This article is for educational purposes only. It is not intended to diagnose, treat, or cure any disease. If you think you are experiencing perimenopause symptoms, please consult with your healthcare provider.

Tearing up over nothing? Irrationally irritated by things you’d never noticed before—why does the icemaker make that sound?!?—or suddenly furious about things you used to shrug off? If you’re in your 40s (or even your late 30s) and experiencing shifts in mood that are making you feel a bit unhinged, you might be in perimenopause.¹⁰

These shifts are often referred to as “mood swings,” and for some women, they do feel like sudden, unexpected ups and downs. But mood changes during perimenopause don’t always swing from one extreme to another. They can also show up as longer stretches of anxiety, irritability, or low mood that feel out of character for you.

Wondering WTF is happening, and how to get a grip on your emotions, stat? Keep reading for a deeper dive into how perimenopause can affect mood, what symptoms you might experience, and how to support yourself through the transition.

How Can Perimenopause Affect Your Mood?

Many women experience an increase in anxiety, irritability, and mood swings during perimenopause.^1,5 Hormones are thought to play a role in these changes.^4,5

During perimenopause, estrogen levels fluctuate unpredictably, which can affect brain chemistry involved in regulating mood.⁵ Estrogen helps support serotonin, a brain chemical involved in mood regulation.⁵ It also supports GABA, which has a calming effect on the brain.⁵ As estrogen fluctuates and declines during perimenopause, both of these systems can be affected, which may contribute to mood changes, including mood swings.⁵

But hormones aren’t the only factor. Poor sleep, stress, and difficult life events can affect mood at any stage of life, and they can compound mood changes during perimenopause.^1,4 The physical symptoms of perimenopause can play a role in mood, too: night sweats can disrupt your sleep, and poor sleep can make it harder to feel emotionally steady, while hot flashes can be uncomfortable and disruptive, adding to daily stress.¹

You may be used to experiencing similar mood-related symptoms with your period, as part of PMS.⁶ One key difference between those symptoms and perimenopause symptoms is timing: PMS-related mood changes follow a predictable pattern, typically arriving in the luteal phase and easing once your period starts.⁶ Perimenopausal mood changes can be less predictable and appear at times unrelated to your menstrual cycle.¹

Here’s a quick way to tell them apart:

	When it shows up	Pattern	What may accompany it
PMS	The week or two before your period6	Predictable, monthly; lifts when bleeding starts6	Other premenstrual symptoms (bloating, breast tenderness, cramps)6
Perimenopause mood shifts	May occur at times unrelated to your cycle1	Can be less predictable1	Other signs of the transition, like hot flashes and disrupted sleep1

PMS and perimenopausal mood changes can feel similar, which makes it hard to tell them apart on your own. If you’re unsure which you’re experiencing, a healthcare provider can help you sort out what’s going on.¹

What Do Perimenopause Mood Swings Feel Like?

In perimenopause, mood swings can look like sudden irritability, flashes of anger, or feeling like you might “fly off the handle.”⁷ But the emotional experience of perimenopause varies from person to person. Mood changes can also show up less dramatically, as longer stretches of low or changed mood that come and go across the transition—or both.¹

In a survey of more than 1,500 women in perimenopause or the years leading up to it, 63% reported ‘not feeling like themselves’ at least half of the time over the previous three months.⁷ Symptoms associated with that feeling included:

• Fatigue⁷
• Low mood⁷
• Anxiety⁷
• Feeling overwhelmed by tasks you’d normally handle with ease, or less able to cope⁷
• Waking in the night feeling anxious or on edge⁷
• Sudden shifts in mood (mood swings)⁷

Perimenopausal mood changes often show up alongside other signs of the transition, like disrupted sleep and cognitive changes such as trouble concentrating or increased forgetfulness. These symptoms can add to the sense of ‘not feeling like yourself.’⁷ If these feelings become overwhelming or persistent, it’s worth talking with a healthcare provider.¹

Risk Factors for Perimenopause Mood Swings

About 4 in 10 women experience mood symptoms during perimenopause, though how often they occur and how intense they feel varies from person to person.¹ Some risk factors can increase the odds of having a bumpier emotional experience through this transition:

• A history of depression or anxiety⁴
• A history of mood changes tied to hormonal shifts, such as severe PMS or PMDD, or depression during or after pregnancy, which may signal a greater sensitivity to the hormonal changes of perimenopause⁸
• Concurrent life stressors, such as caring for aging parents, career pressure, or relationship changes¹
• Poor sleep⁴

None of these risk factors guarantees a difficult transition, but knowing you may be more prone to symptoms like mood swings, irritability, or low mood can give you and your provider useful context for recognizing and managing symptoms if they arise.

