Is It Perimenopause or Something More? Understanding Mood Changes
Many women are told that mood swings, anxiety, or low energy in their 30’s, 40’s, or 50’s mean they need an antidepressant. Medications like Zoloft or Lexapro can certainly help some women. But sometimes what looks like depression or anxiety is really the body responding to hormone changes in perimenopause.
One key change during this time is a drop in progesterone relative to the fluctuating estrogen during this time. Progesterone doesn’t just prepare the body for pregnancy — it also has a calming effect on the brain. When progesterone levels fall, women often notice:
Irritability or mood swings
Increased anxiety or restlessness
Difficulty sleeping
Brain fog and fatigue
Heavier or irregular cycles
Bloating or breast tenderness
These symptoms can mimic depression, which is why SSRIs are often prescribed. While antidepressants may help with mood, they don’t address the underlying hormone imbalance — and they can bring their own side effects.
By restoring progesterone with bioidentical hormone therapy, many women notice steadier moods, better sleep, and less anxiety. And because perimenopause involves changes in multiple hormones, balancing estrogen, progesterone, and sometimes testosterone can support not just mood, but also bone, heart, and overall health.
A Different Path Forward
If you’ve been placed on an antidepressant but wonder if perimenopause could be part of the picture, you’re not alone. Looking at both hormones and mental health together often uncovers new options for relief — without relying only on medication.
Key Takeaways
- Progesterone deficiency is common in perimenopause and can affect mood, sleep, and energy.
- SSRIs may ease mood symptoms but don’t address the underlying hormone shifts.
- Bioidentical hormones can restore balance and improve both emotional and physical health.
