{"id":2963,"date":"2025-10-14T10:00:00","date_gmt":"2025-10-14T08:00:00","guid":{"rendered":"https:\/\/equilibriumpsychotherapy.net\/perimenopause-and-mood\/"},"modified":"2026-11-02T15:02:43","modified_gmt":"2026-11-02T14:02:43","slug":"perimenopause-and-mood","status":"publish","type":"post","link":"https:\/\/equilibriumpsychotherapy.net\/hr\/perimenopause-and-mood\/","title":{"rendered":"Perimenopause and Mood"},"content":{"rendered":"\n<style>\n\/* The accent is a light-background device. 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button[aria-pressed=true]{color:#44557a;font-weight:700;border-top-color:#44557a}\n.wn-wx .rd{margin:18px 0 0;background:#faf8f3;border:1.5px solid #e8e1d5;border-radius:16px;padding:20px 22px}\n.wn-wx .rd .st{font-family:\"Playfair Display\",Georgia,serif;font-size:22px;font-weight:700;color:#2a2622;margin:0 0 12px}\n.wn-wx .rd .st::first-letter{text-transform:uppercase}\n.wn-wx .rd .cols{display:grid;grid-template-columns:minmax(0,1fr) minmax(0,1fr);gap:18px 26px}\n.wn-wx .rd .k{font-size:11.5px;font-weight:700;letter-spacing:.14em;text-transform:uppercase;color:#44557a;margin:0 0 5px}\n.wn-wx .rd .t{font-size:16.5px;line-height:1.55;color:#2a2622;margin:0}\n.wn-wx .hint{font-size:14px;color:#6b6259;margin:10px 0 0 54px}\n@media(max-width:700px){\n  .wn-wx .plot{grid-template-columns:minmax(0,1fr)}\n  .wn-wx .ax{display:none}\n  .wn-wx svg{height:210px}\n  .wn-wx .stg{grid-template-columns:1fr 1fr;margin-left:0}\n  .wn-wx .stg button{border-top:0;border-left:3px solid #e8e1d5;padding:6px 8px}\n  .wn-wx .stg button[aria-pressed=true]{border-left-color:#44557a}\n  .wn-wx .rd .cols{grid-template-columns:minmax(0,1fr)}\n  .wn-wx .hint{margin-left:0}\n}\n\n\/* ---- figure 0: where am I? ---- *\/\n.wn-sc .trail{list-style:none;margin:0 0 14px;padding:0;display:grid;gap:6px}\n.wn-sc .trail:empty{display:none}\n.wn-sc .trail li{display:flex;gap:10px;align-items:baseline;margin:0;font-size:15px;line-height:1.45;color:#6b6259}\n.wn-sc .trail li b{flex:0 0 auto;font-weight:700;color:#44557a;min-width:28px}\n.wn-sc .qbox{background:#faf8f3;border:1.5px solid #e8e1d5;border-radius:16px;padding:20px 22px}\n.wn-sc .qn{font-size:11.5px;font-weight:700;letter-spacing:.14em;text-transform:uppercase;color:#44557a;margin:0 0 8px}\n.wn-sc .qt{font-size:clamp(18px,1.9vw,20px);line-height:1.45;font-weight:600;color:#2a2622;margin:0 0 16px}\n.wn-sc .qt:focus,.wn-sc .res .st:focus{outline:none}\n.wn-sc .yn{display:flex;flex-wrap:wrap;gap:10px}\n.wn-sc .yn button,.wn-sc 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a{font-size:16px;font-weight:600;color:#8a6300;text-decoration:underline;text-underline-offset:3px;text-decoration-color:#f0dca4}\n.wn-sc .res a:hover{text-decoration-color:#8a6300}\n.wn-sc .note{font-size:14.5px;line-height:1.55;color:#6b6259;margin:14px 0 0}\n\n\/* ---- figure 2: sleep carries most of the link ---- *\/\n.wn-chain{display:grid;grid-template-columns:minmax(0,1fr) 44px minmax(0,1fr) 44px minmax(0,1fr);align-items:center;margin:0 0 8px}\n.wn-chain .nd{border:1.5px solid #e8e1d5;background:#faf8f3;border-radius:14px;padding:14px 16px;text-align:center;\n  font-size:16.5px;font-weight:600;line-height:1.35;color:#2a2622;transition:background .3s ease,border-color .3s ease,color .3s ease}\n.wn-chain .ar{height:2px;background:#c7cfdf;position:relative;margin:0 6px}\n.wn-chain .ar::after{content:\"\";position:absolute;right:-1px;top:-5px;border:6px solid transparent;border-left:8px solid #c7cfdf;border-right:0}\n.wn-sl[data-v=after] .wn-chain 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span{position:absolute;transform:translateX(-50%);font-size:12.5px;color:#6b6259;font-variant-numeric:tabular-nums}\n.wn-sl .ax{font-size:13px;color:#6b6259;text-align:center;margin:2px 0 0}\n.wn-sl .rd{margin:16px 0 0;font-size:17px;line-height:1.55;color:#2a2622}\n.wn-sl .rd b{color:#654800;font-weight:700;font-variant-numeric:tabular-nums}\n@media(max-width:640px){\n  .wn-chain{grid-template-columns:minmax(0,1fr);gap:0}\n  .wn-chain .ar{width:2px;height:22px;margin:0 auto}\n  .wn-chain .ar::after{right:auto;left:-5px;top:auto;bottom:-2px;border:6px solid transparent;border-top:8px solid #c7cfdf;border-bottom:0}\n}\n\n\/* ---- figure 3: the weather diary ---- *\/\n.wn-di .tools{display:flex;flex-wrap:wrap;align-items:center;gap:10px 16px;margin:0 0 16px}\n.wn-di .tools>span{font-size:14.5px;color:#6b6259}\n.wn-di .lay{display:grid;grid-template-columns:minmax(0,1fr);gap:0 30px;align-items:start}\n@media(min-width:900px){.wn-di .lay{grid-template-columns:minmax(0,1.15fr) 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.pd{position:absolute;left:8px;right:8px;bottom:6px;height:3px;border-radius:2px;background:#b5566b}\n.wn-di .legend{display:flex;flex-wrap:wrap;gap:6px 18px;margin:14px 0 0;font-size:14px;color:#6b6259}\n.wn-di .legend span{display:inline-flex;align-items:center;gap:7px}\n.wn-di .legend svg{width:20px;height:20px}\n.wn-di .legend .dot{width:9px;height:9px;border-radius:50%;background:#44557a}\n.wn-di .legend .bar{width:16px;height:3px;border-radius:2px;background:#b5566b}\n.wn-di .sum{margin:18px 0 0;background:#faf8f3;border:1.5px solid #e8e1d5;border-radius:14px;padding:16px 18px;font-size:16.5px;line-height:1.6;color:#2a2622}\n.wn-di .sum .ex{display:inline-block;font-size:11.5px;font-weight:700;letter-spacing:.14em;text-transform:uppercase;color:#654800;\n  background:#fcf3dd;border-radius:6px;padding:3px 8px;margin:0 0 8px}\n.wn-di .sum .ex[hidden]{display:none}\n.wn-di .sum p{margin:0}\n.wn-di .act{display:flex;flex-wrap:wrap;align-items:center;gap:8px 10px;margin:16px 0 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It carries the\n   nudge in reverse so it stays under the term when the card has moved. *\/\n.eqp .gd::after{content:\"\";position:absolute;left:calc(50% - 6px - var(--sx,0px));\n  bottom:-7px;width:12px;height:12px;background:#fff;\n  border-right:1.5px solid var(--eqp-line2);border-bottom:1.5px solid var(--eqp-line2);\n  transform:rotate(45deg)}\n.eqp .gl:hover .gd,.eqp .gl:focus .gd,.eqp .gl:focus-within .gd{\n  opacity:1;visibility:visible;pointer-events:auto;\n  transform:translateX(-50%) translateY(0)}\n@media(prefers-reduced-motion:reduce){\n  .eqp .gd{transition:none;transform:translateX(-50%)}\n}\n\/* A popup means nothing on paper, and nothing is lost: every glossed term keeps\n   the author's own sentence around it. *\/\n@media print{.eqp .gd{display:none}.eqp .gl{border-bottom:0}}\n<\/style><style>\n.eqp .gl{color:#8a6300}\n.eqp .gl:hover{background:#fcf3dd}\n.eqp .eqb .gl{color:inherit}\n.eqp .gd{border-left:3px solid #a57a00}\n.eqp .gd b{color:#654800;background:#fcf3dd;margin:-14px -16px 12px;padding:10px 16px 9px;border-bottom:1px solid #f0dca4}\n.eqp .gd::after{border-right-color:#f0dca4;border-bottom-color:#f0dca4}\n<\/style><script>\n(function(){\n  \/* The sheet is the first block on the page, so at parse time not one .gl\n     exists yet and binding straight away binds to nothing. 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id=\"eq-sweep-2963\">\/* eq-sweep-2963 M1 (17 Oct 2026): bold #a57a00 is 3.9:1 on white and 3.53:1 on cream; the post's own #8a6300 under 960px and in light boxes *\/@media (max-width:959px){body .eqp .eqb{color:#8a6300}}body .eqp .has-background:not(.eq-ondark) .eqb{color:#8a6300}<\/style><style id=\"eq-sweep-2963b\">\/* 17 Oct 2026, S1 term name 12px, S2 closing heading on a phone, S3 lone last words (balance on headings and short labels, pretty on sublines and sentences) *\/body .eqp .gd b{font-size:.75rem}@media (max-width:600px){body .eqp .eq-ondark h3.wp-block-heading{font-size:1.2rem!important}}body .eqp h1,body .eqp h2,body .eqp h3,body .eqp .wn-sc .qt,body .eqp .wn-start .h,body .eqp .wn-next .ti,body .eqp .eq-toc .ttl,body .eqp .wn-chain .nd{text-wrap:balance}body .eqp .wn-part .sb,body .eqp .wn-fig .hd .q,body .eqp .wn-sc .res .t,body .eqp .wn-wx .rd .t,body .eqp .wn-start .t,body .eqp .wn-next .wy,body .eqp figcaption,body .eqp .wn-sc .note,body .eqp .wn-di .sum p,body .eqp .wn-wx .hint,body .eqp .has-background p,body .eqp .has-background li{text-wrap:pretty}\nbody .eqp h3,body .eqp .wn-start .h,body .eqp .wn-next .ti{text-wrap:pretty}<\/style><div id=\"eqp-rail\" aria-hidden=\"true\"><i><\/i><\/div><nav id=\"eqp-parts\" aria-hidden=\"true\"><a href=\"#part-1\" data-i=\"1\" tabindex=\"-1\"><span class=\"dot\"><\/span><span class=\"lbl\">What perimenopause actually is<\/span><\/a><a href=\"#part-2\" data-i=\"2\" tabindex=\"-1\"><span class=\"dot\"><\/span><span class=\"lbl\">A window of higher risk<\/span><\/a><a href=\"#part-3\" data-i=\"3\" tabindex=\"-1\"><span class=\"dot\"><\/span><span class=\"lbl\">Weather, not climate<\/span><\/a><a href=\"#part-4\" data-i=\"4\" tabindex=\"-1\"><span class=\"dot\"><\/span><span class=\"lbl\">Night sweats, sleep and mood<\/span><\/a><a href=\"#part-5\" data-i=\"5\" tabindex=\"-1\"><span class=\"dot\"><\/span><span class=\"lbl\">Anxiety, irritability and brain fog<\/span><\/a><a href=\"#part-6\" data-i=\"6\" tabindex=\"-1\"><span class=\"dot\"><\/span><span class=\"lbl\">What helps<\/span><\/a><\/nav><button id=\"eqp-top\" type=\"button\" aria-label=\"Back to the top of the article\"><svg viewBox=\"0 0 12 12\" aria-hidden=\"true\" focusable=\"false\"><path d=\"M6 10.5V2M2 5.5 6 1.5l4 4\" fill=\"none\" stroke=\"currentColor\" stroke-width=\"1.7\" stroke-linecap=\"round\" stroke-linejoin=\"round\"\/><\/svg>Top<\/button><script>(function(){document.documentElement.setAttribute(\"data-eqp\",\"on\");function init(){var RM=false;if(window.matchMedia){RM=window.matchMedia(\"(prefers-reduced-motion: reduce)\").matches;}var bar=document.querySelector(\"#eqp-rail i\");var hasST=false;if(window.CSS){if(CSS.supports){hasST=CSS.supports(\"animation-timeline\",\"scroll()\");}}if(bar){if(!hasST){  var tick=function(){    var h=document.documentElement.scrollHeight-window.innerHeight;    var p=h>0?window.scrollY\/h:0;    if(p<0)p=0; if(p>1)p=1;    bar.style.transform=\"scaleX(\"+p+\")\";  };  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.pmw-pl-k::after{left:14px;background:#44557a}\n@media(prefers-reduced-motion:reduce){.pmw-pill,.pmw-pill.pmw-pill-on,.pmw-segb{transition:none!important}}\n@media print{.pmw-seg,.pmw-hint,.pmw-pill{display:none!important}}\n\/* the back to top button (house chrome) sits one pill higher so the two never overlap *\/\n#eqp-top{right:max(16px,env(safe-area-inset-right))!important;bottom:calc(max(16px,env(safe-area-inset-bottom)) + 54px)!important}\n\/* figure 2 key: its labels are spans that CSS sets to inline-flex, which would beat the hide rule above *\/\n.pmw-post .wn-wx .key .pmw-pln{display:none}\n.pmw-post.pmw-plain .wn-wx .key .pmw-pln{display:inline-flex}\n\/*>*\/<\/style>\n\n\n\n<div class=\"wp-block-group alignfull eqp pmw-post has-global-padding is-layout-constrained wp-container-core-group-is-layout-69fa9525 wp-block-group-is-layout-constrained\" style=\"margin-top:0;margin-bottom:0;padding:0px 22px\">\n\n\n<div class=\"wp-block-group has-global-padding is-layout-constrained wp-container-core-group-is-layout-d12c95ff wp-block-group-is-layout-constrained\">\n\n<div style=\"color:#6b6259;font-size:clamp(14px, 0.875rem + ((1vw - 3.2px) * 0.455), 18px);font-style:normal;font-weight:400;margin-top:54px;margin-bottom:0\" class=\"has-link-color wp-elements-1 wp-block-post-date has-text-color has-work-sans-regular-font-family\"><time datetime=\"2025-10-14T10:00:00+02:00\">14 listopada, 2025<\/time><\/div>\n\n<div style=\"color:#6b6259;font-size:clamp(14px, 0.875rem + ((1vw - 3.2px) * 0.455), 18px);font-style:normal;font-weight:700;text-transform:uppercase;margin-top:0;margin-bottom:0\" class=\"taxonomy-category has-link-color wp-elements-2 wp-block-post-terms has-text-color has-work-sans-regular-font-family\"><a href=\"https:\/\/equilibriumpsychotherapy.net\/hr\/category\/body-and-mind\/\" rel=\"tag\">Body and Mind<\/a><span class=\"wp-block-post-terms__separator\">, <\/span><a href=\"https:\/\/equilibriumpsychotherapy.net\/hr\/category\/too-afraid-to-ask\/\" rel=\"tag\">Everything You Were Too Afraid to Ask<\/a><span class=\"wp-block-post-terms__separator\">, <\/span><a href=\"https:\/\/equilibriumpsychotherapy.net\/hr\/category\/womens-health\/\" rel=\"tag\">Women&#8217;s Health<\/a><\/div>\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family ra-series wp-block-paragraph\" style=\"color:#44557a;margin-top:24px;margin-bottom:0;font-size:12.5px;font-weight:700;letter-spacing:0.2em;line-height:1.4\">Everything you were too afraid to ask<\/p>\n\n\n\n<h1 class=\"wp-block-heading has-text-color has-playfair-display-font-family\" id=\"top\" style=\"color:#2a2622;margin-top:8px;margin-bottom:10px;font-size:clamp(25.014px, 1.563rem + ((1vw - 3.2px) * 1.93), 42px);font-style:normal;font-weight:800;line-height:1.12\">Perimenopause and Mood<\/h1>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family eq-subtitle wp-block-paragraph\" style=\"color:#44557a;margin-top:0;margin-bottom:20px;font-size:clamp(14px, 0.875rem + ((1vw - 3.2px) * 0.114), 15px);font-weight:600;letter-spacing:.14em;line-height:1.5;text-transform:uppercase\">Weather, not climate<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#524a42;margin-top:0;margin-bottom:22px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.55\">What perimenopause actually is, why mood can change in these years, why swings in estrogen seem to matter more than its level, how night sweats and broken sleep feed into low mood, what is happening with anxiety, irritability and brain fog, and what helps<\/p>\n\n\n\n<p class=\"eq-credit\" style=\"--eq-credit-ac:#44557a\">Written by <a href=\"\/our-team-ivana\/\" rel=\"author\">Ivana<\/a>, psychologist and psychotherapist<\/p>\n\n\n\n<div style=\"margin-top:0px;margin-bottom:0px\"><div class=\"pmw-swbox pmw-keep\" id=\"pmw-swbox\"><div class=\"pmw-metarow\"><p class=\"has-text-color has-work-sans-regular-font-family pmw-metat\" style=\"color:#6b6259;margin-top:0;margin-bottom:0;font-size:15px;line-height:1.5\"><span class=\"pmw-mtw\"><span class=\"pmw-mt-f\"><strong style=\"color:#44557a\">19 minute read<\/strong> &nbsp;&middot;&nbsp; 4,366 words<\/span><span class=\"pmw-mt-p\"><strong style=\"color:#44557a\">16 minute read<\/strong> &nbsp;&middot;&nbsp; 3,601 words<\/span><\/span><\/p><div class=\"pmw-seg\" id=\"pmw-seg\" role=\"radiogroup\" aria-label=\"Reading version\" aria-describedby=\"pmw-sw-h\"><button type=\"button\" class=\"pmw-segb\" id=\"pmw-seg-full\" role=\"radio\" aria-checked=\"true\" tabindex=\"0\">Detailed<\/button><button type=\"button\" class=\"pmw-segb\" id=\"pmw-seg-plain\" role=\"radio\" aria-checked=\"false\" tabindex=\"-1\">Plain words<\/button><\/div><\/div><p class=\"pmw-hint\" id=\"pmw-sw-h\">Detailed explains the research and the reasons behind each point. 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The observer says when the control leaves the screen; a passive scroll listener recomputes from the real positions as well, because a jump (a contents link, the End key) can skip an observer entirely. *\/var ends=[null,null],busy=false;function update(){busy=false;var h=window.innerHeight,show=false,hide=false,k,r,q,sf,fg,pr;if(!ends[0]){ends[0]=document.querySelector(\".pmw-end\");}if(!ends[1]){ends[1]=document.querySelector(\"footer\");}r=seg.getBoundingClientRect();if(r.bottom<=0){show=true;}for(k=0;k< ends.length;k+=1){if(ends[k]){r=ends[k].getBoundingClientRect();if(r.top< h-72){if(r.bottom>0){hide=true;}}}}sf=document.querySelectorAll(\".pmw-nopill\");for(q=0;q< sf.length;q+=1){r=sf[q].getBoundingClientRect();if(r.top< h){if(r.bottom>0){hide=true;}}}if(!hide){pr=pill.getBoundingClientRect();fg=document.querySelectorAll(\"figure,figcaption\");for(q=0;q< fg.length;q+=1){r=fg[q].getBoundingClientRect();if(r.bottom>pr.top-6){if(r.top< pr.bottom+6){if(r.right>pr.left-6){if(r.left< pr.right+6){hide=true;break;}}}}}}if(show){if(!hide){pill.classList.add(\"pmw-pill-on\");return;}}pill.classList.remove(\"pmw-pill-on\");}function soon(){if(!busy){busy=true;window.requestAnimationFrame(update);}}window.addEventListener(\"scroll\",soon,{passive:true});window.addEventListener(\"resize\",soon);if(window.IntersectionObserver){new IntersectionObserver(soon).observe(seg);}window.addEventListener(\"load\",soon);document.addEventListener(\"click\",function(){window.setTimeout(soon,80);},true);document.addEventListener(\"pmw-plain-change\",function(){window.setTimeout(soon,200);});update();})();\/*>*\/<\/script><\/div>\n\n\n<\/div>\n\n\n\n<div class=\"wp-block-group pmw-keep has-global-padding is-layout-constrained wp-container-core-group-is-layout-d12c95ff wp-block-group-is-layout-constrained\">\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family eq-drop wp-block-paragraph\" style=\"color:#35302a;margin-top:46px;margin-bottom:26px;font-size:clamp(14.642px, 0.915rem + ((1vw - 3.2px) * 0.836), 22px);line-height:1.62\">Some women describe it as a change in the weather, and you may know exactly what they mean. Nothing much in your life has changed, and yet for a few days at a time you feel flat, or short-tempered, or close to tears over things that would normally roll off you. Then it lifts, you feel like yourself again, and a few weeks later it&#8217;s back.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">If you&#8217;re in your forties and this sounds familiar, it may have something to do with perimenopause, the years of hormonal change before periods stop for good. It gets far less attention than menopause itself, even though, where mood is concerned, it seems to be the part that matters most.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">This article looks at what the research shows about perimenopause and mood: who is more likely to be affected, what seems to drive the change, and what helps.<span class=\"pmw-fl\"> If you&#8217;d like everything in plainer words, choose Plain words above.<\/span> The short version is that <strong class=\"eqb\">the change is real, it&#8217;s common, and for most women it passes<\/strong>. It isn&#8217;t all in your head, and there are things that help.