Perimenopause And Depression

Perimenopause is the transitional phase before menopause when a woman’s body starts preparing to end her reproductive years. For some, it comes and goes without much fuss. But for many others, it can feel like riding an emotional rollercoaster—and depression is often part of that journey.

If you’ve been feeling unusually low, tearful, unmotivated, or just not yourself, you’re not alone. Many women report mood shifts during this phase of life, leading to an important question: is there a connection between perimenopause and depression?

Let’s explore how perimenopause affects mental health, why it happens, and what you can do to feel like yourself again.

What Is Perimenopause, Exactly?

Perimenopause is the natural transition leading up to menopause. It usually begins in your 40s (sometimes earlier) and can last anywhere from a few months to over a decade.

During perimenopause, oestrogen and progesterone levels begin to fluctuate, not decline in a straight line. This hormonal rollercoaster affects everything from your menstrual cycle and sleep to your energy, mood, and mental clarity.

The challenge is that many women don’t realise that their symptoms—especially emotional ones like sadness, anxiety, or mood swings—are part of perimenopause.
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The Link Between Perimenopause and Depression

So, what’s really going on here? Why are so many women experiencing low mood or even depression during perimenopause?

Here are some of the key factors:

1. Hormonal Imbalance

The most significant driver of perimenopausal depression is changing hormone levels.

• Oestrogen supports serotonin, a brain chemical that stabilises mood. As oestrogen fluctuates, so do serotonin levels—leading to mood changes, irritability, and even clinical depression.

• Progesterone, known for its calming properties, also declines. This can contribute to feelings of anxiety, restlessness, and poor sleep, which may make low moods worse.

2. Sleep Disturbances

Hormonal changes can cause night sweats, hot flushes, and insomnia—all of which disrupt sleep. And anyone who’s dealt with poor sleep knows how much it can affect mental wellbeing.

Sleep deprivation worsens:

• Irritability and anxiety

• Concentration and memory

• Overall emotional resilience

3. Increased Stress and Life Changes

Perimenopause often coincides with a range of stressful life events, such as:

• Children becoming teenagers or leaving home

• Caring for ageing parents

• Career changes or financial pressures

• Relationship issues or separation

This added emotional load can intensify feelings of sadness or hopelessness—especially when paired with hormonal fluctuations.

4. Blood Sugar Imbalance

As women age, insulin sensitivity often decreases. This can result in blood sugar highs and lows, which can mimic or worsen depressive symptoms.

You might feel:

• Sudden fatigue

• Irritability

• Cravings for sugar or carbs

• Mental fog or lack of motivation

A low-carb, nutrient-dense diet helps stabilise blood sugar and can support better mental clarity and emotional stability.

Signs of Perimenopausal Depression

It’s normal to have the occasional off day, but if you’re experiencing persistent low moods, you might be dealing with perimenopausal depression.

Look out for these signs:

• Feeling low or sad most of the time

• Loss of interest in things you used to enjoy

• Fatigue, even after rest

• Difficulty concentrating

• Changes in appetite or weight

• Feeling hopeless, irritable, or worthless

• Withdrawal from social activities

• Increased anxiety or nervousness

• Disturbed sleep patterns

If these symptoms last more than a couple of weeks or interfere with your daily life, it’s important to reach out for support.

Can Diet Influence Perimenopause Depression? Absolutely.

What you eat has a direct effect on your hormonal balance, brain function, and emotional wellbeing. During perimenopause, a low-carb, high-fat approach can be incredibly effective.

Why Low-Carb Helps

• Regulates blood sugar – Stable blood sugar helps stabilise mood and energy levels.

• Reduces inflammation – Chronic inflammation is linked to both depression and hormonal imbalance.

• Supports hormone production – Healthy fats are the building blocks of hormones.

• Nourishes the brain – Fats like omega-3s improve brain health and mood regulation.

Best Foods for Hormonal and Emotional Health

Include more of these in your daily meals:

• Fatty meats like steak, lamb, pork belly, and liver

• Fatty fish such as sardines, salmon, and mackerel

• Eggs – especially with the yolk, for healthy fats and nutrients

• Avocados, olives, coconut oil, and grass-fed butter

• Bone broth for gut healing and mineral support

• Fermented foods like kimchi, sauerkraut, and full-fat yoghurt

• Low-carb veg like spinach, broccoli, cauliflower, kale, and courgette

Avoid:

• High-sugar and refined-carb foods

• Vegetable oils and trans fats

• Highly processed and packaged snacks

A consistent, real food approach can help support emotional stability and reduce the intensity of perimenopausal mood swings.

Lifestyle Changes to Support Your Mental Health

In addition to changing your diet, there are several other natural ways to reduce perimenopausal depression.

1. Improve Sleep Hygiene

Prioritise sleep like it’s a health prescription.

• Stick to a consistent routine—same bedtime and wake-up time

• Avoid blue light from screens before bed

• Keep your bedroom cool and dark

• Magnesium or herbal teas can promote calm and better sleep

2. Move Your Body (Gently)

Exercise doesn’t have to be intense to be effective. Aim for movement that supports mood and doesn’t deplete your energy.

Try:

• Walking in nature

• Strength training to support bone and muscle health

• Yoga or stretching to calm the nervous system

• Dancing or swimming if you enjoy it

3. Reduce Stress

Chronic stress not only worsens perimenopausal symptoms, but also contributes directly to depression.

Support your mental health by:

• Practising mindfulness, breathing exercises, or journaling

• Spending time outdoors or in natural light

• Limiting screen time and negative media consumption

• Connecting with friends or support groups

4. Don’t Go It Alone

It’s not a sign of weakness to ask for help. Whether it’s from a health professional, therapist, or supportive friend, opening up is often the first step toward healing.

If you’re unsure where to start, a GP with a special interest in metabolic and hormonal health—like Dr. Avi Charlton—can provide guidance and support.

Final Thoughts

Perimenopause and depression are deeply connected, but that doesn’t mean you have to suffer in silence or feel like a stranger to yourself.

With the right tools—nourishing low-carb foods, gentle lifestyle changes, and emotional support—you can navigate this phase with greater ease, confidence, and calm.

If you’re feeling stuck, low, or overwhelmed, know that help is available, and it’s absolutely possible to feel like yourself again.