings are part of the picture too. Broken sleep is common in perimenopause, and when you are not sleeping well, irritability and anxiety often feel sharper. Looking at your sleep can be a useful part of managing how your mood feels overall. ## What helps with mood changes in perimenopause A range of things can help, from everyday changes you can make yourself to treatments you can discuss with a GP. These work well together, and you may find you use more than one at the same time. ### Lifestyle adjustments Regular movement, as much rest as you can get, and time for calming activities like yoga or tai chi can all help with mood symptoms. These tend to work best alongside other support, and they sit well next to professional care if you need it. Talking to other people going through something similar, whether friends, family, or colleagues, can help too. Knowing your experience is shared can ease the sense of going through it alone. ### Cognitive Behavioural Therapy Cognitive Behavioural Therapy (CBT) is a talking therapy that can help with the low mood and anxiety that come with perimenopause. It is one option your GP can talk through with you. Access to CBT through the NHS varies depending on where you live in the UK, and waiting times differ across England, Scotland, Wales, and Northern Ireland. Your GP can tell you what is available to you. ### Hormone Replacement Therapy Hormone Replacement Therapy (HRT) can be an effective treatment for low mood that comes with perimenopause. It is a prescription-only medicine in the UK, so it needs medical supervision to start. If you want to know whether HRT might suit you, your GP is the place to start. ## When to seek support If mood symptoms are having a real impact on your day-to-day life, it is worth speaking to your GP. They can talk through your options, which might include lifestyle changes, CBT, or HRT, depending on your situation. If your low mood is persistent, or you think you might be experiencing depression, speak to a healthcare professional rather than waiting it out. If you are in immediate distress, call NHS 111 or contact the Samaritans on 116 123. > **INFO**: This article covers the broad mood picture of perimenopause. If you want to go deeper on one experience, there are dedicated articles on intense irritability, persistent low mood, how Premenstrual Dysphoric Disorder (PMDD) can intensify in perimenopause, and ADHD in perimenopause. --- **Q: Can mood changes be an early sign of perimenopause?** Yes. Low mood and anxiety can show up before physical symptoms like hot flushes. If you are noticing mood changes and are not sure what is behind them, speaking to your GP is the most reliable way to understand what is happening. **Q: Is the low mood in perimenopause the same as depression?** Low mood, sadness, and feeling tearful are common in perimenopause, and they are different from clinical depression, which is more constant and more severe. If your low mood continues or feels hard to manage, it is worth speaking to a healthcare professional rather than waiting for it to pass on its own. **Q: Can HRT help with mood changes in perimenopause?** HRT can be an effective treatment for low mood connected to the hormonal changes of perimenopause. It is a prescription-only medicine, so you will need to discuss it with your GP, who can advise whether it suits your situation. **Q: What can you do day to day to manage mood symptoms?** Regular movement, making rest a priority, and activities like yoga or tai chi can all help. Talking to others going through something similar can ease the sense of going through it alone. You can use these alongside professional support whenever you need it. ### Clinical Sources - [Symptoms of menopause and perimenopause](https://www.nhs.uk/conditions/menopause-and-perimenopause/symptoms/) - [Mental health and menopause — Mind](https://www.mind.org.uk/information-support/tips-for-everyday-living/menopause-and-mental-health/) - [Treatment for symptoms of the menopause](https://www.rcog.org.uk/media/kihaya3e/pi-treatment-symptoms-menopause.pdf) - [How can menopause affect my mental health?](https://www.mind.org.uk/information-support/tips-for-everyday-living/menopause-and-mental-health/how-can-menopause-affect-mental-health/) - [Menopause and your mental wellbeing](https://www.nhsinform.scot/healthy-living/womens-health/later-years-around-50-years-and-over/menopause-and-post-menopause-health/menopause-and-your-mental-wellbeing/) - [Menopause and your mental wellbeing](https://www.nhsinform.scot/healthy-living/womens-health/later-years-around-50-years-and-over/menopause-and-post-menopause-health/menopause-and-your-mental-wellbeing/) - [Things you can do to help menopause and perimenopause symptoms](https://www.nhs.uk/conditions/menopause-and-perimenopause/things-you-can-do/) - [Things you can do to help menopause and perimenopause symptoms](https://www.nhs.uk/conditions/menopause-and-perimenopause/things-you-can-do/) - [Things you can do to help menopause and perimenopause symptoms](https://www.nhs.uk/conditions/menopause-and-perimenopause/things-you-can-do/) - [Treatment for symptoms of the menopause](https://www.rcog.org.uk/for-the-public/browse-our-patient-information/treatment-for-symptoms-of-the-menopause/) - [Menopause | NHS North East London](https://northeastlondon.icb.nhs.uk/health-advice/womens-health/menopause/) - [Emotional wellness in menopause](https://www.womens-health-concern.org/wp-content/uploads/2023/06/30-WHC-FACTSHEET-Emotional-wellness-in-menopause-JUNE2023-A.pdf) --- Reviewed by Dr Jade Thomas, HCPC Registered Psychologist and BPS Chartered Psychologist | [Medical Board](https://blog.bloume.com/perimenopause/medical-board.md) | July 2026