<\/p>\n\n\n<\/div>\n\n\n\n<div class=\"wp-block-group pmw-keep has-global-padding is-layout-constrained wp-container-core-group-is-layout-d2a766d4 wp-block-group-is-layout-constrained\">\n\n\n<div class=\"wp-block-group has-background has-global-padding is-layout-constrained wp-container-core-group-is-layout-4ccedd2e wp-block-group-is-layout-constrained\" style=\"border-color:#e8e1d5;border-width:1.5px;border-style:solid;border-radius:22px;background-color:#faf8f3;margin-top:56px;margin-bottom:20px;padding:30px 34px\">\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#6b6259;margin-top:0;margin-bottom:22px;font-size:12px;font-weight:700;letter-spacing:0.16em;line-height:1.4\">WHAT THIS ARTICLE COVERS &middot; SIX PARTS<\/p>\n\n\n\n<div class=\"wp-block-rank-math-toc-block\">\n<div class=\"eq-toc\"><details><summary><svg class=\"chev\" viewBox=\"0 0 12 12\" aria-hidden=\"true\" focusable=\"false\"><path d=\"M4 2l4 4-4 4\" fill=\"none\" stroke=\"currentColor\" stroke-width=\"1.7\" stroke-linecap=\"round\" stroke-linejoin=\"round\"\/><\/svg><span class=\"num\">PART 1<\/span><a class=\"ttl\" href=\"#part-1\">What perimenopause actually is<\/a><span class=\"cnt\"><span class=\"pmw-n2\">1<\/span><span class=\"pmw-p2\">2 min<\/span>span class=&#8221;sec&#8221;>4 sections<\/span><span class=\"sep\"> &middot; <\/span>3 min<\/span><\/summary><ul><li><a href=\"#menopause-is-a-single-day\">Menopause is a single day<\/a><\/li><li><a href=\"#why-it-is-easy-to-miss\">Why it is easy to miss<\/a><\/li><li><a href=\"#how-to-tell-where-you-are\">How to tell where you are<\/a><\/li><li><a href=\"#uneven-not-simply-lower\">Uneven, not simply lower<\/a><\/li><\/ul><\/details><details><summary><svg class=\"chev\" viewBox=\"0 0 12 12\" aria-hidden=\"true\" focusable=\"false\"><path d=\"M4 2l4 4-4 4\" fill=\"none\" stroke=\"currentColor\" stroke-width=\"1.7\" stroke-linecap=\"round\" stroke-linejoin=\"round\"\/><\/svg><span class=\"num\">PART 2<\/span><a class=\"ttl\" href=\"#part-2\">A window of higher risk<\/a><span class=\"cnt\"><span class=\"pmw-n2\">2<\/span><span class=\"pmw-p2\">1 min<\/span>span class=&#8221;sec&#8221;>3 sections<\/span><span class=\"sep\"> &middot; <\/span>2 min<\/span><\/summary><ul><li><a href=\"#most-women-do-not-become-depressed\">Most women do not become depressed<\/a><\/li><li><a href=\"#even-without-a-history-of-depression\">Even without a history of depression<\/a><\/li><li><a href=\"#when-depression-has-happened-before\">When depression has happened before<\/a><\/li><\/ul><\/details><details><summary><svg class=\"chev\" viewBox=\"0 0 12 12\" aria-hidden=\"true\" focusable=\"false\"><path d=\"M4 2l4 4-4 4\" fill=\"none\" stroke=\"currentColor\" stroke-width=\"1.7\" stroke-linecap=\"round\" stroke-linejoin=\"round\"\/><\/svg><span class=\"num\">PART 3<\/span><a class=\"ttl\" href=\"#part-3\">Weather, not climate<\/a><span class=\"cnt\"><span class=\"pmw-n2\">3<\/span><span class=\"pmw-p2\">2 min<\/span>span class=&#8221;sec&#8221;>4 sections<\/span><span class=\"sep\"> &middot; <\/span>3 min<\/span><\/summary><ul><li><a href=\"#two-ways-of-describing-the-same-sky\">Two ways of describing the same sky<\/a><\/li><li><a href=\"#what-the-penn-study-saw\">What the Penn study saw<\/a><\/li><li><a href=\"#swings-and-stress-together\">Swings and stress together<\/a><\/li><li><a href=\"#some-women-are-more-sensitive-than-others\">Some women are more sensitive than others<\/a><\/li><\/ul><\/details><details><summary><svg class=\"chev\" viewBox=\"0 0 12 12\" aria-hidden=\"true\" focusable=\"false\"><path d=\"M4 2l4 4-4 4\" fill=\"none\" stroke=\"currentColor\" stroke-width=\"1.7\" stroke-linecap=\"round\" stroke-linejoin=\"round\"\/><\/svg><span class=\"num\">PART 4<\/span><a class=\"ttl\" href=\"#part-4\">Night sweats, sleep and mood<\/a><span class=\"cnt\"><span class=\"pmw-n2\">4<\/span><span class=\"pmw-p2\">1 min<\/span>span class=&#8221;sec&#8221;>3 sections<\/span><span class=\"sep\"> &middot; <\/span>2 min<\/span><\/summary><ul><li><a href=\"#hot-flashes-last-longer-than-most-people-expect\">Hot flashes last longer than most people expect<\/a><\/li><li><a href=\"#night-is-where-it-matters\">Night is where it matters<\/a><\/li><li><a href=\"#sleep-carries-most-of-the-link\">Sleep carries most of the link<\/a><\/li><\/ul><\/details><details><summary><svg class=\"chev\" viewBox=\"0 0 12 12\" aria-hidden=\"true\" focusable=\"false\"><path d=\"M4 2l4 4-4 4\" fill=\"none\" stroke=\"currentColor\" stroke-width=\"1.7\" stroke-linecap=\"round\" stroke-linejoin=\"round\"\/><\/svg><span class=\"num\">PART 5<\/span><a class=\"ttl\" href=\"#part-5\">Anxiety, irritability and brain fog<\/a><span class=\"cnt\"><span class=\"pmw-n2\">5<\/span><span class=\"pmw-p2\">2 min<\/span>span class=&#8221;sec&#8221;>4 sections<\/span><span class=\"sep\"> &middot; <\/span>2 min<\/span><\/summary><ul><li><a href=\"#anxiety-rises-too\">Anxiety rises too<\/a><\/li><li><a href=\"#irritability-deserves-its-own-mention\">Irritability deserves its own mention<\/a><\/li><li><a href=\"#brain-fog-is-real-and-it-lifts\">Brain fog is real, and it lifts<\/a><\/li><li><a href=\"#not-everything-at-47-is-hormones\">Not everything at 47 is hormones<\/a><\/li><\/ul><\/details><details><summary><svg class=\"chev\" viewBox=\"0 0 12 12\" aria-hidden=\"true\" focusable=\"false\"><path d=\"M4 2l4 4-4 4\" fill=\"none\" stroke=\"currentColor\" stroke-width=\"1.7\" stroke-linecap=\"round\" stroke-linejoin=\"round\"\/><\/svg><span class=\"num\">PART 6<\/span><a class=\"ttl\" href=\"#part-6\">What helps<\/a><span class=\"cnt\"><span class=\"pmw-n2\">6<\/span><span class=\"pmw-p2\">4 min<\/span>span class=&#8221;sec&#8221;>5 sections<\/span><span class=\"sep\"> &middot; <\/span>5 min<\/span><\/summary><ul><li><a href=\"#start-with-a-conversation\">Start with a conversation<\/a><\/li><li><a href=\"#what-the-guidelines-say-about-treatment\">What the guidelines say about treatment<\/a><\/li><li><a href=\"#therapy-designed-for-this-stage\">Therapy designed for this stage<\/a><\/li><li><a href=\"#let-the-people-close-to-you-know\">Let the people close to you know<\/a><\/li><li><a href=\"#movement-and-sleep\">Movement and sleep<\/a><\/li><\/ul><\/details><\/div>\n<\/div>\n\n\n<\/div>\n\n\n<\/div>\n\n\n\n<div class=\"wp-block-group pmw-keep has-global-padding is-layout-constrained wp-container-core-group-is-layout-d2a766d4 wp-block-group-is-layout-constrained\">\n\n\n<div style=\"margin-top:92px;margin-bottom:34px\"><div class=\"wn-part\"><div class=\"meta\"><p class=\"lb\">Part one of six<\/p><span class=\"tk\" aria-hidden=\"true\"><i class=\"now\"><\/i><i class=\"\"><\/i><i class=\"\"><\/i><i class=\"\"><\/i><i class=\"\"><\/i><i class=\"\"><\/i><\/span><\/div><h2 id=\"part-1\">What perimenopause actually is<\/h2><p class=\"sb\">The years of change before the last period, and the signs of each stage<\/p><\/div><\/div>\n\n\n<\/div>\n\n\n\n<div class=\"wp-block-group pmw-pl has-global-padding is-layout-constrained wp-container-core-group-is-layout-d12c95ff wp-block-group-is-layout-constrained\">\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family pmw-plk wp-block-paragraph\" style=\"color:#44557a;margin-top:38px;margin-bottom:14px;font-size:12px;font-weight:700;letter-spacing:0.16em;line-height:1.4\">In plain words<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">Menopause is technically a single day, the date of your last period. You can only know it looking back, once a whole year has passed with no period.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">The years of change before that are called the menopausal transition. Perimenopause is the everyday name for those years plus the first year after the last period. For most women it starts somewhere in their forties and <strong class=\"eqb\">usually lasts several years<\/strong>.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">It&#8217;s easy to miss at first. Your periods may still come every month, just a few days earlier or later than they used to. <strong class=\"eqb\">Changes in sleep, mood or energy are easy to put down to everything else going on at this age<\/strong>, like work, children or aging parents.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">Researchers use a set of stages called STRAW+10, and you can use the markers on yourself. <strong class=\"eqb\">The early transition starts when your cycle gets seven days or more longer or shorter from one cycle to the next<\/strong>, and that happens again within ten cycles. A cycle that was always 28 days might be 21 days one month and 30 the next. <strong class=\"eqb\">The late transition starts when you go 60 days or more without a period<\/strong>, and it lasts one to three years on average. After the last period comes postmenopause.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">The questions below use these markers to show which stage your periods point to.<\/p>\n\n\n<\/div>\n\n\n\n<div class=\"wp-block-group pmw-n has-global-padding is-layout-constrained wp-container-core-group-is-layout-d12c95ff wp-block-group-is-layout-constrained\">\n\n\n<h3 class=\"wp-block-heading has-text-color has-work-sans-regular-font-family\" id=\"menopause-is-a-single-day\" style=\"color:#44557a;margin-top:72px;margin-bottom:18px;font-size:clamp(16.293px, 1.018rem + ((1vw - 3.2px) * 0.989), 25px);font-style:normal;font-weight:700;line-height:1.28\">Menopause is a single day<\/h3>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">Strictly speaking, menopause is the date of your last period. You can only know it looking back, once a full year has passed without another one. Everything before it, from the first noticeable changes in your cycle, is the menopausal transition, and perimenopause is the everyday name for that stretch together with the first year after the last period.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">For most women it begins somewhere in their forties. <strong class=\"eqb\">It isn&#8217;t a brief phase: taken together, the early and late stages of the transition usually last several years<\/strong>, and the first signs are easy to miss.<\/p>\n\n\n\n<h3 class=\"wp-block-heading has-text-color has-work-sans-regular-font-family\" id=\"why-it-is-easy-to-miss\" style=\"color:#44557a;margin-top:72px;margin-bottom:18px;font-size:clamp(16.293px, 1.018rem + ((1vw - 3.2px) * 0.989), 25px);font-style:normal;font-weight:700;line-height:1.28\">Why it is easy to miss<\/h3>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">You might not notice perimenopause starting at all. Periods may still arrive every month, only a few days earlier or later than they used to, so nothing seems obviously different. And <strong class=\"eqb\">the changes that are harder to pin down, in sleep, mood or energy, are easy to put down to everything else going on at this age<\/strong>: a demanding job, children, aging parents, a difficult few weeks. Many women only connect the pieces looking back, which is one reason it&#8217;s worth knowing what the early markers are.<\/p>\n\n\n\n<h3 class=\"wp-block-heading has-text-color has-work-sans-regular-font-family\" id=\"how-to-tell-where-you-are\" style=\"color:#44557a;margin-top:72px;margin-bottom:18px;font-size:clamp(16.293px, 1.018rem + ((1vw - 3.2px) * 0.989), 25px);font-style:normal;font-weight:700;line-height:1.28\">How to tell where you are<\/h3>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">An international group of researchers agreed on a set of stages, known as <em class=\"eqi\">STRAW+10<\/em>, so that studies around the world would describe the same thing in the same way. Their markers are simple enough to use on yourself.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\"><strong class=\"eqb\">The early transition begins when the length of your cycle starts to change by seven days or more from one cycle to the next<\/strong>, and that happens again within ten cycles. A cycle that was reliably 28 days might become 21 days one month and 30 the next.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\"><strong class=\"eqb\">The late transition begins when there&#8217;s a gap of 60 days or more between periods.<\/strong> This stage lasts, on average, one to three years. After the last period comes postmenopause, and its early stage, when the body is still settling, lasts roughly five to eight years.<\/p>\n\n\n<\/div>\n\n\n\n<div class=\"wp-block-group pmw-keep has-global-padding is-layout-constrained wp-container-core-group-is-layout-d2a766d4 wp-block-group-is-layout-constrained\">\n\n\n<div style=\"margin-top:40px;margin-bottom:48px\"><figure class=\"wn-fig wn-sc\" id=\"wn-sc\"><div class=\"hd\"><p class=\"ti\">Where am I?<\/p><p class=\"q\"><span class=\"pmw-nrm\">Up to three questions, based on the STRAW+10 stages<\/span><span class=\"pmw-pln\">Up to three questions about your periods, based on the STRAW+10 stages<\/span><\/p><\/div><ol class=\"trail\" id=\"wn-sct\" aria-label=\"Your answers so far\"><\/ol><div class=\"qbox\" id=\"wn-scq\"><p class=\"qn\" id=\"wn-scn\"><\/p><p class=\"qt\" id=\"wn-scqt\" tabindex=\"-1\"><\/p><div class=\"yn\"><button type=\"button\" data-a=\"1\">Yes<\/button><button type=\"button\" data-a=\"0\">No<\/button><\/div><\/div><div class=\"res\" id=\"wn-scr\" hidden aria-live=\"polite\"><p class=\"k\">By these markers<\/p><p class=\"st\" id=\"wn-scs\" tabindex=\"-1\"><\/p><p class=\"t\" id=\"wn-scx\"><\/p><div class=\"go\"><a href=\"#wn-wx\" id=\"wn-scl\">See this stage on the chart<\/a><button type=\"button\" class=\"again\" id=\"wn-sca\">Start again<\/button><\/div><\/div><p class=\"note\">This is a guide to the stages, not a diagnosis. It does not work if something else controls your periods, such as hormonal contraception, a hormonal IUD (coil), a hysterectomy, endometrial ablation or pregnancy. If your periods do not tell you much, your doctor can help.<\/p><figcaption><span class=\"pmw-nrm\">The stages are read from the cycle alone, which is why the questions are about periods rather than symptoms.<\/span><span class=\"pmw-pln\">The stages are worked out from your periods alone, which is why every question is about your periods.<\/span><\/figcaption><script>(function(){var Q=[\"Has it been 12 months or more since your last period?\",\"Have you gone 60 days or more without a period at any point?\",\"Has your cycle length changed by seven days or more from one cycle to the next, and has that happened again within ten cycles?\"],R=[[\"early postmenopause\",3,\"A full year without a period marks menopause, so by these markers you are past it. The early years after it, while the body is still settling, last roughly five to eight years. For mood, the research is mostly reassuring: the extra risk is highest around the transition and fades in the years after it, especially for women with no history of depression.\"],[\"late transition\",2,\"Gaps of 60 days or more mark the late transition, which lasts one to three years on average. It is still part of the window when low mood is more likely, so it is a good time to keep an eye on sleep and mood.\"],[\"early transition\",1,\"A cycle that keeps changing length by a week or more marks the start of the transition. This is the stage where the risk of low mood starts to rise, and it can last several years.\"],[\"probably not in the transition yet\",0,\"If your cycle is still regular, these markers put you in the late reproductive years. Changes usually begin gradually, so it may be worth checking again in a few months if things start to shift.\"]];var f=document.getElementById(\"wn-sc\");if(!f){return;}var qb=document.getElementById(\"wn-scq\"),qn=document.getElementById(\"wn-scn\"),qt=document.getElementById(\"wn-scqt\"),tr=document.getElementById(\"wn-sct\");var rb=document.getElementById(\"wn-scr\"),rs=document.getElementById(\"wn-scs\"),rx=document.getElementById(\"wn-scx\"),rl=document.getElementById(\"wn-scl\");var step=0,res=null,SHORT=[\"12 months without a period\",\"A gap of 60 days or more\",\"Cycle length changing by a week or more\"],QP=[\"Has it been 12 months or more since your last period?\",\"Have you gone 60 days or more without a period at any point?\",\"Has one cycle been seven days or more longer or shorter than the one before, and has that happened again within ten cycles? A cycle runs from the first day of one period to the first day of the next.\"],RP=[[\"early postmenopause, the first years after your last period\",3,\"A full year with no period marks menopause, so by these markers you\u2019re past it. The first years after it, while your body is still settling, last roughly five to eight years. For mood, the research is mostly reassuring. The extra risk is highest around the transition and fades in the years after it, especially for women who have never been depressed.\"],[\"late transition, when periods start to space out\",2,\"Gaps of 60 days or more between periods mark the late transition. It lasts one to three years on average. Low mood is still more likely at this stage, so it\u2019s a good time to keep an eye on your sleep and mood.\"],[\"early transition, when cycles start to change\",1,\"A cycle that keeps changing length by a week or more marks the start of the transition. This is when the chance of low mood starts to go up, and this stage can last several years.\"],[\"probably not in the transition yet\",0,\"If your cycle is still regular, these markers put you in the late reproductive years, before the changes begin. Changes usually start slowly, so it may be worth checking again in a few months if things start to shift.\"]],SHORTP=[\"12 months without a period\",\"A gap of 60 days or more\",\"Cycles changing length by a week or more\"],cur=0;function pl(){var r=document.querySelector(\".pmw-post\");if(r){return r.classList.contains(\"pmw-plain\");}return false;}function ask(focus){qb.hidden=false;rb.hidden=true;qn.textContent=\"Question \"+(step+1)+\" of 3\";qt.textContent=pl()?QP[step]:Q[step];if(focus){qt.focus();}}function paint(){var r=pl()?RP[cur]:R[cur];rs.textContent=r[0].charAt(0).toUpperCase()+r[0].slice(1);rx.textContent=r[2];}function done(i){res=R[i];cur=i;qb.hidden=true;rb.hidden=false;paint();rs.focus();}function add(a){var li=document.createElement(\"li\"),b=document.createElement(\"b\"),s=document.createElement(\"span\");b.textContent=a?