Perimenopause and Mental Health: What’s Hormonal vs. What’s Not

Perimenopause, the transitional phase leading up to menopause, can begin in the mid-30s to early 40s and last for several years. During this time, estrogen and progesterone levels don’t just decline — they fluctuate unpredictably. Those fluctuations affect mood, sleep, focus, and emotional resilience in ways that are real, measurable, and too often missed.