Health Insights
Mood changes during perimenopause: when to seek support
Low mood, anxiety and irritability can happen during perimenopause, but hormonal change is not the only possible explanation. Learn when a routine appointment is reasonable, when to seek prompt assessment and when to get urgent help.
If you or someone else is in immediate danger or at immediate risk of harm, call Triple Zero on 000. If you are having thoughts of suicide or self-harm, seek help now; crisis-support options are listed below. (Healthdirect Australia)
Some women notice changes in mood during the years leading up to menopause; others do not. The risk of mood changes and symptoms of depression and anxiety is higher during perimenopause, including in women without a past history of depression, but this is not a problem for everyone. (Australasian Menopause Society)
This article describes changes you may wish to discuss and how to tell when routine, prompt or urgent help is needed. It does not diagnose any condition.
Mood changes you may notice
Changes some women describe include feeling irritable, sad, anxious or hopeless, finding it harder to concentrate, or feeling tired or unmotivated. (Australasian Menopause Society)
Sleep disruption and night sweats can overlap with these feelings and make it harder to tell what is causing what. (Australasian Menopause Society)
Emotional changes can affect relationships, work and everyday life. If low mood is affecting how you cope at home or at work, that is a reason to talk with a doctor. (Healthdirect Australia)
Hormonal change is not the only explanation
Unstable oestrogen levels during perimenopause can affect the brain and may make some women more vulnerable to feelings of depression and anxiety. (Australasian Menopause Society)
That does not mean every new mood symptom is caused by perimenopause. Stress related to life circumstances, such as caring for children or ageing parents, career or relationship changes, body changes and illness, can also have a strong effect on mood. (Australasian Menopause Society)
Other contributors may include physical health problems such as thyroid conditions, alcohol or other drug use, and a personal or family history of mental health conditions. (Healthdirect Australia: anxiety; Healthdirect Australia: depression) Some medicines can also affect mood; for example, mood changes are a possible side effect of hormonal contraceptives. (Jean Hailes for Women's Health)
Because these factors overlap, a doctor can look at the whole picture rather than assuming a single cause. (Australasian Menopause Society)
If you have ADHD, or wonder whether attention difficulties are part of the picture, ADHD and perimenopause covers that overlap separately.
Information that can help a clinician
Your doctor may ask about several areas to understand what may be contributing. (Australasian Menopause Society) It can help to think about:
- 01
when the changes began, and whether they come and go
- 02
how your mood is affecting sleep, relationships, work and daily life
- 03
other changes you have noticed, such as period changes, hot flushes or night sweats
- 04
any past experience of mental health concerns
- 05
sleep, physical activity and alcohol
- 06
stressful life circumstances
- 07
the medicines and supplements you take
You do not need to have everything written down. Brief notes about what has changed and what worries you most are enough to start the conversation.
Support options
Support depends on what is contributing and how much it is affecting you. Options may include lifestyle changes, psychological therapies, social support and, where appropriate after an individual assessment, medicines. (Australasian Menopause Society)
Lifestyle changes that can help include regular physical activity, improving sleep, reducing stress where possible and limiting alcohol. (Australasian Menopause Society)
Beyond Blue offers information and support for depression and anxiety on 1300 22 4636. It is not an emergency service. (Healthdirect Australia: mental health helplines)
At Mahila, a perimenopause consultation can include discussing mood alongside your other symptoms and wider health. Mahila does not provide crisis or emergency mental health services. Learn more about perimenopause care at Mahila.
Mahila hosted Mental Health in Midlife on 12 October 2026, an educational event about hormones, mental health and emotional wellbeing in midlife.
When a routine appointment is reasonable
A routine appointment with your GP is a reasonable place to start if mood changes are mild or come and go, or are part of a wider set of changes you want to understand. Given how physical and emotional changes can overlap, speaking with your doctor is the best place to start. (Australasian Menopause Society)
When to seek prompt assessment
Arrange a prompt appointment if you are feeling sad, teary or overwhelmed most of the time, if these feelings have lasted two weeks or more, or if low mood is affecting how you cope at home or at work. (Healthdirect Australia)
Also seek prompt help if your symptoms feel severe. Help is available for severe mental health symptoms. (Australasian Menopause Society)
When to get urgent or emergency help
If you or someone else is in immediate danger, or at immediate risk of harm, call Triple Zero on 000. (Healthdirect Australia)
If you are having thoughts of suicide or self-harm, do not wait. Seek help now. (Healthdirect Australia)
For crisis support, you can call Lifeline on 13 11 14 or the Suicide Call Back Service on 1300 659 467, 24 hours a day, 7 days a week. These services provide crisis counselling and support. They are not a substitute for emergency services: if there is immediate danger, call 000. (Healthdirect Australia: mental health helplines; Suicide Call Back Service)
Aboriginal and Torres Strait Islander people can call 13YARN on 13 92 76 for 24/7 crisis support with an Aboriginal or Torres Strait Islander Crisis Supporter. (13YARN)
You can talk about mood at a perimenopause appointment
A consultation can help you discuss what has changed, what may be contributing and what support may suit you. If you are in immediate danger, call Triple Zero on 000 rather than booking an appointment.