\"Yes\":\"No\";s.textContent=pl()?SHORTP[step]:SHORT[step];s.setAttribute(\"data-i\",String(step));li.appendChild(b);li.appendChild(s);tr.appendChild(li);}var yn=f.querySelectorAll(\".yn button\");for(var i=0;i<yn.length;i++){yn[i].addEventListener(\"click\",function(){var a=this.getAttribute(\"data-a\")===\"1\";add(a);if(a){done(step);return;}step=step+1;if(step>2){done(3);return;}ask(true);});}document.getElementById(\"wn-sca\").addEventListener(\"click\",function(){step=0;res=null;tr.innerHTML=\"\";ask(true);});rl.addEventListener(\"click\",function(){if(res){if(window.wnWxPick){window.wnWxPick(res[1]);}}});document.addEventListener(\"pmw-plain-change\",function(){var k,sp=tr.querySelectorAll(\"li span\");if(!qb.hidden){qt.textContent=pl()?QP[step]:Q[step];}if(!rb.hidden){paint();}for(k=0;k< sp.length;k+=1){sp[k].textContent=(pl()?SHORTP:SHORT)[Number(sp[k].getAttribute(\"data-i\"))];}});ask(false);})();\/*>*\/<\/script><\/figure><\/div>\n\n\n<\/div>\n\n\n\n<div class=\"wp-block-group pmw-pl has-global-padding is-layout-constrained wp-container-core-group-is-layout-d12c95ff wp-block-group-is-layout-constrained\">\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family pmw-plk wp-block-paragraph\" style=\"color:#44557a;margin-top:38px;margin-bottom:14px;font-size:12px;font-weight:700;letter-spacing:0.16em;line-height:1.4\">In plain words<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">Estrogen is one of the main hormones your ovaries make. It rises and falls in a regular pattern each month, and that pattern drives your cycle. <a href=\"\/is-it-your-hormones\/\" style=\"color:#8a6300;text-decoration:underline;text-underline-offset:3px;text-decoration-thickness:1.5px;text-decoration-color:#f0dca4\">Estrogen also acts on the brain<\/a>, where it affects chemical messengers involved in mood, sleep and memory.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">Over the years of perimenopause, estrogen slowly goes down. <strong class=\"eqb\">From month to month, though, it gets much less predictable.<\/strong> It can go higher than usual one month and very low the next. Most studies measure estradiol, the main form of estrogen before menopause. The difference between the slow fall and the swings seems to matter a lot for mood, and part three explains why.<\/p>\n\n\n<\/div>\n\n\n\n<div class=\"wp-block-group has-global-padding is-layout-constrained wp-container-core-group-is-layout-d12c95ff wp-block-group-is-layout-constrained\">\n\n\n<h3 class=\"wp-block-heading has-text-color has-work-sans-regular-font-family pmw-n\" id=\"uneven-not-simply-lower\" style=\"color:#44557a;margin-top:72px;margin-bottom:18px;font-size:clamp(16.293px, 1.018rem + ((1vw - 3.2px) * 0.989), 25px);font-style:normal;font-weight:700;line-height:1.28\">Uneven, not simply lower<\/h3>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family pmw-n wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">Estrogen is one of the main hormones made by the ovaries. Through the reproductive years it rises and falls in a regular pattern each month, and that pattern is what drives the menstrual cycle. <a href=\"\/is-it-your-hormones\/\" style=\"color:#8a6300;text-decoration:underline;text-underline-offset:3px;text-decoration-thickness:1.5px;text-decoration-color:#f0dca4\">Estrogen also acts on the brain<\/a>, where it influences chemical messengers involved in mood, sleep and memory, which is why you can feel changes in it as well as measure them. In perimenopause the ovaries become less regular, and so does the estrogen they make.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family pmw-n wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">You might picture this as a slow, steady decline, like a dimmer switch being turned down over a decade. Over the long run, that&#8217;s roughly what happens. <strong class=\"eqb\">From month to month, though, estrogen becomes much less predictable<\/strong>: it can rise higher than usual in one cycle and fall very low in the next, and the regular rhythm that used to shape each month gets harder to find. Most studies measure estradiol, the main form of estrogen before menopause.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family pmw-n wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">That difference, between the long, slow trend and the short, unpredictable swings, seems to matter a great deal for mood. <a href=\"#part-3\" style=\"color:#8a6300;text-decoration:underline;text-underline-offset:3px;text-decoration-thickness:1.5px;text-decoration-color:#f0dca4\">Part three<\/a> explains why.<\/p>\n\n\n\n<div class=\"pmw-keep\" style=\"margin-top:6px;margin-bottom:34px\"><a class=\"wn-start\" href=\"\/womens-health-101\/\"><div><p class=\"k\">Start here<\/p><p class=\"h\">Feeling a bit lost?<\/p><p class=\"t\">If estrogen, cycles and stages are new to you, it can help to start with the basics. <i>Everything You Were Too Afraid to Ask: Women\u2019s Health 101<\/i> walks through the body and the monthly cycle from the very beginning, with drawings you can explore.<\/p><\/div><span class=\"go\">Start with the basics<svg viewBox=\"0 0 16 16\" aria-hidden=\"true\"><path d=\"M2 8h11M9 4l4 4-4 4\" fill=\"none\" stroke=\"currentColor\" stroke-width=\"1.8\" stroke-linecap=\"round\" stroke-linejoin=\"round\"\/><\/svg><\/span><\/a><\/div>\n\n\n<\/div>\n\n\n\n<div class=\"wp-block-group pmw-keep has-global-padding is-layout-constrained wp-container-core-group-is-layout-d2a766d4 wp-block-group-is-layout-constrained\">\n\n\n<div style=\"margin-top:92px;margin-bottom:34px\"><div class=\"wn-part\"><div class=\"meta\"><p class=\"lb\">Part two of six<\/p><span class=\"tk\" aria-hidden=\"true\"><i class=\"past\"><\/i><i class=\"now\"><\/i><i class=\"\"><\/i><i class=\"\"><\/i><i class=\"\"><\/i><i class=\"\"><\/i><\/span><\/div><h2 id=\"part-2\">A window of higher risk<\/h2><p class=\"sb\">What the large studies found, and who is most likely to be affected<\/p><\/div><\/div>\n\n\n<\/div>\n\n\n\n<div class=\"wp-block-group pmw-pl has-global-padding is-layout-constrained wp-container-core-group-is-layout-d12c95ff wp-block-group-is-layout-constrained\">\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family pmw-plk wp-block-paragraph\" style=\"color:#44557a;margin-top:38px;margin-bottom:14px;font-size:12px;font-weight:700;letter-spacing:0.16em;line-height:1.4\">In plain words<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">Most women don&#8217;t become depressed during perimenopause. That&#8217;s worth saying first, because this topic can sound scarier than it is.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">The chance of low mood does go up. In SWAN, a long-running US study that has followed thousands of women through their forties and fifties, women were about 1.3 to 1.7 times as likely to score high on a depression questionnaire during and after the transition as before it. Even so, <strong class=\"eqb\">the researchers concluded that most midlife women don&#8217;t develop high levels of depressive symptoms.<\/strong><\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">This doesn&#8217;t only happen to women who were depressed before. Two US studies followed only women who had never been depressed. In one, women in perimenopause were twice as likely to develop significant depressive symptoms as women who hadn&#8217;t reached it yet. In the other, a diagnosed depression was two and a half times as likely during the transition as before it. <strong class=\"eqb\">So low mood that shows up for the first time in these years isn&#8217;t just a sign that you were always prone to it. The transition itself seems to play a part.<\/strong><\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\"><strong class=\"eqb\">If you&#8217;ve been depressed before, that history is still the strongest single signal of risk.<\/strong> In one SWAN group, women were two to four times as likely to have an episode of major depression, the kind a doctor diagnoses, during perimenopause or the first years after it as before it. A past episode strongly predicted another.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">So if depression is part of your history, that isn&#8217;t a reason to expect the worst. <strong class=\"eqb\">Take early changes seriously, rather than waiting to see whether they pass.<\/strong><\/p>\n\n\n<\/div>\n\n\n\n<div class=\"wp-block-group pmw-n has-global-padding is-layout-constrained wp-container-core-group-is-layout-d12c95ff wp-block-group-is-layout-constrained\">\n\n\n<h3 class=\"wp-block-heading has-text-color has-work-sans-regular-font-family\" id=\"most-women-do-not-become-depressed\" style=\"color:#44557a;margin-top:72px;margin-bottom:18px;font-size:clamp(16.293px, 1.018rem + ((1vw - 3.2px) * 0.989), 25px);font-style:normal;font-weight:700;line-height:1.28\">Most women do not become depressed<\/h3>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">This topic can easily sound more alarming than it is, so it&#8217;s worth starting here. The Study of Women&#8217;s Health Across the Nation, known as SWAN, is a long-running US study that has followed thousands of women through their forties and fifties. Women in it were about 1.3 to 1.7 times as likely to have high scores on a questionnaire about depressive symptoms during the transition and after it as before it.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\"><strong class=\"eqb\">The researchers concluded that most midlife women do not develop high levels of depressive symptoms.<\/strong> So the risk goes up, and for most women it doesn&#8217;t turn into depression.<\/p>\n\n\n\n<h3 class=\"wp-block-heading has-text-color has-work-sans-regular-font-family\" id=\"even-without-a-history-of-depression\" style=\"color:#44557a;margin-top:72px;margin-bottom:18px;font-size:clamp(16.293px, 1.018rem + ((1vw - 3.2px) * 0.989), 25px);font-style:normal;font-weight:700;line-height:1.28\">Even without a history of depression<\/h3>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">If you&#8217;ve never been depressed before, you might wonder whether this happens mainly to women who were already prone to low mood. Two American studies were designed to answer exactly that, and both followed only women who had never been depressed.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">The Harvard Study of Moods and Cycles followed women in the Boston area. Those who entered perimenopause were twice as likely to develop significant depressive symptoms as those who hadn&#8217;t reached it yet, even after taking age and difficult life events into account. The risk was somewhat higher for women who also had hot flashes.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">The Penn Ovarian Aging Study, based in Philadelphia, compared each woman with herself, before and during the transition. High depressive scores were more than four times as likely during the transition, and a diagnosed depressive disorder was two and a half times as likely. So <strong class=\"eqb\">low mood that shows up for the first time in these years isn&#8217;t just a sign that you were always prone to it; the transition itself seems to play a part<\/strong>.<\/p>\n\n\n\n<h3 class=\"wp-block-heading has-text-color has-work-sans-regular-font-family\" id=\"when-depression-has-happened-before\" style=\"color:#44557a;margin-top:72px;margin-bottom:18px;font-size:clamp(16.293px, 1.018rem + ((1vw - 3.2px) * 0.989), 25px);font-style:normal;font-weight:700;line-height:1.28\">When depression has happened before<\/h3>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\"><strong class=\"eqb\">If you&#8217;ve been depressed before, that history is still the strongest single signal of risk.<\/strong> A smaller SWAN study at one site used clinical interviews rather than questionnaires. The women in it were two to four times more likely to have an episode of <span class=\"gl\" tabindex=\"0\" aria-describedby=\"gd-1\"><em class=\"eqi\">major depression<\/em><span class=\"gd\" role=\"tooltip\" id=\"gd-1\"><b>major depression<\/b>A diagnosis made when low mood or a loss of interest lasts most of the day, nearly every day, for at least two weeks, together with other changes such as in sleep, appetite, energy or concentration.<\/span><\/span> during perimenopause or the first years after it than before, and a past episode strongly predicted another one.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">Guidelines published in 2018 by the North American Menopause Society, which has since been renamed The Menopause Society, and the US National Network of Depression Centers make the same point: most midlife women who have major depression during perimenopause have had an episode before.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">So if depression is part of your history, that isn&#8217;t a reason to expect the worst. <strong class=\"eqb\">Take early changes seriously, rather than waiting to see whether they pass.<\/strong><\/p>\n\n\n<\/div>\n\n\n\n<div class=\"wp-block-group pmw-keep has-global-padding is-layout-constrained wp-container-core-group-is-layout-d2a766d4 wp-block-group-is-layout-constrained\">\n\n\n<div style=\"margin-top:92px;margin-bottom:34px\"><div class=\"wn-part\"><div class=\"meta\"><p class=\"lb\">Part three of six<\/p><span class=\"tk\" aria-hidden=\"true\"><i class=\"past\"><\/i><i class=\"past\"><\/i><i class=\"now\"><\/i><i class=\"\"><\/i><i class=\"\"><\/i><i class=\"\"><\/i><\/span><\/div><h2 id=\"part-3\">Weather, not climate<\/h2><p class=\"sb\">What happens when studies track hormones and mood over time<\/p><\/div><\/div>\n\n\n<\/div>\n\n\n\n<div class=\"wp-block-group pmw-pl has-global-padding is-layout-constrained wp-container-core-group-is-layout-d12c95ff wp-block-group-is-layout-constrained\">\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family pmw-plk wp-block-paragraph\" style=\"color:#44557a;margin-top:38px;margin-bottom:14px;font-size:12px;font-weight:700;letter-spacing:0.16em;line-height:1.4\">In plain words<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">Climate is what a place is like over years. Weather is what happens this week. Your hormones in perimenopause can be described the same way. The climate is the slow fall in estrogen across the whole transition. The weather is how much it goes up and down from week to week and month to month. <strong class=\"eqb\">The research more and more suggests that mood follows the weather more closely than the climate.<\/strong> How much your estrogen moves seems to matter more than how low it goes.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">The chart below draws the climate and the weather across the four stages.<\/p>\n\n\n<\/div>\n\n\n\n<div class=\"wp-block-group pmw-n has-global-padding is-layout-constrained wp-container-core-group-is-layout-d12c95ff wp-block-group-is-layout-constrained\">\n\n\n<h3 class=\"wp-block-heading has-text-color has-work-sans-regular-font-family\" id=\"two-ways-of-describing-the-same-sky\" style=\"color:#44557a;margin-top:72px;margin-bottom:18px;font-size:clamp(16.293px, 1.018rem + ((1vw - 3.2px) * 0.989), 25px);font-style:normal;font-weight:700;line-height:1.28\">Two ways of describing the same sky<\/h3>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">Climate is what a place is like over years: the average temperature, the usual rainfall. Weather is what happens this week: the sudden cold spell, the three wet days in a row. A town can have a mild climate and still have days that knock you sideways.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">Your hormones in perimenopause can be described in the same two ways. The climate is the long, gradual fall in estrogen across the transition. The weather is how much it rises and falls from week to week and month to month. <strong class=\"eqb\">The research increasingly suggests that mood follows the weather more closely than the climate.<\/strong> It&#8217;s less about how low your estrogen goes, and more about how much it moves.<\/p>\n\n\n<\/div>\n\n\n\n<div class=\"wp-block-group pmw-keep has-global-padding is-layout-constrained wp-container-core-group-is-layout-d2a766d4 wp-block-group-is-layout-constrained\">\n\n\n<div style=\"margin-top:40px;margin-bottom:48px\"><figure class=\"wn-fig wn-wx\" id=\"wn-wx\" data-v=\"both\"><div class=\"hd\"><p class=\"ti\">Weather, not climate<\/p><p class=\"q\"><span class=\"pmw-nrm\">Estrogen across the transition: the long trend, and the swings around it<\/span><span class=\"pmw-pln\">Estrogen over these years: the slow fall, and the ups and downs around it<\/span><\/p><\/div><div class=\"ctl\"><div class=\"wn-seg\" role=\"group\" aria-label=\"Show\"><button type=\"button\" data-v=\"both\" aria-pressed=\"true\">both<\/button><button type=\"button\" data-v=\"climate\" aria-pressed=\"false\">the climate<\/button><button type=\"button\" data-v=\"weather\" aria-pressed=\"false\">the weather<\/button><\/div><div class=\"key\"><span><i><\/i><span class=\"pmw-nrm\">estrogen, the long trend<\/span><span class=\"pmw-pln\">estrogen, the slow fall<\/span><\/span><span><i class=\"w\"><\/i>estrogen, month to month<\/span><\/div><\/div><div class=\"plot\"><div class=\"ax\" aria-hidden=\"true\"><span>higher<\/span><span>lower<\/span><\/div><svg viewBox=\"0 0 1000 356\" preserveAspectRatio=\"none\" role=\"img\" aria-label=\"An illustration. A thick line falls gradually from high to low across four stages. A thin line follows a regular wave at first, swings widely and unpredictably through the two transition stages, and settles low after menopause.