Lifestyle Habits That Support Your Mood

A few everyday habits can help support mood during perimenopause:

• Move most days. Regular activity can help lift your mood and support better sleep.^1,9 It may help with hot flashes, too.⁹
• Protect your sleep. Keep your bedroom cool and dark, hold steady sleep and wake times, and put screens away in the hour before bed.⁹ If night sweats become disruptive, sleeping in breathable layers you can peel off can help.⁹
• Go easy on alcohol and caffeine. Both interfere with sleep, and both are common hot flash triggers.⁹
• Build in stress relief. Meditation, yoga, journaling, or even a minute or two of slow, deep breathing can help ease stress.¹

Some of these habits may support mood directly, while others address factors like poor sleep and stress that can make an already challenging transition feel harder. Together, they offer a set of tools to lean on as you navigate perimenopause.

Supplements Studied for Mood and Stress: What to Know in Perimenopause

Some women also explore supplements for mood and stress support during perimenopause. While research specifically on perimenopausal mood interventions is limited, several ingredients have been studied more broadly for their potential effects on mood and stress.*

Saffron

Saffron, a spice, isn’t just for fancy paella. Researchers think its active compounds, crocin and safranal, play a role in how the brain handles serotonin.² In a study on perimenopausal women, saffron was shown to promote a positive mood.*¹⁷

Ashwagandha

Ashwagandha (Withania somnifera) is an adaptogenic herb studied for how it may help the body respond to stress.³

Shatavari

Shatavari (Asparagus racemosus) is an adaptogenic herb long used in Ayurvedic medicine for women’s health and stress adaptation. In a study of perimenopausal women, it was shown to support emotional well-being.¹⁴

If you’re curious about support for perimenopausal mood symptoms, a healthcare provider may be able to offer additional insight and help you build a plan that fits your existing medication and supplement regimen.

When to Seek Professional Help

Some symptoms deserve a healthcare provider’s attention sooner rather than later. Reach out if you notice persistent sadness, hopelessness, or a loss of interest in things you usually enjoy, or if anxiety or worry become severe enough to interfere with your day.

With that said, you don’t have to hit a crisis point to deserve support. Mood changes during perimenopause are part of a natural process, but they can still be uncomfortable and disruptive. If they’re straining your relationships, work, or day-to-day life, that’s reason enough to talk with a healthcare provider. A medical expert can also help you figure out if the symptoms you’re experiencing are being caused by the menopausal transition or another condition.

If you’re ever in crisis or thinking about harming yourself, you don’t have to wait, and you don’t have to handle it alone. In the U.S. you can call or text 988 to reach the Suicide and Crisis Lifeline, any time.

Mood Swings Don’t Have to Run the Show

Let’s be honest: perimenopausal mood changes can make you feel unrecognizable to yourself, which can be more than a little disconcerting. But it’s helpful to remember that these changes don’t reflect a sudden change in personality—or your sanity. Your body undergoes many shifts during the menopausal transition, and mood changes, including sudden mood swings, are one of the ways those changes show up.

This doesn’t mean you have to feel powerless against them. Understanding what’s happening in your body, and why, can help you feel better equipped to weather the ups and downs. And while there’s no silver bullet for managing your mood during this transition, certain lifestyle habits may help support it. Some people also explore natural ingredients that have been studied for mood and stress, like saffron, shatavari, and ashwagandha.* The goal isn’t to white-knuckle your way through perimenopausal mood changes, but rather to support your body, speak with a provider when helpful, and find what helps you feel more like yourself.

Frequently Asked Questions (FAQ)

What are the best natural supplements for mood support during perimenopause?

There’s no single “best” supplement for mood support during perimenopause, and research specifically on perimenopausal mood interventions is limited. However, a few ingredients have been studied more broadly for mood and stress, including saffron, ashwagandha, L-theanine, shatavari, and vitamin B6.^2,3,13,14,15* Look for them in traceable, clinically studied forms from brands you trust. If you have any health conditions, or take medications, check with a provider first.*

Can hormone changes cause mood swings in perimenopause?

During perimenopause, estrogen levels fluctuate unpredictably, and this hormonal variability is thought to play a role in mood changes.⁴ Estrogen helps regulate brain chemicals involved in mood, including serotonin, which helps maintain balanced mood, and GABA, which has a calming effect.⁵ As estrogen levels change, these systems can be affected, which may contribute to the irritability, anxiety, and low mood many women notice during this stage.⁵ That said, hormones aren’t the only factor; sleep, stress, and life circumstances all play a role, too.^1,4

How are perimenopause mood swings different from PMS?

