Perimenopause can mess with your mental health

By naturopath Margaret Jasinska

Did you know that the sharp hormonal swings in the lead up to menopause can impair your stress coping abilities? Mood difficulties, sleep problems and unpleasant physical symptoms are all typical during the perimenopause years.

Perimenopause is the two to twelve years before menopause. It typically begins when a woman is in her mid 30s. It can cause heavy periods, irregular periods, mood swings, insomnia, and night sweats.

The World Health Organization defines perimenopause as ‘the time immediately preceding the menopause, beginning with endocrine, biologic and clinical changes, and ending a year after the final menstrual period’. Menopause is the phase that begins one year after the last period, or when the blood level of Follicle Stimulating Hormone (FSH) is 30 or above. The first few years of menopause typically cause hot flushes, weight gain around the torso, and insomnia. Perimenopausal and menopausal symptoms can usually be relieved with natural treatments.

Progesterone drops during perimenopause

Your progesterone level will drop long before oestrogen does. That means in your forties you may find you don’t cope with stress as well as you used to. This happens because losing progesterone during perimenopause can destabilise your HPA axis (hypothalamic-pituitary-adrenal) axis. This describes the way your brain and adrenal glands communicate with each other when you are stressed. Impaired function of this system is why perimenopause is associated with an increased risk of anxiety, depression and insomnia.

During perimenopause you still produce oestrogen, but the rise and fall is no longer as smooth. Dramatic swings in oestrogen are more common and this also adversely affects mood.

Progesterone improves how your brain copes with stress

Your progesterone can be converted to the calming anti inflammatory steroid allopregnanolone (ALLO), progesterone calms GABA receptors and it stabilises the hypothalamic pituitary adrenal axis. Progesterone also promotes neurogenesis (new nerve growth) in the hippocampus, further supporting healthy brain function.

A recent study called Estradiol and Progesterone as Resilience Markers showed that lower progesterone during perimenopause is associated with lower life satisfaction, greater levels of perceived stress, and increased risk of depression and anxiety.

How to help your nervous system during perimenopause

  • You can start feeling the beneficial health effects of progesterone quite quickly by using a bio-identical progesterone cream.  This requires a doctor’s prescription. If you’d like more information, feel free to contact us via email: or by calling 02 4655 4666.
  • Magnesium helps your body to cope with stress. It has calming effects on the nervous system and helps improve sleep quality. There is magnesium in green leafy vegetables but you may not be getting enough in your diet and could benefit from a magnesium supplement.
  • Regular exercise helps improve mental health and stress coping abilities. Exercise also helps reduce levels of visceral fat in the body. This is the deep internal fat inside and around abdominal organs. Levels of this dangerous fat rise after menopause.
  • Tyrosine is an amino acid that your brain uses to manufacture the neurotransmitters dopamine and noradrenalin. Dr Cabot refers to it as Mood Food because it helps support a healthy mood and healthy stress coping abilities.
  • Your diet plays an important role in your mental health. Preparing your own home cooked meals comprised of protein, vegetables and natural fats is important to ensure you get enough vitamins and minerals to produce neurotransmitters and hormones. Folate is found in green vegetables and liver. It’s very important for mental health, especially in people with impaired methylation. Sugar and high carbohydrate foods can cause a glucose spike and then crash. Fluctuating blood sugar has a disastrous effect on mental health.

Perimenopause can cause extremely distressing symptoms for a lot of women. It is typically a challenging phase of life anyway, and the hormonal swings only worsen symptoms. Fortunately there are natural remedies to help.

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