\"><rect class=\"band\" data-s=\"0\" x=\"0\" y=\"0\" width=\"220\" height=\"356\"\/><rect class=\"band alt\" data-s=\"1\" x=\"220\" y=\"0\" width=\"340\" height=\"356\"\/><rect class=\"band\" data-s=\"2\" x=\"560\" y=\"0\" width=\"220\" height=\"356\"\/><rect class=\"band alt\" data-s=\"3\" x=\"780\" y=\"0\" width=\"220\" height=\"356\"\/><line class=\"sep\" x1=\"220\" y1=\"0\" x2=\"220\" y2=\"356\"\/><line class=\"sep\" x1=\"560\" y1=\"0\" x2=\"560\" y2=\"356\"\/><line class=\"sep\" x1=\"780\" y1=\"0\" x2=\"780\" y2=\"356\"\/><path class=\"cl\" d=\"M0 128.3L4 128.3L8 128.3L12 128.3L16 128.4L20 128.4L24 128.4L28 128.4L32 128.4L36 128.4L40 128.5L44 128.5L48 128.5L52 128.5L56 128.5L60 128.6L64 128.6L68 128.6L72 128.6L76 128.7L80 128.7L84 128.7L88 128.8L92 128.8L96 128.8L100 128.9L104 128.9L108 128.9L112 129.0L116 129.0L120 129.1L124 129.1L128 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290.8L932 291.1L936 291.2L940 291.4L944 291.6L948 291.8L952 292.0L956 292.1L960 292.3L964 292.4L968 292.6L972 292.7L976 292.9L980 293.0L984 293.1L988 293.2L992 293.3L996 293.4L1000 293.5\"\/><path class=\"wxl\" d=\"M0 128.3L4 112.4L8 104.0L12 107.0L16 119.9L20 136.8L24 149.8L28 152.7L32 144.3L36 128.4L40 112.6L44 104.2L48 107.1L52 120.1L56 137.0L60 150.0L64 152.9L68 144.5L72 128.7L76 112.8L80 104.4L84 107.3L88 120.3L92 137.2L96 150.2L100 153.2L104 144.8L108 129.0L112 113.1L116 104.7L120 107.7L124 120.6L128 137.6L132 150.6L136 153.6L140 145.2L144 129.4L148 113.6L152 105.2L156 108.2L160 121.2L164 138.1L168 151.1L172 154.2L176 145.8L180 130.0L184 114.2L188 105.8L192 108.9L196 121.9L200 138.9L204 155.2L208 162.5L212 154.0L216 130.9L220 103.0L224 84.4L228 86.8L232 84.5L236 72.9L240 58.0L244 49.2L248 47.8L252 66.2L256 60.8L260 89.2L264 111.4L268 123.9L272 146.4L276 150.8L280 161.5L284 155.1L288 169.3L292 151.2L296 146.7L300 136.4L304 153.8L308 140.4L312 134.7L316 145.0L320 158.9L324 167.2L328 195.2L332 175.9L336 169.3L340 186.2L344 180.4L348 154.9L352 143.8L356 130.3L360 106.2L364 88.0L368 95.7L372 94.6L376 95.5L380 105.4L384 125.2L388 153.3L392 162.4L396 174.7L400 159.9L404 178.5L408 164.5L412 175.0L416 170.3L420 152.4L424 179.3L428 167.0L432 183.1L436 202.3L440 211.3L444 215.4L448 226.9L452 250.1L456 240.9L460 254.3L464 248.7L468 228.5L472 213.7L476 174.3L480 159.4L484 157.1L488 123.1L492 138.7L496 140.4L500 122.0L504 146.5L508 140.5L512 147.7L516 152.2L520 142.2L524 153.0L528 126.0L532 123.8L536 116.3L540 91.6L544 115.7L548 101.4L552 131.4L556 157.2L560 180.0L564 174.6L568 222.6L572 229.1L576 237.9L580 236.4L584 246.3L588 232.5L592 217.3L596 231.3L600 204.3L604 202.2L608 199.5L612 226.1L616 228.2L620 238.6L624 236.4L628 250.8L632 235.6L636 247.4L640 248.2L644 225.8L648 202.9L652 205.4L656 174.3L660 185.6L664 178.2L668 167.7L672 171.1L676 204.8L680 230.3L684 247.8L688 264.0L692 261.3L696 278.8L700 278.7L704 305.7L708 309.6L712 282.4L716 296.1L720 283.1L724 277.2L728 303.3L732 308.2L736 312.6L740 309.9L744 337.0L748 328.8L752 332.7L756 328.3L760 312.3L764 300.1L768 293.2L772 275.8L776 277.0L780 265.2L784 266.1L788 266.0L792 281.9L796 270.4L800 273.2L804 278.8L808 277.4L812 278.5L816 280.8L820 278.9L824 278.1L828 285.2L832 282.1L836 279.0L840 282.6L844 282.3L848 282.9L852 288.4L856 287.6L860 285.7L864 284.8L868 289.7L872 291.2L876 289.5L880 289.4L884 289.6L888 287.0L892 285.1L896 292.1L900 288.9L904 288.2L908 294.6L912 285.1L916 285.6L920 292.0L924 294.4L928 289.1L932 289.7L936 294.8L940 288.4L944 291.2L948 287.8L952 287.4L956 296.1L960 294.2L964 291.9L968 291.4L972 295.9L976 288.8L980 296.6L984 293.3L988 290.2L992 292.2L996 291.9L1000 294.1\"\/><\/svg><\/div><div class=\"stg\" role=\"group\" aria-label=\"Choose a stage\"><button type=\"button\" data-s=\"0\" aria-pressed=\"false\">late reproductive years<\/button><button type=\"button\" data-s=\"1\" aria-pressed=\"true\">early transition<\/button><button type=\"button\" data-s=\"2\" aria-pressed=\"false\">late transition<\/button><button type=\"button\" data-s=\"3\" aria-pressed=\"false\">early postmenopause<\/button><\/div><p class=\"hint\">Choose a stage to see what it looks like and what the research found.<\/p><div class=\"rd\" aria-live=\"polite\"><p class=\"st\" id=\"wn-st\"><\/p><div class=\"cols\"><div><p class=\"k\">How you might notice it<\/p><p class=\"t\" id=\"wn-no\"><\/p><\/div><div><p class=\"k\">What the research found<\/p><p class=\"t\" id=\"wn-fo\"><\/p><\/div><\/div><\/div><figcaption><span class=\"pmw-nrm\"><b>An illustration, not measured data.<\/b> The shape follows the pattern described in the text rather than the levels of any one woman. Stage markers from STRAW+10.<\/span><span class=\"pmw-pln\"><b>An illustration, not real measurements.<\/b> It follows the general pattern described in this article, not any one woman\u2019s levels. The stages come from STRAW+10, the stages described in part one.<\/span><\/figcaption><script>(function(){var D=[[\"late reproductive years\",\"Cycles are still regular, and roughly the same length from one month to the next.\",\"This is the comparison point in most of the studies: the risk in later stages is measured against these years.\"],[\"early transition\",\"Cycle length changes by seven days or more from one cycle to the next, and that happens again within ten cycles.\",\"The risk of depressive symptoms starts to rise. In one trial, hormone therapy reduced new depressive symptoms only in women at this stage.\"],[\"late transition\",\"There are gaps of 60 days or more between periods. This stage lasts one to three years on average.\",\"Depressive symptoms are still more likely than before the transition. In SWAN, processing speed stopped improving with practice during this stage.\"],[\"early postmenopause\",\"A full year without a period marks menopause. The early years after it last roughly five to eight years.\",\"Hormones settle at a low level. The extra risk of low mood fades in the years after the last period, and in SWAN the usual gains from practice on memory tests came back.\"]];var P=[[\"late reproductive years, before the changes begin\",\"Your cycle is still regular, and about the same length from month to month.\",\"Most studies compare the later stages with these years, so this is the starting point for measuring risk.\"],[\"early transition, when cycles start to change\",\"One cycle is seven days or more longer or shorter than the one before, and that happens again within ten cycles.\",\"The chance of depressive symptoms starts to go up. In one trial, hormone therapy reduced new depressive symptoms only in women at this stage.\"],[\"late transition, when periods start to space out\",\"You go 60 days or more between periods. This stage lasts one to three years on average.\",\"Depressive symptoms are still more likely than before the transition. In SWAN, processing speed, how quickly you take in and respond to simple information, stopped improving with practice during this stage.\"],[\"early postmenopause, the first years after your last period\",\"A full year with no period marks menopause. The first years after it last roughly five to eight years.\",\"Hormones settle at a low level. The extra risk of low mood fades in the years after the last period, and in SWAN, the usual gains from practice on memory tests came back.\"]],cur=1;function pl(){var r=document.querySelector(\".pmw-post\");if(r){return r.classList.contains(\"pmw-plain\");}return false;}var f=document.getElementById(\"wn-wx\");if(!f){return;}var vb=f.querySelectorAll(\".wn-seg button\"),sb=f.querySelectorAll(\".stg button\"),bd=f.querySelectorAll(\".band\");var st=document.getElementById(\"wn-st\"),no=document.getElementById(\"wn-no\"),fo=document.getElementById(\"wn-fo\");function pick(i){for(var j=0;j<sb.length;j++){sb[j].setAttribute(\"aria-pressed\",j===i?\"true\":\"false\");var c=bd[j].getAttribute(\"class\").replace(\" on\",\"\");bd[j].setAttribute(\"class\",j===i?c+\" on\":c);}cur=i;var Q=pl()?P:D;st.textContent=Q[i][0];no.textContent=Q[i][1];fo.textContent=Q[i][2];}for(var i=0;i<sb.length;i++){(function(i){sb[i].addEventListener(\"click\",function(){pick(i);});bd[i].addEventListener(\"click\",function(){pick(i);});})(i);}for(var k=0;k<vb.length;k++){vb[k].addEventListener(\"click\",function(){var v=this.getAttribute(\"data-v\");f.setAttribute(\"data-v\",v);for(var m=0;m<vb.length;m++){vb[m].setAttribute(\"aria-pressed\",vb[m]===this?\"true\":\"false\");}});}window.wnWxPick=pick;document.addEventListener(\"pmw-plain-change\",function(){pick(cur);});pick(1);})();\/*>*\/<\/script><\/figure><\/div>\n\n\n<\/div>\n\n\n\n<div class=\"wp-block-group pmw-pl has-global-padding is-layout-constrained wp-container-core-group-is-layout-d12c95ff wp-block-group-is-layout-constrained\">\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family pmw-plk wp-block-paragraph\" style=\"color:#44557a;margin-top:38px;margin-bottom:14px;font-size:12px;font-weight:700;letter-spacing:0.16em;line-height:1.4\">In plain words<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">One long US study, the Penn Ovarian Aging Study, measured women&#8217;s hormones again and again over the years. <strong class=\"eqb\">The more a woman&#8217;s hormones moved around her own usual levels, the more likely her mood was to drop.<\/strong><\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">Swings may also make stress hit harder. In a small study, women whose estradiol varied more went on to have more symptoms of depression, but only if they had also been through more very stressful events lately. The researchers suggested that <strong class=\"eqb\">hormone swings may make women more sensitive to stress, especially to feeling left out or turned away<\/strong>. That fits what many women describe: ordinary difficulties, like a sharp comment or a friend who doesn&#8217;t call back, land harder than they used to.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">Women differ a lot in this. When the same team checked hormones every week for twelve weeks, <strong class=\"eqb\">how closely mood followed those weekly changes varied greatly from one woman to the next<\/strong>, both in strength and in direction. For some women mood moved with their hormones, and for others it barely moved at all. If a sister or a friend sailed through these years and you haven&#8217;t, that doesn&#8217;t mean you&#8217;re handling it badly.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">A small US experiment shows how big that difference can be. It involved women who were past menopause and well, but who had been depressed during perimenopause and had recovered while taking estradiol. Without knowing it, some of them were switched from estradiol to a placebo, a dummy treatment. In those women, depression symptoms came back within weeks. Women with no such history went through the same drop in estradiol and stayed well. Their hormone levels were similar. <strong class=\"eqb\">What differed was how each woman&#8217;s brain responded to the change.<\/strong><\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">Your cycle may give a clue as well. In one small study, about one in five women with depression in perimenopause also had premenstrual dysphoria, a severe form of low mood before a period. Among perimenopausal women without depression, it was three in a hundred. It&#8217;s only a link, but <strong class=\"eqb\">if your mood has always been affected by your cycle, it may be affected again now<\/strong>.<\/p>\n\n\n<\/div>\n\n\n\n<div class=\"wp-block-group pmw-n has-global-padding is-layout-constrained wp-container-core-group-is-layout-d12c95ff wp-block-group-is-layout-constrained\">\n\n\n<h3 class=\"wp-block-heading has-text-color has-work-sans-regular-font-family\" id=\"what-the-penn-study-saw\" style=\"color:#44557a;margin-top:72px;margin-bottom:18px;font-size:clamp(16.293px, 1.018rem + ((1vw - 3.2px) * 0.989), 25px);font-style:normal;font-weight:700;line-height:1.28\">What the Penn study saw<\/h3>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">The Penn Ovarian Aging Study measured hormones again and again over the years it followed women. Several things went with high depressive scores: moving into the transition itself, rising levels of two other hormones that regulate the cycle, and how much each woman&#8217;s estradiol and those two hormones varied around her own usual average. That last link is the weather: <strong class=\"eqb\">the more a woman&#8217;s levels moved, compared with her own normal, the more likely her mood was to drop<\/strong>.<\/p>\n\n\n\n<h3 class=\"wp-block-heading has-text-color has-work-sans-regular-font-family\" id=\"swings-and-stress-together\" style=\"color:#44557a;margin-top:72px;margin-bottom:18px;font-size:clamp(16.293px, 1.018rem + ((1vw - 3.2px) * 0.989), 25px);font-style:normal;font-weight:700;line-height:1.28\">Swings and stress together<\/h3>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">Maybe you&#8217;ve noticed that a sharp comment, or a friend who doesn&#8217;t call back, hurts more than it used to. A small study that measured estradiol in women over fourteen months points to one reason. Women whose estradiol varied more went on to have more depressive symptoms, but only if they had also been through a larger number of very stressful events recently. Greater variation also went with stronger feelings of rejection in a laboratory task.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">The researchers suggested that <strong class=\"eqb\">hormonal swings may make women more sensitive to stress, especially to the feeling of being left out or turned away<\/strong>. That fits what many women describe: ordinary difficulties land harder than they used to.<\/p>\n\n\n\n<h3 class=\"wp-block-heading has-text-color has-work-sans-regular-font-family\" id=\"some-women-are-more-sensitive-than-others\" style=\"color:#44557a;margin-top:72px;margin-bottom:18px;font-size:clamp(16.293px, 1.018rem + ((1vw - 3.2px) * 0.989), 25px);font-style:normal;font-weight:700;line-height:1.28\">Some women are more sensitive than others<\/h3>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">If a sister or a friend sailed through these years and you haven&#8217;t, that doesn&#8217;t mean you&#8217;re handling it badly. In a later study, the same research team measured hormones every week for twelve weeks in women in perimenopause. <strong class=\"eqb\">How closely mood followed those weekly changes varied greatly from one woman to the next<\/strong>, both in strength and in direction. For some women mood moved with their hormones, and for others it barely moved at all.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">A small experiment at the US National Institute of Mental Health shows how strong that difference can be. It involved women who were past menopause and well, but who had been depressed during their perimenopause and had recovered on estradiol. They took estradiol for three weeks and were then switched, without knowing it, to either estradiol or a placebo. Among those switched to placebo, depressive symptoms came back within weeks.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">Women with no such history went through exactly the same drop in estradiol and stayed well. Their hormone levels were similar. <strong class=\"eqb\">What differed was how each woman&#8217;s brain responded to the change.<\/strong><\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">There are also signs that this sensitivity can be tied to the monthly cycle. In one small study that tracked daily ratings over a cycle, about one in five women with perimenopausal depression met the criteria for premenstrual dysphoria, a severe form of premenstrual low mood, compared with three in a hundred perimenopausal women who were not depressed. It looked at one point in time, so it shows a link rather than a prediction. Still, it matches what many women notice: <strong class=\"eqb\">if your mood has always been affected by your cycle, it may be affected again now<\/strong>.<\/p>\n\n\n<\/div>\n\n\n\n<div class=\"wp-block-group pmw-keep has-global-padding is-layout-constrained wp-container-core-group-is-layout-d2a766d4 wp-block-group-is-layout-constrained\">\n\n\n<div style=\"margin-top:92px;margin-bottom:34px\"><div class=\"wn-part\"><div class=\"meta\"><p class=\"lb\">Part four of six<\/p><span class=\"tk\" aria-hidden=\"true\"><i class=\"past\"><\/i><i class=\"past\"><\/i><i class=\"past\"><\/i><i class=\"now\"><\/i><i class=\"\"><\/i><i class=\"\"><\/i><\/span><\/div><h2 id=\"part-4\">Night sweats, sleep and mood<\/h2><p class=\"sb\">How hot flashes at night, broken sleep and low mood are connected<\/p><\/div><\/div>\n\n\n<\/div>\n\n\n\n<div class=\"wp-block-group pmw-pl has-global-padding is-layout-constrained wp-container-core-group-is-layout-d12c95ff wp-block-group-is-layout-constrained\">\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family pmw-plk wp-block-paragraph\" style=\"color:#44557a;margin-top:38px;margin-bottom:14px;font-size:12px;font-weight:700;letter-spacing:0.16em;line-height:1.4\">In plain words<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">Hot flashes and night sweats are the best-known signs of the transition, and they often last longer than people expect. In the SWAN study, <strong class=\"eqb\">women who had frequent hot flashes typically had them for 7.4 years in total<\/strong>. Women whose hot flashes started early in the transition typically had them for more than eleven years.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">For mood, when they happen matters too. In one experiment, healthy young women took a medicine that stops the ovaries from making estradiol for a while. Their levels fell and stayed low, and within four weeks most of them had hot flashes. Their mood got worse the more their sleep was broken and the more hot flashes they had at night. Hot flashes during the day made no measurable difference. The study was small and short, but <strong class=\"eqb\">what a hot flash does to your mood seems to depend on whether it wakes you up<\/strong>.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">A much bigger analysis pooled eight studies from several countries. Women with frequent or severe hot flashes were more likely to report low mood later on. Once the researchers took sleep problems into account, most of that link disappeared. <strong class=\"eqb\">The chain ran from hot flashes to broken sleep, and from broken sleep to low mood.<\/strong><\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">It ran the other way too. Women with low mood were more likely to report hot flashes later, so it&#8217;s a loop. That&#8217;s one of the more hopeful findings, because <strong class=\"eqb\">sleep is something you can protect, and improving your sleep, including sleep broken by night sweats, may take some of the weight off your mood<\/strong>!