PMS follows your menstrual cycle: symptoms tend to hit in the days before your period and ease once it starts.⁶ Perimenopausal mood shifts can be less predictable. They may occur at times unrelated to your menstrual cycle and can continue for years without a clear pattern. They’re also often tangled up with sleep loss and hot flashes.¹

At what age does perimenopause usually start?

Most people enter perimenopause in their 40s, but it can start as early as the 30s.¹⁰ By ages 45 to 47, research shows that most women have begun the transition.^11,16 It commonly lasts five to ten years, but can run shorter or longer.¹¹ Perimenopause includes the time leading up to, and for one year after, menopause. Menopause is your final menstrual period, confirmed retroactively after you’ve gone 12 consecutive months without a period.¹²

References

1. American College of Obstetricians and Gynecologists (Silver NE). Mood changes during perimenopause are real. Here’s what to know. ACOG; April 2023. acog.org
2. Butnariu M, Quispe C, Herrera-Bravo J, et al. The pharmacological activities of Crocus sativus L.: a review based on the mechanisms and therapeutic opportunities of its phytoconstituents. Evid Based Complement Alternat Med. 2022;2022:8214821. doi:10.1155/2022/8214821.
3. Lopresti AL, Smith SJ, Malvi H, Kodgule R. An investigation into the stress-relieving and pharmacological actions of an ashwagandha (Withania somnifera) extract: a randomized, double-blind, placebo-controlled study. Medicine (Baltimore). 2019;98(37):e17186. doi:10.1097/MD.0000000000017186.
4. Davis SR, Pinkerton J, Santoro N, Simoncini T. Menopause—biology, consequences, supportive care, and therapeutic options. Cell. 2023;186(19):4038-4058. doi:10.1016/j.cell.2023.08.016.
5. Cho JM, Lee J, Ahn EM, Bae J. Beyond hot flashes: the role of estrogen receptors in menopausal mental health and cognitive decline. Brain Sci. 2025;15(9):1003. doi:10.3390/brainsci15091003.
6. Gudipally PR, Sharma GK. Premenstrual syndrome. In: StatPearls. Treasure Island (FL): StatPearls Publishing; 2025.
7. Coslov N, Richardson MK, Woods NF. “Not feeling like myself” in perimenopause—what does it mean? Observations from the Women Living Better survey. Menopause. 2024;31(5):390-398. doi:10.1097/GME.0000000000002339.
8. Parry BL. Perimenopausal depression. Am J Psychiatry. 2008;165(1):23-27. doi:10.1176/appi.ajp.2007.07071152.
9. Office on Women’s Health. Menopause symptoms and relief. U.S. Department of Health and Human Services. May 2025.
10. Santoro N, Roeca C, Peters BA, Neal-Perry G. The menopause transition: signs, symptoms, and management options. J Clin Endocrinol Metab. 2021;106(1):1-15. doi:10.1210/clinem/dgaa764.
11. Cunningham A, Hewings-Martin Y, Wickham A, Prentice C, Payne J, Zhaunova L. Perimenopause symptoms, severity, and healthcare seeking in women in the US. npj Womens Health. 2025;3. doi:10.1038/s44294-025-00061-3.
12. World Health Organization. Menopause. WHO Fact Sheet. October 2024.
13. Williams JL, Everett JM, D’Cunha NM, et al. The effects of green tea amino acid L-theanine consumption on the ability to manage stress and anxiety levels: a systematic review. Plant Foods Hum Nutr. 2020;75(1):12-23. doi:10.1007/s11130-019-00771-5.
14. Swaroop A, Swaroop A. Asparagus racemosus root extract (SheVari4®) alleviates menopausal symptoms in pre-, peri-, and post-menopausal healthy women. Cureus. 2026;18(4):e106987.
15. Linus Pauling Institute, Micronutrient Information Center. Vitamin B6. Corvallis (OR): Oregon State University.
16. Wegrzynowicz AK, Walls AC, Godfrey M, Beckley A. Insights into perimenopause: a survey of perceptions, opinions on treatment, and potential approaches. Women (Basel). 2025;5(1):4. doi:10.3390/women5010004.
17. Lopresti AL, Smith SJ. The effects of a saffron extract (affron®) on menopausal symptoms in women during perimenopause: a randomised, double-blind, placebo-controlled study. J Menopausal Med. 2021;27(2):66-78. doi:10.6118/jmm.21002.

*These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure, or prevent any disease.