<\/p>\n\n\n<\/div>\n\n\n\n<div class=\"wp-block-group pmw-n has-global-padding is-layout-constrained wp-container-core-group-is-layout-d12c95ff wp-block-group-is-layout-constrained\">\n\n\n<h3 class=\"wp-block-heading has-text-color has-work-sans-regular-font-family\" id=\"hot-flashes-last-longer-than-most-people-expect\" style=\"color:#44557a;margin-top:72px;margin-bottom:18px;font-size:clamp(16.293px, 1.018rem + ((1vw - 3.2px) * 0.989), 25px);font-style:normal;font-weight:700;line-height:1.28\">Hot flashes last longer than most people expect<\/h3>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">If you&#8217;re waking up drenched at 3am, you might be hoping it will all be over in a few months. Hot flashes and night sweats are the best-known signs of the transition, and in SWAN, <strong class=\"eqb\">women who had frequent hot flashes typically had them for 7.4 years in total<\/strong>. Women whose hot flashes began early in the transition had them for longer, typically for more than eleven years.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">For mood, the question isn&#8217;t only how long they last, but when they happen.<\/p>\n\n\n\n<h3 class=\"wp-block-heading has-text-color has-work-sans-regular-font-family\" id=\"night-is-where-it-matters\" style=\"color:#44557a;margin-top:72px;margin-bottom:18px;font-size:clamp(16.293px, 1.018rem + ((1vw - 3.2px) * 0.989), 25px);font-style:normal;font-weight:700;line-height:1.28\">Night is where it matters<\/h3>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">One experiment separated the effects of estrogen, hot flashes and sleep in a way that everyday life never does. Healthy young women were given a medication that temporarily stops the ovaries from making estradiol, so their levels fell and stayed low, without the swings of the transition. Within four weeks, most of them had hot flashes.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">Their mood got worse in step with how broken their sleep became and with how many hot flashes they had at night. Hot flashes during the day made no measurable difference. The study was small and short, but the pattern is clear: <strong class=\"eqb\">what a hot flash does to your mood seems to depend on whether it wakes you up<\/strong>.<\/p>\n\n\n\n<h3 class=\"wp-block-heading has-text-color has-work-sans-regular-font-family\" id=\"sleep-carries-most-of-the-link\" style=\"color:#44557a;margin-top:72px;margin-bottom:18px;font-size:clamp(16.293px, 1.018rem + ((1vw - 3.2px) * 0.989), 25px);font-style:normal;font-weight:700;line-height:1.28\">Sleep carries most of the link<\/h3>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">A much larger analysis pooled eight studies from several countries. Women with frequent or severe hot flashes were more likely to report low mood later on. Once the researchers took sleep difficulties into account, most of that link disappeared: <strong class=\"eqb\">the chain ran from hot flashes to broken sleep, and from broken sleep to low mood<\/strong>.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">The chain also ran the other way. Women with low mood were more likely to report hot flashes later, so this is a loop rather than a straight line. That makes it one of the more hopeful findings in this area, because <strong class=\"eqb\">sleep is something that can be protected, and improving your sleep, including sleep broken by night sweats, may take some of the weight off your mood<\/strong>!<\/p>\n\n\n<\/div>\n\n\n\n<div class=\"wp-block-group pmw-keep has-global-padding is-layout-constrained wp-container-core-group-is-layout-d2a766d4 wp-block-group-is-layout-constrained\">\n\n\n<div style=\"margin-top:40px;margin-bottom:48px\"><figure class=\"wn-fig wn-sl\" id=\"wn-sl\" data-v=\"before\"><div class=\"hd\"><p class=\"ti\">Taking sleep into account<\/p><p class=\"q\"><span class=\"pmw-nrm\">What happens to the link between hot flashes and low mood once sleep is included<\/span><span class=\"pmw-pln\">What happens to the link between hot flashes and low mood once sleep is counted in<\/span><\/p><\/div><div class=\"wn-chain\" aria-hidden=\"true\"><div class=\"nd\">Hot flashes at night<\/div><div class=\"ar\"><\/div><div class=\"nd mid\">Broken sleep<\/div><div class=\"ar\"><\/div><div class=\"nd\">Low mood<\/div><\/div><p class=\"back\"><span class=\"pmw-nrm\">The loop runs back too: low mood also predicted more hot flashes later.<\/span><span class=\"pmw-pln\">It works the other way too. Low mood also went with more hot flashes later.<\/span><\/p><div class=\"ctl\"><div class=\"wn-seg\" role=\"group\" aria-label=\"Show the link\"><button type=\"button\" data-v=\"before\" aria-pressed=\"true\"><span class=\"pmw-nrm\">before accounting for sleep<\/span><span class=\"pmw-pln\">leaving sleep out<\/span><\/button><button type=\"button\" data-v=\"after\" aria-pressed=\"false\"><span class=\"pmw-nrm\">after accounting for sleep<\/span><span class=\"pmw-pln\">counting sleep in<\/span><\/button><\/div><\/div><div class=\"wn-ci\" aria-hidden=\"true\"><div class=\"base\"><\/div><div class=\"one\"><span>no link<\/span><\/div><div class=\"bar\" style=\"left:39.167%;width:54.166%\"><\/div><div class=\"pt\" style=\"left:63.333%\"><\/div><div class=\"tks\"><span style=\"left:0.000%\">0.8<\/span><span style=\"left:16.667%\">1.0<\/span><span style=\"left:33.333%\">1.2<\/span><span style=\"left:50.000%\">1.4<\/span><span style=\"left:66.667%\">1.6<\/span><span style=\"left:83.333%\">1.8<\/span><span style=\"left:100.000%\">2.0<\/span><\/div><\/div><p class=\"ax\">how many times as likely to report low mood later<\/p><p class=\"rd\" id=\"wn-slr\" aria-live=\"polite\">Women with frequent or severe hot flashes were <b>1.56 times<\/b> as likely to report low mood later on (likely range 1.27 to 1.92).<\/p><figcaption><span class=\"pmw-nrm\">Pooled data from <b>21,312 women in eight studies<\/b> across several countries, followed for three years. The dot is the best estimate, and the bar is the range the true figure probably lies in (the 95% confidence interval). Most of the link between hot flashes and later low mood ran through broken sleep.<\/span><span class=\"pmw-pln\">Data from <b>21,312 women in eight studies<\/b> in several countries, followed for three years. The dot is the best estimate. The bar shows the range the real figure probably falls in, called the 95% confidence interval. Most of the link between hot flashes and later low mood ran through broken sleep.<\/span><\/figcaption><script>(function(){var J={\"before\":[\"39.167\",\"54.166\",\"63.333\",\"Women with frequent or severe hot flashes were <b>1.56 times<\/b> as likely to report low mood later on (likely range 1.27 to 1.92).\"],\"after\":[\"8.333\",\"41.667\",\"27.500\",\"Once sleep difficulties are taken into account, the link falls to <b>1.13 times<\/b>, and its likely range (0.90 to 1.40) now includes 1, which would mean no link at all.\"]};var JP={\"before\":\"Women with frequent or severe hot flashes were <b>1.56 times<\/b> as likely to report low mood later on. The real figure is probably somewhere between 1.27 and 1.92.\",\"after\":\"Once sleep problems are counted in, the link falls to <b>1.13 times<\/b>. Its likely range, 0.90 to 1.40, now includes 1, which would mean no link at all.\"},vcur=\"before\";function pl(){var r=document.querySelector(\".pmw-post\");if(r){return r.classList.contains(\"pmw-plain\");}return false;}var f=document.getElementById(\"wn-sl\");if(!f){return;}var b=f.querySelectorAll(\".wn-seg button\"),bar=f.querySelector(\".wn-ci .bar\"),pt=f.querySelector(\".wn-ci .pt\"),r=document.getElementById(\"wn-slr\");function show(v){var d=J[v];f.setAttribute(\"data-v\",v);vcur=v;bar.style.left=d[0]+\"%\";bar.style.width=d[1]+\"%\";pt.style.left=d[2]+\"%\";r.innerHTML=pl()?JP[v]:d[3];for(var i=0;i<b.length;i++){b[i].setAttribute(\"aria-pressed\",b[i].getAttribute(\"data-v\")===v?\"true\":\"false\");}}for(var i=0;i<b.length;i++){b[i].addEventListener(\"click\",function(){show(this.getAttribute(\"data-v\"));});}document.addEventListener(\"pmw-plain-change\",function(){show(vcur);});if(pl()){show(\"before\");}})();\/*>*\/<\/script><\/figure><\/div>\n\n\n<\/div>\n\n\n\n<div class=\"wp-block-group has-global-padding is-layout-constrained wp-container-core-group-is-layout-d12c95ff wp-block-group-is-layout-constrained\">\n\n<\/div>\n\n\n\n<div class=\"wp-block-group pmw-keep has-global-padding is-layout-constrained wp-container-core-group-is-layout-d2a766d4 wp-block-group-is-layout-constrained\">\n\n\n<div style=\"margin-top:92px;margin-bottom:34px\"><div class=\"wn-part\"><div class=\"meta\"><p class=\"lb\">Part five of six<\/p><span class=\"tk\" aria-hidden=\"true\"><i class=\"past\"><\/i><i class=\"past\"><\/i><i class=\"past\"><\/i><i class=\"past\"><\/i><i class=\"now\"><\/i><i class=\"\"><\/i><\/span><\/div><h2 id=\"part-5\">Anxiety, irritability and brain fog<\/h2><p class=\"sb\">What women notice, and what the research shows about each<\/p><\/div><\/div>\n\n\n<\/div>\n\n\n\n<div class=\"wp-block-group pmw-pl has-global-padding is-layout-constrained wp-container-core-group-is-layout-d12c95ff wp-block-group-is-layout-constrained\">\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family pmw-plk wp-block-paragraph\" style=\"color:#44557a;margin-top:38px;margin-bottom:14px;font-size:12px;font-weight:700;letter-spacing:0.16em;line-height:1.4\">In plain words<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\"><strong class=\"eqb\">Anxiety can rise in these years too.<\/strong> In SWAN, women who weren&#8217;t very anxious to begin with were about 1.6 times as likely to have high anxiety during and after the transition. Women who were already quite anxious tended to stay that way, but their anxiety didn&#8217;t go up further.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">You snap at someone you love, and a moment later you wonder where that came from. <strong class=\"eqb\">Many women say the change they notice most is a shorter fuse.<\/strong> They flare up faster and have less patience than they&#8217;re used to. In one small study of women who were already mildly depressed, irritability came and went from week to week, and it went with smaller swings in estradiol, not bigger ones. So the weather idea explains a lot, but not everything. <strong class=\"eqb\">Different symptoms may have different causes, and hormones are only one of them.<\/strong><\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">Brain fog is real, and it lifts. Forgetting words, or walking into a room and not knowing why, can be unsettling, partly because it can feel like the start of something worse. SWAN tested women&#8217;s memory and thinking again and again over four years. People usually get a little better at the same tests each time, just from practice. During the transition, that improvement stalled, for memory and for processing speed, how quickly you take in simple information and respond. After menopause, it came back.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">The researchers concluded that the difficulties may be limited to the transition itself. So if you&#8217;ve been worried about your memory, this is reassuring. <strong class=\"eqb\">What the tests show looks like a temporary dip in learning, and not the start of a decline.<\/strong> A 2026 review of 26 studies agrees that thinking-test scores are lower in perimenopause than before it, but it could not show clearly that they recover afterward, so this is a hopeful sign rather than a promise. If your memory is getting worse or getting in the way of daily life, mention it to a doctor.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">Not every change at this age is hormones. Perimenopause often comes at a crowded time of life, with children or teenagers, aging parents, work and changes in your own health, sometimes all at once. In SWAN, health and life circumstances were sometimes more important for mood than menopausal stage. The hormonal part is still real. The two usually arrive together, so <strong class=\"eqb\">a change in mood deserves to be looked at from both sides<\/strong>. If the pressure of these years is a big part of the picture, it may help to read about <a href=\"\/your-brain-on-stress\/\" style=\"color:#8a6300;text-decoration:underline;text-underline-offset:3px;text-decoration-thickness:1.5px;text-decoration-color:#f0dca4\">what stress does to the brain and body<\/a>.<\/p>\n\n\n<\/div>\n\n\n\n<div class=\"wp-block-group pmw-n has-global-padding is-layout-constrained wp-container-core-group-is-layout-d12c95ff wp-block-group-is-layout-constrained\">\n\n\n<h3 class=\"wp-block-heading has-text-color has-work-sans-regular-font-family\" id=\"anxiety-rises-too\" style=\"color:#44557a;margin-top:72px;margin-bottom:18px;font-size:clamp(16.293px, 1.018rem + ((1vw - 3.2px) * 0.989), 25px);font-style:normal;font-weight:700;line-height:1.28\">Anxiety rises too<\/h3>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">Feeling on edge without a clear reason can be part of these years as well. <strong class=\"eqb\">Low mood gets most of the attention, but anxiety follows a similar pattern.<\/strong> In SWAN, women who started out with little anxiety were about 1.6 times as likely to have high anxiety during and after the transition, even after accounting for stress and hot flashes. Women who were already quite anxious at the start tended to stay that way, but their anxiety didn&#8217;t rise further as they moved through the stages.<\/p>\n\n\n\n<h3 class=\"wp-block-heading has-text-color has-work-sans-regular-font-family\" id=\"irritability-deserves-its-own-mention\" style=\"color:#44557a;margin-top:72px;margin-bottom:18px;font-size:clamp(16.293px, 1.018rem + ((1vw - 3.2px) * 0.989), 25px);font-style:normal;font-weight:700;line-height:1.28\">Irritability deserves its own mention<\/h3>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">You snap at someone you love, and a moment later you wonder where that came from. <strong class=\"eqb\">Many women say the change they notice most isn&#8217;t sadness but a shorter fuse<\/strong>: feeling crowded, flaring up faster, having less patience than they recognize in themselves. In a small study of women in perimenopause who were already mildly depressed, most had moderate or severe irritability at least once over eight weeks, and it came and went from week to week.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">In that study, though, irritability went with less variation in estradiol, not more. It&#8217;s a small study, but it&#8217;s a useful reminder that the weather image from <a href=\"#part-3\" style=\"color:#8a6300;text-decoration:underline;text-underline-offset:3px;text-decoration-thickness:1.5px;text-decoration-color:#f0dca4\">part three<\/a> explains a good deal without explaining everything. <strong class=\"eqb\">Different symptoms may have different causes, and hormones are only one of them.<\/strong><\/p>\n\n\n\n<h3 class=\"wp-block-heading has-text-color has-work-sans-regular-font-family\" id=\"brain-fog-is-real-and-it-lifts\" style=\"color:#44557a;margin-top:72px;margin-bottom:18px;font-size:clamp(16.293px, 1.018rem + ((1vw - 3.2px) * 0.989), 25px);font-style:normal;font-weight:700;line-height:1.28\">Brain fog is real, and it lifts<\/h3>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">Forgetting words, walking into a room and not knowing why, reading the same paragraph twice: these are some of the most unsettling changes, partly because they can feel like the start of something worse. SWAN tested women&#8217;s memory and thinking again and again over four years. Normally people get a little better at the same tests each time they take them, just through practice. During the transition, that improvement stalled, for <span class=\"gl\" tabindex=\"0\" aria-describedby=\"gd-2\"><em class=\"eqi\">processing speed<\/em><span class=\"gd\" role=\"tooltip\" id=\"gd-2\"><b>processing speed<\/b>How quickly you can take in simple information and respond to it, measured with short timed tasks.<\/span><\/span> late in the transition and for verbal memory, how well you remember something you&#8217;ve heard, throughout it.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">After menopause, the usual gains from practice returned to the level seen before the transition. The researchers concluded that the difficulties may be limited to the transition itself. So if you&#8217;ve been worried about your memory, this is reassuring: <strong class=\"eqb\">what shows up in the tests looks like a temporary dip in learning, not the beginning of a decline<\/strong>. A 2026 review of 26 studies agrees that thinking-test scores are lower in perimenopause than before it, but it could not show clearly that they recover afterward, so this is a hopeful sign rather than a promise. If your memory is getting worse or getting in the way of daily life, mention it to a doctor.<\/p>\n\n\n\n<h3 class=\"wp-block-heading has-text-color has-work-sans-regular-font-family\" id=\"not-everything-at-47-is-hormones\" style=\"color:#44557a;margin-top:72px;margin-bottom:18px;font-size:clamp(16.293px, 1.018rem + ((1vw - 3.2px) * 0.989), 25px);font-style:normal;font-weight:700;line-height:1.28\">Not everything at 47 is hormones<\/h3>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">Perimenopause arrives at a crowded time of life. You may be raising children or teenagers, caring for aging parents, carrying responsibility at work, and noticing changes in your own health, all at once. The SWAN researchers found that health and life circumstances were sometimes more important for mood than menopausal stage.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">The hormonal part is still real. The two usually arrive together, and <strong class=\"eqb\">a change in mood deserves to be looked at from both sides<\/strong>. If the pressure of those years is a large part of the picture, it may help to read about <a href=\"\/your-brain-on-stress\/\" style=\"color:#8a6300;text-decoration:underline;text-underline-offset:3px;text-decoration-thickness:1.5px;text-decoration-color:#f0dca4\">what stress does to the brain and body<\/a>.<\/p>\n\n\n<\/div>\n\n\n\n<div class=\"wp-block-group pmw-keep has-global-padding is-layout-constrained wp-container-core-group-is-layout-d2a766d4 wp-block-group-is-layout-constrained\">\n\n\n<div style=\"margin-top:92px;margin-bottom:34px\"><div class=\"wn-part\"><div class=\"meta\"><p class=\"lb\">Part six of six<\/p><span class=\"tk\" aria-hidden=\"true\"><i class=\"past\"><\/i><i class=\"past\"><\/i><i class=\"past\"><\/i><i class=\"past\"><\/i><i class=\"past\"><\/i><i class=\"now\"><\/i><\/span><\/div><h2 id=\"part-6\">What helps<\/h2><p class=\"sb\">When to talk to a doctor, which treatments have evidence, and what you can do day to day<\/p><\/div><\/div>\n\n\n<\/div>\n\n\n\n<div class=\"wp-block-group pmw-pl has-global-padding is-layout-constrained wp-container-core-group-is-layout-d12c95ff wp-block-group-is-layout-constrained\">\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family pmw-plk wp-block-paragraph\" style=\"color:#44557a;margin-top:38px;margin-bottom:14px;font-size:12px;font-weight:700;letter-spacing:0.16em;line-height:1.4\">In plain words<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">If you&#8217;ve been putting off an appointment because you&#8217;re not sure it&#8217;s bad enough, <strong class=\"eqb\">you don&#8217;t have to wait for a change in mood to become severe before raising it with a doctor<\/strong>. Guidelines published in 2018 by the North American Menopause Society, now called The Menopause Society, and the US National Network of Depression Centers described perimenopause as a window of vulnerability for depression, a time when it&#8217;s more likely.<\/p>\n\n\n<\/div>\n\n\n\n<div class=\"wp-block-group has-global-padding is-layout-constrained wp-container-core-group-is-layout-d12c95ff wp-block-group-is-layout-constrained\">\n\n\n<h3 class=\"wp-block-heading has-text-color has-work-sans-regular-font-family pmw-n\" id=\"start-with-a-conversation\" style=\"color:#44557a;margin-top:72px;margin-bottom:18px;font-size:clamp(16.293px, 1.018rem + ((1vw - 3.2px) * 0.989), 25px);font-style:normal;font-weight:700;line-height:1.28\">Start with a conversation<\/h3>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family pmw-n wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">If you&#8217;ve been putting off an appointment because you&#8217;re not sure it&#8217;s bad enough, <strong class=\"eqb\">you don&#8217;t have to wait for a change in mood to become severe before raising it with a doctor<\/strong>. The 2018 guidelines described perimenopause as a <em class=\"eqi\">window of vulnerability<\/em> for depression.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family pmw-keep pmw-nopill wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">It&#8217;s useful to know where the line is. Mood that dips for a few days and then lifts is the kind of weather this article describes. <strong class=\"eqb\">Low mood or a loss of interest that lasts most of the day, nearly every day, for two weeks or more is different<\/strong>: it&#8217;s what doctors look for in an episode of depression, and it needs treatment whatever your hormones are doing.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family pmw-keep pmw-nopill wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">If there&#8217;s no doctor you can see soon or afford, or you&#8217;ve felt brushed off before, a women&#8217;s health or menopause clinic or a nurse line can be where the first conversation happens. And if your mood is that low or you&#8217;re having thoughts of harming yourself, please don&#8217;t wait: you can find the crisis lines and emergency numbers for your country on <a href=\"\/crisis-helplines\/\" style=\"color:#8a6300;text-decoration:underline;text-underline-offset:3px;text-decoration-thickness:1.5px;text-decoration-color:#f0dca4\">our helplines page<\/a>. If you&#8217;re in immediate danger, call your local emergency number.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family pmw-keep wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">The guidelines also point out that the symptoms of the transition can overlap with those of depression, and poor sleep and low energy can belong to either. A few weeks of notes often show a pattern that&#8217;s hard to describe from memory.<\/p>\n\n\n\n<div class=\"wp-block-group has-background pmw-keep pmw-nopill has-global-padding is-layout-constrained wp-container-core-group-is-layout-bd3116f4 wp-block-group-is-layout-constrained\" style=\"background-color:#fcf3dd;border-radius:18px;margin-top:4px;margin-bottom:30px;padding:24px 28px\">\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#654800;margin-top:0;margin-bottom:12.5px;font-size:12px;font-weight:700;letter-spacing:0.16em;line-height:1.4\">BEFORE YOUR APPOINTMENT<\/p>\n\n\n\n<ul class=\"wp-block-list has-text-color has-work-sans-regular-font-family\" style=\"color:#2a2622;margin-top:0;margin-bottom:0;font-size:clamp(14px, 0.875rem + ((1vw - 3.2px) * 0.568), 19px);line-height:1.7\">\n<li>Note how your mood has changed, and whether it comes and goes.<\/li>\n\n\n\n<li>Write down how you&#8217;re sleeping, and whether hot flashes or night sweats wake you.<\/li>\n\n\n\n<li>Keep track of your periods and how your cycle has changed.<\/li>\n\n\n\n<li>Take the notes with you, and mention anything that has lasted two weeks or more.<\/li>\n<\/ul>\n\n\n<\/div>\n\n\n<\/div>\n\n\n\n<div class=\"wp-block-group pmw-keep has-global-padding is-layout-constrained wp-container-core-group-is-layout-d2a766d4 wp-block-group-is-layout-constrained\">\n\n\n<div style=\"margin-top:40px;margin-bottom:48px\"><figure class=\"wn-fig wn-di\" id=\"wn-di\"><div class=\"hd\"><p class=\"ti\">A weather diary<\/p><p class=\"q\">Four weeks of mood, night sweats and periods, one tap a day<\/p><\/div><div class=\"tools\"><span>What are you marking?<\/span><div class=\"wn-seg\" role=\"group\" aria-label=\"What to mark\"><button type=\"button\" data-m=\"mood\" aria-pressed=\"true\">mood<\/button><button type=\"button\" data-m=\"sweat\" aria-pressed=\"false\">night sweats<\/button><button type=\"button\" data-m=\"period\" aria-pressed=\"false\">period<\/button><\/div><\/div><div class=\"lay\"><div class=\"gcol\"><div class=\"grid\" role=\"group\" aria-label=\"Days one to twenty-eight\"><button type=\"button\" class=\"day\" data-d=\"0\"><span class=\"n\">1<\/span><\/button><button type=\"button\" class=\"day\" data-d=\"1\"><span class=\"n\">2<\/span><\/button><button type=\"button\" class=\"day\" data-d=\"2\"><span class=\"n\">3<\/span><\/button><button type=\"button\" class=\"day\" data-d=\"3\"><span class=\"n\">4<\/span><\/button><button type=\"button\" class=\"day\" data-d=\"4\"><span class=\"n\">5<\/span><\/button><button type=\"button\" class=\"day\" data-d=\"5\"><span class=\"n\">6<\/span><\/button><button type=\"button\" class=\"day\" data-d=\"6\"><span class=\"n\">7<\/span><\/button><button type=\"button\" class=\"day\" data-d=\"7\"><span class=\"n\">8<\/span><\/button><button type=\"button\" class=\"day\" data-d=\"8\"><span class=\"n\">9<\/span><\/button><button type=\"button\" class=\"day\" data-d=\"9\"><span class=\"n\">10<\/span><\/button><button type=\"button\" class=\"day\" data-d=\"10\"><span class=\"n\">11<\/span><\/button><button type=\"button\" class=\"day\" data-d=\"11\"><span class=\"n\">12<\/span><\/button><button type=\"button\" class=\"day\" data-d=\"12\"><span class=\"n\">13<\/span><\/button><button type=\"button\" class=\"day\" data-d=\"13\"><span class=\"n\">14<\/span><\/button><button type=\"button\" class=\"day\" data-d=\"14\"><span class=\"n\">15<\/span><\/button><button type=\"button\" class=\"day\" data-d=\"15\"><span class=\"n\">16<\/span><\/button><button type=\"button\" class=\"day\" data-d=\"16\"><span class=\"n\">17<\/span><\/button><button type=\"button\" class=\"day\" data-d=\"17\"><span class=\"n\">18<\/span><\/button><button type=\"button\" class=\"day\" data-d=\"18\"><span class=\"n\">19<\/span><\/button><button type=\"button\" class=\"day\" data-d=\"19\"><span class=\"n\">20<\/span><\/button><button type=\"button\" class=\"day\" data-d=\"20\"><span class=\"n\">21<\/span><\/button><button type=\"button\" class=\"day\" data-d=\"21\"><span class=\"n\">22<\/span><\/button><button type=\"button\" class=\"day\" data-d=\"22\"><span class=\"n\">23<\/span><\/button><button type=\"button\" class=\"day\" data-d=\"23\"><span class=\"n\">24<\/span><\/button><button type=\"button\" class=\"day\" data-d=\"24\"><span class=\"n\">25<\/span><\/button><button type=\"button\" class=\"day\" data-d=\"25\"><span class=\"n\">26<\/span><\/button><button type=\"button\" class=\"day\" data-d=\"26\"><span class=\"n\">27<\/span><\/button><button type=\"button\" class=\"day\" data-d=\"27\"><span class=\"n\">28<\/span><\/button><\/div><div class=\"legend\" aria-hidden=\"true\"><span id=\"wn-lg1\"><\/span><span id=\"wn-lg2\"><\/span><span id=\"wn-lg3\"><\/span><span><i class=\"dot\"><\/i>night sweats<\/span><span><i class=\"bar\"><\/i>period<\/span><\/div><\/div><div class=\"scol\"><div class=\"sum\" aria-live=\"polite\"><span class=\"ex\" id=\"wn-ex\">Example<\/span><p id=\"wn-sum\"><\/p><\/div><div class=\"act\"><button type=\"button\" class=\"go\" id=\"wn-copy\">Copy a summary<\/button><button type=\"button\" id=\"wn-new\">Start a fresh month<\/button><button type=\"button\" id=\"wn-exb\">Show the example<\/button><span class=\"msg\" id=\"wn-msg\" role=\"status\"><\/span><\/div><p class=\"priv\">This diary is kept only in this browser, on this device. Nothing is sent anywhere.<\/p><\/div><\/div><figcaption><span class=\"pmw-nrm\">When you are marking mood, each tap moves a day from clear to cloudy to stormy, then back to blank. The summary counts how many of the days after a night with night sweats were cloudy or stormy.<\/span><span class=\"pmw-pln\">When you\u2019re marking mood, each tap changes a day from clear to cloudy to stormy, then back to blank. The summary counts the cloudy or stormy days that came after a night with night sweats.<\/span><\/figcaption><script>(function(){\nvar f=document.getElementById(\"wn-di\");if(!f){return;}\nvar KEY=\"eqp-weather-diary-v1\";\nvar SUN='<svg viewBox=\"0 0 24 24\" aria-hidden=\"true\"><circle cx=\"12\" cy=\"12\" r=\"4.6\" fill=\"#a57a00\"\/><g stroke=\"#a57a00\" stroke-width=\"1.9\" stroke-linecap=\"round\"><path d=\"M12 2.5v2.6M12 18.9v2.6M2.5 12h2.6M18.9 12h2.6M5.3 5.3l1.8 1.8M16.9 16.9l1.8 1.8M5.3 18.7l1.8-1.8M16.9 7.1l1.8-1.8\"\/><\/g><\/svg>';\nvar CLOUD='<svg viewBox=\"0 0 24 24\" aria-hidden=\"true\"><path d=\"M7.2 18.5h10a4 4 0 0 0 .6-7.95A5.6 5.6 0 0 0 7 9.6a4.45 4.45 0 0 0 .2 8.9z\" fill=\"#b9b3a8\"\/><\/svg>';\nvar STORMI='<svg viewBox=\"0 0 24 24\" aria-hidden=\"true\"><path d=\"M7.2 14.6h10a4 4 0 0 0 .6-7.95A5.6 5.6 0 0 0 7 5.7a4.45 4.45 0 0 0 .2 8.9z\" fill=\"#44557a\"\/><g stroke=\"#44557a\" stroke-width=\"1.9\" stroke-linecap=\"round\"><path d=\"M8.5 17.3l-1 2.6M12.5 17.3l-1 2.6M16.5 17.3l-1 2.6\"\/><\/g><\/svg>';\nvar ICON=[\"\",SUN,CLOUD,STORMI],WORD=[\"\",\"clear\",\"cloudy\",\"stormy\"];\nvar EX={m:[1,1,2,2,1,1,1,1,2,3,2,1,1,1,1,1,1,2,2,3,2,1,1,1,1,2,1,1],\n s:[0,0,1,0,0,0,0,0,1,1,0,0,0,0,0,0,0,1,1,1,0,0,0,0,0,1,0,0],\n p:[0,0,0,0,0,0,0,0,0,0,0,1,1,1,1,1,0,0,0,0,0,0,0,0,0,0,0,0]};\nvar copy=function(o){return {m:o.m.slice(),s:o.s.slice(),p:o.p.slice()};};\nvar blank=function(){var z=[];for(var i=0;i<28;i++){z.push(0);}return {m:z.slice(),s:z.slice(),p:z.slice()};};\nvar st=null,isEx=true,mode=\"mood\";\ntry{var raw=window.localStorage.getItem(KEY);if(raw){var o=JSON.parse(raw);if(o){if(o.m){if(o.m.length===28){st=o;isEx=false;}}}}}catch(e){}\nif(!st){st=copy(EX);}\nvar save=function(){if(isEx){return;}try{window.localStorage.setItem(KEY,JSON.stringify(st));}catch(e){}};\nvar days=f.querySelectorAll(\".day\"),mb=f.querySelectorAll(\".wn-seg button\");\nvar sum=document.getElementById(\"wn-sum\"),ex=document.getElementById(\"wn-ex\"),msg=document.getElementById(\"wn-msg\");\ndocument.getElementById(\"wn-lg1\").innerHTML=SUN+\"clear\";\ndocument.getElementById(\"wn-lg2\").innerHTML=CLOUD+\"cloudy\";\ndocument.getElementById(\"wn-lg3\").innerHTML=STORMI+\"stormy\";\nvar summary=function(){\n var c=[0,0,0,0],sw=0,after=0,afterLow=0,pd=[];\n for(var i=0;i<28;i++){c[st.m[i]]++;if(st.s[i]){sw++;if(i<27){if(st.m[i+1]){after++;if(st.m[i+1]>1){afterLow++;}}}}if(st.p[i]){pd.push(i+1);}}\n var marked=c[1]+c[2]+c[3];\n if(!marked){if(!sw){if(!pd.length){return \"Nothing marked yet. Tap a day to start.\";}}}\n var t=marked+\" days marked: \"+c[1]+\" clear, \"+c[2]+\" cloudy, \"+c[3]+\" stormy.\";\n t+=sw?\" Night sweats on \"+sw+(sw===1?\" night.\":\" nights.\"):\" No night sweats marked.\";\n if(after){t+=\" On \"+afterLow+\" of the \"+after+\" days after a night with night sweats, the day was cloudy or stormy.\";}\n if(pd.length){t+=\" Period marked on day\"+(pd.length>1?\"s \":\" \")+pd.join(\", \")+\".\";}\n return t;};\nvar draw=function(){\n for(var i=0;i<28;i++){var d=days[i],m=st.m[i];\n  d.className=\"day\"+(m?\" m\"+m:\"\");\n  d.innerHTML='<span class=\"n\">'+(i+1)+\"<\/span>\"+ICON[m]+(st.s[i]?'<span class=\"sw\"><\/span>':\"\")+(st.p[i]?'<span class=\"pd\"><\/span>':\"\");\n  var l=\"Day \"+(i+1)+\": \"+(m?WORD[m]:\"mood not marked\");if(st.s[i]){l+=\", night sweats\";}if(st.p[i]){l+=\", period\";}\n  d.setAttribute(\"aria-label\",l);}\n sum.textContent=summary();ex.hidden=!isEx;};\nvar touch=function(){if(isEx){isEx=false;}msg.textContent=\"\";};\nfor(var i=0;i<28;i++){(function(i){days[i].addEventListener(\"click\",function(){\n touch();\n if(mode===\"mood\"){st.m[i]=(st.m[i]+1)%4;}else{if(mode===\"sweat\"){st.s[i]=st.s[i]?0:1;}else{st.p[i]=st.p[i]?0:1;}}\n save();draw();});})(i);}\nfor(var k=0;k<mb.length;k++){mb[k].addEventListener(\"click\",function(){mode=this.getAttribute(\"data-m\");\n for(var j=0;j<mb.length;j++){mb[j].setAttribute(\"aria-pressed\",mb[j]===this?\"true\":\"false\");}});}\ndocument.getElementById(\"wn-new\").addEventListener(\"click\",function(){st=blank();isEx=false;save();draw();msg.textContent=\"A fresh month. Tap a day to start.\";days[0].focus();});\ndocument.getElementById(\"wn-exb\").addEventListener(\"click\",function(){st=copy(EX);isEx=true;draw();msg.textContent=\"\";});\ndocument.getElementById(\"wn-copy\").addEventListener(\"click\",function(){\n var t=\"Weather diary, 28 days. \"+summary();\n var done=function(){msg.textContent=\"Copied.\";};\n try{navigator.clipboard.writeText(t).then(done,function(){msg.textContent=t;});}catch(e){msg.textContent=t;}});\ndraw();\n})();\/*>*\/<\/script><\/figure><\/div>\n\n\n<\/div>\n\n\n\n<div class=\"wp-block-group pmw-pl has-global-padding is-layout-constrained wp-container-core-group-is-layout-d12c95ff wp-block-group-is-layout-constrained\">\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family pmw-plk wp-block-paragraph\" style=\"color:#44557a;margin-top:38px;margin-bottom:14px;font-size:12px;font-weight:700;letter-spacing:0.16em;line-height:1.4\">In plain words<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">If you&#8217;re wondering about hormones or an antidepressant, the guidelines give a clear starting point. <strong class=\"eqb\">For depression in perimenopause, they start with what&#8217;s already proven to work for depression in general, which is antidepressants and talking therapy.<\/strong> <strong class=\"eqb\">Estrogen is not approved as a treatment for perimenopausal depression.<\/strong> It has shown antidepressant effects in women in the transition, especially those who also have hot flashes. For estrogen taken together with a progestin, a lab-made hormone that acts like progesterone, the evidence was described as sparse and inconclusive.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">One trial tested whether hormone therapy could stop low mood before it started. It followed women without depression for a year. Among women given a placebo, about one in three developed significant symptoms of depression, compared with about one in six of those given estradiol with progesterone. The benefit showed up in women early in the transition, and not in those further along.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">It&#8217;s one trial at one site, and it isn&#8217;t a reason to start hormone therapy to prevent low mood. It does support the idea that the transition itself is the sensitive time. The International Menopause Society&#8217;s 2025 recommendations are just as cautious. Estrogen may ease depression during perimenopause, but the evidence is still limited, and more is needed before hormone therapy could be recommended to prevent it. In the UK, doctors are advised to consider hormone therapy for low mood that starts around the same time as other menopause symptoms, and a talking therapy called CBT when low mood comes with hot flashes. Decisions about hormone therapy depend on your health history, so they belong in a conversation with your doctor.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">There&#8217;s also talking therapy designed for this stage. Cognitive behavioral therapy, or CBT, is a structured talking therapy that works on the links between your thoughts, feelings and behavior, and its version adapted for menopause is called CBT-Meno. In a Canadian trial, <strong class=\"eqb\">depression symptoms improved more in women who had it than in women who were waiting for it<\/strong>. Their sleep improved too, and the gains were still there three months later. An earlier British program focused on hot flashes and night sweats. <strong class=\"eqb\">The hot flashes didn&#8217;t necessarily go away, but they caused less trouble<\/strong>, and mood and quality of life improved as well.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">Low mood and a short temper often land first on the people closest to you. <strong class=\"eqb\">Telling a partner, a friend or your family what&#8217;s going on, even in a few words, helps them understand a short temper or a quiet week<\/strong> without blaming themselves or you. You could say you&#8217;re having a hard stretch that seems partly hormonal, and tell them what helps on a bad day.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">If you&#8217;re the partner or family member reading this, you may be feeling the strain too. If things between you have become strained, support for the two of you can sit alongside support for her.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">When you&#8217;re tired and low, exercise can sound like one more thing on the list. Still, a review of 21 trials in women in or after the transition found that physical activity reduced both depression and anxiety symptoms. The studies varied a lot, so how big the effect is isn&#8217;t clear, but the direction was consistent, and how hard people exercised didn&#8217;t seem to matter much. <strong class=\"eqb\">The best form of movement is the one you&#8217;ll keep doing!<\/strong><\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">Part four showed how night sweats and broken sleep feed into low mood, so protecting your sleep isn&#8217;t a side issue. A few things that help are below.<\/p>\n\n\n<\/div>\n\n\n\n<div class=\"wp-block-group has-global-padding is-layout-constrained wp-container-core-group-is-layout-d12c95ff wp-block-group-is-layout-constrained\">\n\n\n<h3 class=\"wp-block-heading has-text-color has-work-sans-regular-font-family pmw-n\" id=\"what-the-guidelines-say-about-treatment\" style=\"color:#44557a;margin-top:72px;margin-bottom:18px;font-size:clamp(16.293px, 1.018rem + ((1vw - 3.2px) * 0.989), 25px);font-style:normal;font-weight:700;line-height:1.28\">What the guidelines say about treatment<\/h3>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family pmw-n wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">If you&#8217;re weighing hormones against an antidepressant, the guidelines give a clear starting point. <strong class=\"eqb\">For depression in perimenopause, the guidelines recommend starting with the treatments already proven for depression in general: antidepressants and psychotherapy.<\/strong> <strong class=\"eqb\">Estrogen is not approved as a treatment for perimenopausal depression<\/strong>, although it has shown antidepressant effects in women in the transition, particularly those who also have hot flashes. The evidence for estrogen combined with a <span class=\"gl\" tabindex=\"0\" aria-describedby=\"gd-3\"><em class=\"eqi\">progestin<\/em><span class=\"gd\" role=\"tooltip\" id=\"gd-3\"><b>progestin<\/b>A synthetic hormone that acts like progesterone. In hormone therapy it is usually given alongside estrogen to protect the lining of the uterus.<\/span><\/span> was described as sparse and inconclusive.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family pmw-n wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">One trial asked whether hormone therapy could prevent depressive symptoms in the first place. It followed women without depression for a year. Among those given a placebo, about one in three developed significant depressive symptoms, compared with about one in six of those given estradiol with progesterone. The benefit showed up in women in the early transition, and not in those further along.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family pmw-n wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">It&#8217;s one trial at one site, and it isn&#8217;t a reason to start hormone therapy to prevent low mood, but it supports the idea that the transition itself is the sensitive window. The International Menopause Society&#8217;s 2025 recommendations reach the same cautious conclusions: estrogen may ease depression during perimenopause, but the evidence is still limited, and more is needed before hormone therapy could be recommended to prevent it. In the UK, the national guideline (NICE) suggests considering hormone therapy for low mood that begins around the same time as other menopause symptoms, and CBT when low mood comes with hot flashes. Depression itself is treated with the usual depression care, alongside menopause care. Decisions about hormone therapy depend on your health history, so they belong in a conversation with your doctor.<\/p>\n\n\n\n<h3 class=\"wp-block-heading has-text-color has-work-sans-regular-font-family pmw-n\" id=\"therapy-designed-for-this-stage\" style=\"color:#44557a;margin-top:72px;margin-bottom:18px;font-size:clamp(16.293px, 1.018rem + ((1vw - 3.2px) * 0.989), 25px);font-style:normal;font-weight:700;line-height:1.28\">Therapy designed for this stage<\/h3>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family pmw-n wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">Cognitive behavioral therapy, a structured form of talking therapy that works on the links between thoughts, feelings and behavior, has been adapted for menopause. In a Canadian trial of a program called CBT-Meno, women in or after the transition either had the therapy or waited for it. <strong class=\"eqb\">Depressive symptoms improved more in those who had the therapy<\/strong>, their sleep improved as well, and the gains were still there three months later.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family pmw-n wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">An earlier British program focused on hot flashes and night sweats. In its trial, both group sessions and a self-help version reduced how much trouble the hot flashes caused, and mood and quality of life improved as well. <strong class=\"eqb\">The hot flashes didn&#8217;t necessarily disappear, but they became easier to live with.<\/strong><\/p>\n\n\n\n<h3 class=\"wp-block-heading has-text-color has-work-sans-regular-font-family pmw-n\" id=\"let-the-people-close-to-you-know\" style=\"color:#44557a;margin-top:72px;margin-bottom:18px;font-size:clamp(16.293px, 1.018rem + ((1vw - 3.2px) * 0.989), 25px);font-style:normal;font-weight:700;line-height:1.28\">Let the people close to you know<\/h3>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family pmw-n wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">The irritability and low mood of these years often land first on the people closest to you, and they may notice the change before you&#8217;ve found the words for it. <strong class=\"eqb\">Telling a partner, a friend or your family what you&#8217;re going through, even briefly, gives them a way to understand a short temper or a quiet week<\/strong> without blaming themselves or you.<\/p>\n\n\n\n<div class=\"wp-block-group has-background pmw-n has-global-padding is-layout-constrained wp-container-core-group-is-layout-bd3116f4 wp-block-group-is-layout-constrained\" style=\"background-color:#fcf3dd;border-radius:18px;margin-top:4px;margin-bottom:30px;padding:24px 28px\">\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#654800;margin-top:0;margin-bottom:12.5px;font-size:12px;font-weight:700;letter-spacing:0.16em;line-height:1.4\">WHEN YOU TALK TO THEM<\/p>\n\n\n\n<ul class=\"wp-block-list has-text-color has-work-sans-regular-font-family\" style=\"color:#2a2622;margin-top:0;margin-bottom:0;font-size:clamp(14px, 0.875rem + ((1vw - 3.2px) * 0.568), 19px);line-height:1.7\">\n<li>Say that you&#8217;re having a hard stretch, and that it seems to be partly hormonal.<\/li>\n\n\n\n<li>Tell them what helps on a bad day, whether that&#8217;s some space, practical help or simply being asked how you are.<\/li>\n\n\n\n<li>Keep it short if that&#8217;s easier; a few words already give them something to go on.<\/li>\n<\/ul>\n\n\n<\/div>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family pmw-n wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">And if you&#8217;re the partner or family member reading this, you may be feeling the strain too. Changes in mood can make ordinary friction feel bigger on both sides, and if the relationship itself has become strained, support for the two of you can sit alongside support for her.<\/p>\n\n\n\n<h3 class=\"wp-block-heading has-text-color has-work-sans-regular-font-family pmw-n\" id=\"movement-and-sleep\" style=\"color:#44557a;margin-top:72px;margin-bottom:18px;font-size:clamp(16.293px, 1.018rem + ((1vw - 3.2px) * 0.989), 25px);font-style:normal;font-weight:700;line-height:1.28\">Movement and sleep<\/h3>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family pmw-n wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">When you&#8217;re tired and low, exercise can sound like one more thing on the list. Still, a review of 21 trials in women in the transition or after it found that physical activity reduced both depressive and anxiety symptoms. The studies varied a lot, so the size of the effect is uncertain, but the direction was consistent, and the intensity of the exercise didn&#8217;t seem to matter much. <strong class=\"eqb\">The best form of movement is the one you&#8217;ll keep doing!<\/strong><\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family pmw-n wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">Given what <a href=\"#part-4\" style=\"color:#8a6300;text-decoration:underline;text-underline-offset:3px;text-decoration-thickness:1.5px;text-decoration-color:#f0dca4\">part four<\/a> showed about hot flashes and broken sleep, protecting sleep is not a side issue either.<\/p>\n\n\n\n<div class=\"wp-block-group has-background pmw-keep pmw-nopill has-global-padding is-layout-constrained wp-container-core-group-is-layout-bd3116f4 wp-block-group-is-layout-constrained\" style=\"background-color:#fcf3dd;border-radius:18px;margin-top:4px;margin-bottom:30px;padding:24px 28px\">\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#654800;margin-top:0;margin-bottom:12.5px;font-size:12px;font-weight:700;letter-spacing:0.16em;line-height:1.4\">WHAT HELPS WITH SLEEP<\/p>\n\n\n\n<ul class=\"wp-block-list has-text-color has-work-sans-regular-font-family\" style=\"color:#2a2622;margin-top:0;margin-bottom:0;font-size:clamp(14px, 0.875rem + ((1vw - 3.2px) * 0.568), 19px);line-height:1.7\">\n<li>Keep your bedroom cool.<\/li>\n\n\n\n<li>Wear layers that are easy to take off.<\/li>\n\n\n\n<li>Get up at a steady time each day.<\/li>\n\n\n\n<li><strong class=\"eqb\">If night sweats are waking you regularly, mention them to a doctor, because they can be treated.<\/strong><\/li>\n<\/ul>\n\n\n<\/div>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family pmw-keep wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">A change in the weather is not a change in who you are. For most women these years are a stretch to get through with good support, not a new climate to live in for good.<\/p>\n\n\n<\/div>\n\n\n\n<div class=\"wp-block-group pmw-keep has-global-padding is-layout-constrained wp-container-core-group-is-layout-d2a766d4 wp-block-group-is-layout-constrained\">\n\n\n<div class=\"wp-block-group has-background has-global-padding is-layout-constrained wp-container-core-group-is-layout-f86ed65e wp-block-group-is-layout-constrained\" style=\"background-color:#f2f4f8;border-color:#dde2ec;border-width:1.5px;border-style:solid;border-radius:20px;margin-top:46px;margin-bottom:46px;padding:34px 38px\">\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#33405c;margin-top:0;margin-bottom:12px;font-size:12px;font-weight:700;letter-spacing:0.16em;line-height:1.4\">WHAT THE RESEARCH SUPPORTS<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:0;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">A 2024 <span class=\"gl\" tabindex=\"0\" aria-describedby=\"gd-4\"><em class=\"eqi\">meta-analysis<\/em><span class=\"gd\" role=\"tooltip\" id=\"gd-4\"><b>meta-analysis<\/b>A study of studies: it pools the results of many studies on the same question to estimate how large an effect usually is, rather than relying on any single result.<\/span><\/span> reviewed 17 long-term studies and combined the results of the seven that could be pooled. Women in perimenopause were about 1.4 times as likely to have depressive symptoms or depression as women before it, with no significant increase once menopause was past. Following women over fourteen years, the Penn Ovarian Aging Study found that high depressive scores became about 15% less likely each year, from ten years before the last period to eight years after it.<\/p>\n\n\n<\/div>\n\n\n<\/div>\n\n\n\n<div class=\"wp-block-group has-global-padding is-layout-constrained wp-container-core-group-is-layout-d12c95ff wp-block-group-is-layout-constrained\">\n\n<\/div>\n\n\n\n<div class=\"wp-block-group pmw-keep has-global-padding is-layout-constrained wp-container-core-group-is-layout-d2a766d4 wp-block-group-is-layout-constrained\">\n\n\n<div class=\"wp-block-group has-background has-global-padding is-layout-constrained wp-container-core-group-is-layout-7c590e6f wp-block-group-is-layout-constrained\" style=\"background-color:#fbf4e6;border-color:#eedcb9;border-width:1.5px;border-style:solid;border-radius:20px;margin-top:0;margin-bottom:46px;padding:34px 38px\">\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#33405c;margin-top:0;margin-bottom:12px;font-size:12px;font-weight:700;letter-spacing:0.16em;line-height:1.4\">WORTH BEING CLEAR ABOUT<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:0;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">Most of this research is observational, which means it shows what tends to happen together rather than proving what causes what. Several of the key studies are small, and many were done in the United States. A single blood test captures one moment, so it says little about how much your hormones are moving from week to week. The findings also describe groups, and your experience of the transition is your own.<\/p>\n\n\n<\/div>\n\n\n<\/div>\n\n\n\n<div class=\"wp-block-group pmw-keep has-global-padding is-layout-constrained wp-container-core-group-is-layout-d2a766d4 wp-block-group-is-layout-constrained\">\n\n\n<div class=\"wp-block-group has-background has-global-padding is-layout-constrained wp-container-core-group-is-layout-69c879e7 wp-block-group-is-layout-constrained\" style=\"background-color:#faf8f3;border-color:#e8e1d5;border-width:1.5px;border-style:solid;border-radius:18px;margin-top:0;margin-bottom:44px;padding:30px 34px\">\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#6b6259;margin-top:0;margin-bottom:14px;font-size:12px;font-weight:700;letter-spacing:0.16em;line-height:1.4\">REFERENCES<\/p>\n\n\n\n<ol class=\"wp-block-list has-text-color has-work-sans-regular-font-family\" style=\"color:#524a42;margin-top:0;margin-bottom:0;font-size:clamp(14px, 0.875rem + ((1vw - 3.2px) * 0.17), 15.5px);line-height:1.7\">\n<li><a href=\"https:\/\/doi.org\/10.1001\/jamainternmed.2014.8063\" target=\"_blank\" rel=\"noopener\" style=\"color:inherit;text-decoration:underline;text-underline-offset:3px;text-decoration-thickness:1px;text-decoration-color:#c7cfdf\">Avis, N. E., Crawford, S. L., Greendale, G., Bromberger, J. T., Everson-Rose, S. A., Gold, E. B., Hess, R., Joffe, H., Kravitz, H. M., Tepper, P. G., Thurston, R. C., &amp; Study of Women&#8217;s Health Across the Nation. (2015). Duration of menopausal vasomotor symptoms over the menopause transition. <em>JAMA Internal Medicine, 175<\/em>(4), 531-539.<\/a><\/li>\n\n\n\n<li><a href=\"https:\/\/doi.org\/10.1097\/gme.0b013e31823fe835\" target=\"_blank\" rel=\"noopener\" style=\"color:inherit;text-decoration:underline;text-underline-offset:3px;text-decoration-thickness:1px;text-decoration-color:#c7cfdf\">Ayers, B., Smith, M., Hellier, J., Mann, E., &amp; Hunter, M. S. (2012). Effectiveness of group and self-help cognitive behavior therapy in reducing problematic menopausal hot flushes and night sweats (MENOS 2): A randomized controlled trial. <em>Menopause, 19<\/em>(7), 749-759.<\/a><\/li>\n\n\n\n<li><a href=\"https:\/\/doi.org\/10.1016\/j.jad.2024.04.041\" target=\"_blank\" rel=\"noopener\" style=\"color:inherit;text-decoration:underline;text-underline-offset:3px;text-decoration-thickness:1px;text-decoration-color:#c7cfdf\">Badawy, Y., Spector, A., Li, Z., &amp; Desai, R. (2024). The risk of depression in the menopausal stages: A systematic review and meta-analysis. <em>Journal of Affective Disorders, 357<\/em>, 126-133.<\/a><\/li>\n\n\n\n<li><a href=\"https:\/\/doi.org\/10.1037\/pag0000946\" target=\"_blank\" rel=\"noopener\" style=\"color:inherit;text-decoration:underline;text-underline-offset:3px;text-decoration-thickness:1px;text-decoration-color:#c7cfdf\">Bangle, A., Williams, D., Walters, J., &amp; Nguyen, L. (2026). Cognitive functioning in perimenopause: An updated systematic review and meta-analysis. <em>Psychology and Aging, 41<\/em>(3), 303-318.<\/a><\/li>\n\n\n\n<li><a href=\"https:\/\/doi.org\/10.1097\/GME.0b013e3182730599\" target=\"_blank\" rel=\"noopener\" style=\"color:inherit;text-decoration:underline;text-underline-offset:3px;text-decoration-thickness:1px;text-decoration-color:#c7cfdf\">Bromberger, J. T., Kravitz, H. M., Chang, Y., Randolph, J. F., Jr., Avis, N. E., Gold, E. B., &amp; Matthews, K. A. (2013). Does risk for anxiety increase during the menopausal transition? Study of Women&#8217;s Health Across the Nation. <em>Menopause, 20<\/em>(5), 488-495.<\/a><\/li>\n\n\n\n<li><a href=\"https:\/\/doi.org\/10.1017\/S003329171100016X\" target=\"_blank\" rel=\"noopener\" style=\"color:inherit;text-decoration:underline;text-underline-offset:3px;text-decoration-thickness:1px;text-decoration-color:#c7cfdf\">Bromberger, J. T., Kravitz, H. M., Chang, Y.-F., Cyranowski, J. M., Brown, C., &amp; Matthews, K. A. (2011). Major depression during and after the menopausal transition: Study of Women&#8217;s Health Across the Nation (SWAN). <em>Psychological Medicine, 41<\/em>(9), 1879-1888.<\/a><\/li>\n\n\n\n<li><a href=\"https:\/\/doi.org\/10.1016\/j.jad.2007.01.034\" target=\"_blank\" rel=\"noopener\" style=\"color:inherit;text-decoration:underline;text-underline-offset:3px;text-decoration-thickness:1px;text-decoration-color:#c7cfdf\">Bromberger, J. T., Matthews, K. A., Schott, L. L., Brockwell, S., Avis, N. E., Kravitz, H. M., Everson-Rose, S. A., Gold, E. B., Sowers, M., &amp; Randolph, J. F., Jr. (2007). Depressive symptoms during the menopausal transition: The Study of Women&#8217;s Health Across the Nation (SWAN). <em>Journal of Affective Disorders, 103<\/em>(1-3), 267-272.<\/a><\/li>\n\n\n\n<li><a href=\"https:\/\/doi.org\/10.1017\/S0033291718000168\" target=\"_blank\" rel=\"noopener\" style=\"color:inherit;text-decoration:underline;text-underline-offset:3px;text-decoration-thickness:1px;text-decoration-color:#c7cfdf\">Chung, H.-F., Pandeya, N., Dobson, A. J., Kuh, D., Brunner, E. J., Crawford, S. L., Avis, N. E., Gold, E. B., Mitchell, E. S., Woods, N. F., Bromberger, J. T., Thurston, R. C., Joffe, H., Yoshizawa, T., Anderson, D., &amp; Mishra, G. D. (2018). The role of sleep difficulties in the vasomotor menopausal symptoms and depressed mood relationships: An international pooled analysis of eight studies in the InterLACE consortium. <em>Psychological Medicine, 48<\/em>(15), 2550-2561.<\/a><\/li>\n\n\n\n<li><a href=\"https:\/\/doi.org\/10.1001\/archpsyc.63.4.385\" target=\"_blank\" rel=\"noopener\" style=\"color:inherit;text-decoration:underline;text-underline-offset:3px;text-decoration-thickness:1px;text-decoration-color:#c7cfdf\">Cohen, L. S., Soares, C. N., Vitonis, A. F., Otto, M. W., &amp; Harlow, B. L. (2006). Risk for new onset of depression during the menopausal transition: The Harvard Study of Moods and Cycles. <em>Archives of General Psychiatry, 63<\/em>(4), 385-390.<\/a><\/li>\n\n\n\n<li><a href=\"https:\/\/doi.org\/10.1016\/j.psyneuen.2021.105128\" target=\"_blank\" rel=\"noopener\" style=\"color:inherit;text-decoration:underline;text-underline-offset:3px;text-decoration-thickness:1px;text-decoration-color:#c7cfdf\">de Wit, A. E., Giltay, E. J., de Boer, M. K., Nathan, M., Wiley, A., Crawford, S., &amp; Joffe, H. (2021). Predictors of irritability symptoms in mildly depressed perimenopausal women. <em>Psychoneuroendocrinology, 126<\/em>, Article 105128.<\/a><\/li>\n\n\n\n<li><a href=\"https:\/\/doi.org\/10.1001\/jamapsychiatry.2013.2819\" target=\"_blank\" rel=\"noopener\" style=\"color:inherit;text-decoration:underline;text-underline-offset:3px;text-decoration-thickness:1px;text-decoration-color:#c7cfdf\">Freeman, E. W., Sammel, M. D., Boorman, D. W., &amp; Zhang, R. (2014). Longitudinal pattern of depressive symptoms around natural menopause. <em>JAMA Psychiatry, 71<\/em>(1), 36-43.<\/a><\/li>\n\n\n\n<li><a href=\"https:\/\/doi.org\/10.1001\/archpsyc.63.4.375\" target=\"_blank\" rel=\"noopener\" style=\"color:inherit;text-decoration:underline;text-underline-offset:3px;text-decoration-thickness:1px;text-decoration-color:#c7cfdf\">Freeman, E. W., Sammel, M. D., Lin, H., &amp; Nelson, D. B. (2006). Associations of hormones and menopausal status with depressed mood in women with no history of depression. <em>Archives of General Psychiatry, 63<\/em>(4), 375-382.<\/a><\/li>\n\n\n\n<li><a href=\"https:\/\/doi.org\/10.1097\/GME.0000000000000528\" target=\"_blank\" rel=\"noopener\" style=\"color:inherit;text-decoration:underline;text-underline-offset:3px;text-decoration-thickness:1px;text-decoration-color:#c7cfdf\">Gordon, J. L., Rubinow, D. R., Eisenlohr-Moul, T. A., Leserman, J., &amp; Girdler, S. S. (2016). Estradiol variability, stressful life events, and the emergence of depressive symptomatology during the menopausal transition. <em>Menopause, 23<\/em>(3), 257-266.<\/a><\/li>\n\n\n\n<li><a href=\"https:\/\/doi.org\/10.1001\/jamapsychiatry.2017.3998\" target=\"_blank\" rel=\"noopener\" style=\"color:inherit;text-decoration:underline;text-underline-offset:3px;text-decoration-thickness:1px;text-decoration-color:#c7cfdf\">Gordon, J. L., Rubinow, D. R., Eisenlohr-Moul, T. A., Xia, K., Schmidt, P. J., &amp; Girdler, S. S. (2018). Efficacy of transdermal estradiol and micronized progesterone in the prevention of depressive symptoms in the menopause transition: A randomized clinical trial. <em>JAMA Psychiatry, 75<\/em>(2), 149-157.<\/a><\/li>\n\n\n\n<li><a href=\"https:\/\/doi.org\/10.1017\/S0033291720000483\" target=\"_blank\" rel=\"noopener\" style=\"color:inherit;text-decoration:underline;text-underline-offset:3px;text-decoration-thickness:1px;text-decoration-color:#c7cfdf\">Gordon, J. L., Sander, B., Eisenlohr-Moul, T. A., &amp; Sykes Tottenham, L. (2021). Mood sensitivity to estradiol predicts depressive symptoms in the menopause transition. <em>Psychological Medicine, 51<\/em>(10), 1733-1741.<\/a><\/li>\n\n\n\n<li><a href=\"https:\/\/doi.org\/10.1097\/GME.0000000000001363\" target=\"_blank\" rel=\"noopener\" style=\"color:inherit;text-decoration:underline;text-underline-offset:3px;text-decoration-thickness:1px;text-decoration-color:#c7cfdf\">Green, S. M., Donegan, E., Frey, B. N., Fedorkow, D. M., Key, B. L., Streiner, D. L., &amp; McCabe, R. E. (2019). Cognitive behavior therapy for menopausal symptoms (CBT-Meno): A randomized controlled trial. <em>Menopause, 26<\/em>(9), 972-980.<\/a><\/li>\n\n\n\n<li><a href=\"https:\/\/doi.org\/10.1212\/WNL.0b013e3181a71193\" target=\"_blank\" rel=\"noopener\" style=\"color:inherit;text-decoration:underline;text-underline-offset:3px;text-decoration-thickness:1px;text-decoration-color:#c7cfdf\">Greendale, G. A., Huang, M.-H., Wight, R. G., Seeman, T., Luetters, C., Avis, N. E., Johnston, J., &amp; Karlamangla, A. S. (2009). Effects of the menopause transition and hormone use on cognitive performance in midlife women. <em>Neurology, 72<\/em>(21), 1850-1857.<\/a><\/li>\n\n\n\n<li><a href=\"https:\/\/doi.org\/10.1097\/gme.0b013e31824d8f40\" target=\"_blank\" rel=\"noopener\" style=\"color:inherit;text-decoration:underline;text-underline-offset:3px;text-decoration-thickness:1px;text-decoration-color:#c7cfdf\">Harlow, S. D., Gass, M., Hall, J. E., Lobo, R., Maki, P., Rebar, R. W., Sherman, S., Sluss, P. M., de Villiers, T. J., &amp; STRAW + 10 Collaborative Group. (2012). Executive summary of the Stages of Reproductive Aging Workshop + 10: Addressing the unfinished agenda of staging reproductive aging. <em>Menopause, 19<\/em>(4), 387-395.<\/a><\/li>\n\n\n\n<li><a href=\"https:\/\/doi.org\/10.1210\/jc.2016-2348\" target=\"_blank\" rel=\"noopener\" style=\"color:inherit;text-decoration:underline;text-underline-offset:3px;text-decoration-thickness:1px;text-decoration-color:#c7cfdf\">Joffe, H., Crawford, S. L., Freeman, M. P., White, D. P., Bianchi, M. T., Kim, S., Economou, N., Camuso, J., Hall, J. E., &amp; Cohen, L. S. (2016). Independent contributions of nocturnal hot flashes and sleep disturbance to depression in estrogen-deprived women. <em>The Journal of Clinical Endocrinology &amp; Metabolism, 101<\/em>(10), 3847-3855.<\/a><\/li>\n\n\n\n<li><a href=\"https:\/\/doi.org\/10.1097\/GME.0000000000001174\" target=\"_blank\" rel=\"noopener\" style=\"color:inherit;text-decoration:underline;text-underline-offset:3px;text-decoration-thickness:1px;text-decoration-color:#c7cfdf\">Maki, P. M., Kornstein, S. G., Joffe, H., Bromberger, J. T., Freeman, E. W., Athappilly, G., Bobo, W. V., Rubin, L. H., Koleva, H. K., Cohen, L. S., &amp; Soares, C. N. (2018). Guidelines for the evaluation and treatment of perimenopausal depression: Summary and recommendations. <em>Menopause, 25<\/em>(10), 1069-1085.<\/a><\/li>\n\n\n\n<li><a href=\"https:\/\/www.nice.org.uk\/guidance\/ng23\" target=\"_blank\" rel=\"noopener\" style=\"color:inherit;text-decoration:underline;text-underline-offset:3px;text-decoration-thickness:1px;text-decoration-color:#c7cfdf\">National Institute for Health and Care Excellence. (2024). <em>Menopause: Identification and management<\/em> (NICE guideline NG23).<\/a><\/li>\n\n\n\n<li><a href=\"https:\/\/doi.org\/10.1080\/13697137.2025.2585487\" target=\"_blank\" rel=\"noopener\" style=\"color:inherit;text-decoration:underline;text-underline-offset:3px;text-decoration-thickness:1px;text-decoration-color:#c7cfdf\">Panay, N., Fenton, A., Hamoda, H., Hillard, T., Islam, R., Pedder, H., Romero, L., Vincent, A. J., &amp; The IMS Recommendations Writing Group. (2025). International Menopause Society (IMS) recommendations and key messages on women\u2019s midlife health and menopause. <em>Climacteric, 28<\/em>(6), 634-656.<\/a><\/li>\n\n\n\n<li><a href=\"https:\/\/doi.org\/10.1176\/appi.ajp.163.1.133\" target=\"_blank\" rel=\"noopener\" style=\"color:inherit;text-decoration:underline;text-underline-offset:3px;text-decoration-thickness:1px;text-decoration-color:#c7cfdf\">Richards, M., Rubinow, D. R., Daly, R. C., &amp; Schmidt, P. J. (2006). Premenstrual symptoms and perimenopausal depression. <em>American Journal of Psychiatry, 163<\/em>(1), 133-137.<\/a><\/li>\n\n\n\n<li><a href=\"https:\/\/doi.org\/10.1001\/jamapsychiatry.2015.0111\" target=\"_blank\" rel=\"noopener\" style=\"color:inherit;text-decoration:underline;text-underline-offset:3px;text-decoration-thickness:1px;text-decoration-color:#c7cfdf\">Schmidt, P. J., Ben Dor, R., Martinez, P. E., Guerrieri, G. M., Harsh, V. L., Thompson, K., Koziol, D. E., Nieman, L. K., &amp; Rubinow, D. R. (2015). Effects of estradiol withdrawal on mood in women with past perimenopausal depression: A randomized clinical trial. <em>JAMA Psychiatry, 72<\/em>(7), 714-726.<\/a><\/li>\n\n\n\n<li><a href=\"https:\/\/doi.org\/10.1186\/s12966-025-01712-z\" target=\"_blank\" rel=\"noopener\" style=\"color:inherit;text-decoration:underline;text-underline-offset:3px;text-decoration-thickness:1px;text-decoration-color:#c7cfdf\">Yue, H., Yang, Y., Xie, F., Cui, J., Li, Y., Si, M., Li, S., &amp; Yao, F. (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 of randomized controlled trials. <em>International Journal of Behavioral Nutrition and Physical Activity, 22<\/em>(1), Article 13.<\/a><\/li>\n<\/ol>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#6b6259;margin-top:30px;margin-bottom:14px;font-size:12px;font-weight:700;letter-spacing:0.16em;line-height:1.4\">BOOKS FROM OUR SHELF<\/p>\n\n\n\n<ol class=\"wp-block-list has-text-color has-work-sans-regular-font-family\" style=\"color:#524a42;margin-top:0;margin-bottom:0;font-size:clamp(14px, 0.875rem + ((1vw - 3.2px) * 0.17), 15.5px);line-height:1.7\">\n<li><a href=\"https:\/\/www.kensingtonbooks.com\/shop\/the-menopause-manifesto\/\" target=\"_blank\" rel=\"noopener\" style=\"color:inherit;text-decoration:underline;text-underline-offset:3px;text-decoration-thickness:1px;text-decoration-color:#c7cfdf\">Gunter, J. (2021). <em>The menopause manifesto: Own your health with facts and feminism<\/em>. Citadel Press.<\/a><\/li>\n<\/ol>\n\n\n\n<p class=\"eq-lastrev\" style=\"margin:34px 0 0;font-family:&quot;Work Sans&quot;,sans-serif;font-size:12px;font-weight:700;letter-spacing:.15em;text-transform:uppercase;line-height:1.5;color:#6b6259\">Last reviewed October 2026<\/p>\n\n\n<\/div>\n\n\n\n<style>.eqp{--rc-accent:#866300;--rc-band:#f9f5e9;--rc-hover:#f4edd9;--rc-bg:#faf8f3}.eqp .eq-rc-btn{display:none}.eqp .eq-rc{position:relative}.eqp .eq-rc li[hidden]{display:block;margin:0;padding:0;height:0;line-height:0;font-size:0}.eqp .eq-rc li.rc-off{display:none}.eqp .eq-rc.is-collapsed::after{content:\"\";position:absolute;left:0;right:0;bottom:0;height:76px;background:linear-gradient(to bottom,transparent,var(--rc-bg) 94%);pointer-events:none}.eqp .eq-rc ~ .eq-rc-btn{display:inline-flex;align-items:center;justify-content:center;gap:8px;box-sizing:border-box;min-width:260px;min-height:48px;margin:22px 0 0;padding:12px 26px;background:var(--rc-band);color:var(--rc-accent);border:1.5px 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a=e.target;\nwhile(a){\nif(a.tagName===\"A\"){break;}\na=a.parentNode;\n}\nif(!a){return;}\nif(!a.getAttribute){return;}\nvar h=a.getAttribute(\"href\");\nif(!h){return;}\nif(h.charAt(0)!==\"#\"){return;}\nreveal(targetOf(h));\n},true);\nwindow.addEventListener(\"hashchange\",fromHash);\nwindow.addEventListener(\"load\",fromHash);\nrun();\nif(document.readyState===\"loading\"){\ndocument.addEventListener(\"DOMContentLoaded\",run);\n}\n})();\/*>*\/<\/script>\n\n\n\n<div class=\"wp-block-group has-global-padding is-layout-constrained wp-container-core-group-is-layout-32086477 wp-block-group-is-layout-constrained\" style=\"border-left-color:#a57a00;border-left-width:4px;border-left-style:solid;border-radius:0px;margin-top:8px;margin-bottom:56px;padding:4px 0px 4px 28px\">\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#6b6259;margin-top:0;margin-bottom:0;font-size:clamp(14px, 0.875rem + ((1vw - 3.2px) * 0.227), 16px);line-height:1.7\"><strong style=\"color:#8a6300\">This article is general information, not medical advice.<\/strong> It cannot diagnose or rule out any condition. Changes in mood, sleep, memory or your cycle around perimenopause deserve proper medical assessment, particularly when they are severe, new or getting worse. If any of this sounds like your experience, please speak to your doctor or gynecologist, and talk with them before starting, stopping or changing any hormonal treatment or antidepressant. Psychological support is intended to work alongside appropriate medical care, never to replace it.<\/p>\n\n\n<\/div>\n\n\n<\/div>\n\n\n\n<div class=\"wp-block-group pmw-keep has-global-padding is-layout-constrained wp-container-core-group-is-layout-d2a766d4 wp-block-group-is-layout-constrained\">\n\n\n<div style=\"margin-top:0px;margin-bottom:44px\"><a class=\"wn-next\" href=\"\/is-it-your-hormones\/\"><span class=\"eyb\">Read next<\/span><span class=\"ar\" aria-hidden=\"true\"><svg viewBox=\"0 0 16 16\"><path d=\"M2 8h11M9 4l4 4-4 4\" fill=\"none\" stroke=\"currentColor\" stroke-width=\"1.8\" stroke-linecap=\"round\" stroke-linejoin=\"round\"\/><\/svg><\/span><span class=\"ti\">So, Is It Your Hormones?<\/span><span class=\"wy\">The wider picture of how hormones and the brain talk to each other, across the monthly cycle, after pregnancy and in midlife.<\/span><\/a><\/div>\n\n\n<\/div>\n\n\n\n<div class=\"wp-block-group pmw-keep pmw-end has-global-padding is-layout-constrained wp-container-core-group-is-layout-d2a766d4 wp-block-group-is-layout-constrained\">\n\n\n<div style=\"margin-top:0px;margin-bottom:0px\"><img loading=\"lazy\" decoding=\"async\" width=\"2560\" height=\"1708\" src=\"https:\/\/equilibriumpsychotherapy.net\/wp-content\/uploads\/2024\/06\/mid-shot-woman-therapist-taking-notes-clipboard-scaled.jpg\" alt=\"A therapist taking notes on a clipboard during a session\" class=\"wp-image-230\" style=\"width:100%;height:340px;object-fit:cover;object-position:center 40%;border-radius:22px 22px 0 0;display:block\" srcset=\"https:\/\/equilibriumpsychotherapy.net\/wp-content\/uploads\/2024\/06\/mid-shot-woman-therapist-taking-notes-clipboard-scaled.jpg 2560w, https:\/\/equilibriumpsychotherapy.net\/wp-content\/uploads\/2024\/06\/mid-shot-woman-therapist-taking-notes-clipboard-300x200.jpg 300w, https:\/\/equilibriumpsychotherapy.net\/wp-content\/uploads\/2024\/06\/mid-shot-woman-therapist-taking-notes-clipboard-1024x683.jpg 1024w, https:\/\/equilibriumpsychotherapy.net\/wp-content\/uploads\/2024\/06\/mid-shot-woman-therapist-taking-notes-clipboard-768x512.jpg 768w, https:\/\/equilibriumpsychotherapy.net\/wp-content\/uploads\/2024\/06\/mid-shot-woman-therapist-taking-notes-clipboard-1536x1025.jpg 1536w\" sizes=\"auto, (max-width: 2560px) 100vw, 2560px\" \/><\/div>\n<div hidden data-eq-related=\"2792,2981,2503\"><\/div>\n\n\n\n<div class=\"wp-block-group has-background eq-ondark has-global-padding is-layout-constrained wp-container-core-group-is-layout-f761ea3b wp-block-group-is-layout-constrained\" style=\"background-color:#44557a;border-radius:0px 0px 22px 22px;margin-top:0;margin-bottom:80px;padding:52px\">\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#c7cfdf;margin-top:0;margin-bottom:14px;font-size:12px;font-weight:700;letter-spacing:0.16em;line-height:1.4\">WORKING WITH THIS<\/p>\n\n\n\n<h3 class=\"wp-block-heading has-text-color has-work-sans-regular-font-family\" id=\"when-your-mood-no-longer-feels-like-your-own\" style=\"color:#ffffff;margin-top:0;margin-bottom:18px;font-size:clamp(16.293px, 1.018rem + ((1vw - 3.2px) * 0.989), 25px);font-style:normal;font-weight:700;line-height:1.28\">When your mood no longer feels like your own<\/h3>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#ffffff;margin-top:0;margin-bottom:30px;font-size:clamp(14px, 0.875rem + ((1vw - 3.2px) * 0.455), 18px);line-height:1.7\">If these years have brought changes in mood that are wearing you down, you do not have to work out alone how much is hormones and how much is everything else. Talking it through can help you see the pattern more clearly and decide what kind of support would help.<\/p>\n\n\n\n<div class=\"wp-block-buttons is-layout-flex wp-block-buttons-is-layout-flex\">\n<div class=\"wp-block-button\"><a class=\"wp-block-button__link has-text-color has-background has-work-sans-regular-font-family wp-element-button\" href=\"\/individual-session\/\" style=\"border-radius:9px;color:#2a2622;background-color:#faf8f3;padding:15px 30px;font-size:clamp(14px, 0.875rem + ((1vw - 3.2px) * 0.284), 16.5px);font-weight:700\">Book a session<\/a><\/div>\n\n\n\n<div class=\"wp-block-button footer_b\"><a class=\"wp-block-button__link has-text-color has-work-sans-regular-font-family wp-element-button\" href=\"\/contact\/\" style=\"border-color:#c7cfdf;border-width:1.5px;border-style:solid;border-radius:9px;color:#ffffff;padding:15px 30px;font-size:clamp(14px, 0.875rem + ((1vw - 3.2px) * 0.284), 16.5px);font-weight:600\">Get in touch<\/a><\/div>\n<\/div>\n\n\n<\/div>\n\n\n<\/div>\n\n\n<\/div>\n","protected":false},"excerpt":{"rendered":"<p>What perimenopause actually is, why mood can change in these years, why swings in estrogen seem to matter more than its level, how night sweats and broken sleep feed into low mood, what is happening with anxiety, irritability and brain fog, and what helps<\/p>","protected":false},"author":2,"featured_media":4723,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"iawp_total_views":370,"footnotes":""},"categories":[15,18,17],"tags":[],"class_list":["post-2963","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-body-and-mind","category-too-afraid-to-ask","category-womens-health"],"_links":{"self":[{"href":"https:\/\/equilibriumpsychotherapy.net\/hr\/wp-json\/wp\/v2\/posts\/2963","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/equilibriumpsychotherapy.net\/hr\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/equilibriumpsychotherapy.net\/hr\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/equilibriumpsychotherapy.net\/hr\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/equilibriumpsychotherapy.net\/hr\/wp-json\/wp\/v2\/comments?post=2963"}],"version-history":[{"count":20,"href":"https:\/\/equilibriumpsychotherapy.net\/hr\/wp-json\/wp\/v2\/posts\/2963\/revisions"}],"predecessor-version":[{"id":4774,"href":"https:\/\/equilibriumpsychotherapy.net\/hr\/wp-json\/wp\/v2\/posts\/2963\/revisions\/4774"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/equilibriumpsychotherapy.net\/hr\/wp-json\/wp\/v2\/media\/4723"}],"wp:attachment":[{"href":"https:\/\/equilibriumpsychotherapy.net\/hr\/wp-json\/wp\/v2\/media?parent=2963"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/equilibriumpsychotherapy.net\/hr\/wp-json\/wp\/v2\/categories?post=2963"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/equilibriumpsychotherapy.net\/hr\/wp-json\/wp\/v2\/tags?post=2963"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}