Is It Just Me? Perimenopause, Menopause and Mental Health

Feeling overwhelmed by perimenopause or menopause? You’re not broken, you’re transforming. Discover why therapy can help, backed by Australian stats and science.

Mid shot of a woman tending to freshly cut flowers. She is reflecting on the metamorphosis that is menopause.

Let’s Start Here: How Often Do You Ask Yourself…

Why am I so irritable?
Why can’t I sleep even though I’m exhausted?
Why do I feel anxious for no reason?
Am I losing my mind, or is this something else?

If these questions sound familiar, you’re not alone.

In Australia, almost 7 million women are currently in perimenopause or menopause, representing about a quarter of the population. One in four women aged 35 - 64 say symptoms make daily life hard, and 7% have missed work because of it (Jean Hailes, 2023).

Over 25% of women experience moderate to severe symptoms that impact their quality of life, and up to 10% have stopped work due to menopausal symptoms.

Yet, so many women keep these struggles hidden, often due to societal expectations to “just cope" (Jean Hailes, 2023).

But here’s the truth: perimenopause and menopause are not just biological events, they’re biopsychosocial transitions that affect your brain, body, and identity (Jean Hailes, 2023)

What’s Really Happening Inside You?

Ever feel like your emotions are all over the place, your mind is in a fog, or stress just hits you harder than it used to? You’re not imagining it!

Here’s what’s really going on behind the scenes (Cleveland Clinic, n.d.; Harvard Health Publishing, 2022):

When your hormones start shifting during perimenopause or menopause, they impact important brain chemicals like serotonin and dopamine. These are the same neurotransmitters that help regulate your mood and motivation, so when they’re out of balance, you might feel more anxious, down, or just “off.”
On top of that, as oestrogen levels drop, it affects your body’s main stress response system, the hypothalamic-pituitary-adrenal (HPA) axis. Think of this as your internal alarm system for stress.

When oestrogen dips, your HPA axis can become extra sensitive. The hypothalamus (a part of your brain) tells the pituitary gland to signal your adrenal glands, which then pump out more cortisol, the stress hormone. During perimenopause, this whole system can go into overdrive, leaving you feeling wired, anxious, and totally exhausted .

So next time you wonder, “Is it just stress?”... remember, your biology might be turning up the volume on everything you’re feeling.

Close up of woman with eyes closed, her hand up to her face. She is struggling with symptoms of perimenopause.

The Psychological Toll in Numbers

As per Jean Hailes for Women's Health (2023):

40% of perimenopausal women in Australia present with depressive symptoms.
Women in this stage are at higher risk of major depressive episodes, especially if they’ve had depression before.
80% of women will have hot flushes and sweats, lasting on average 7 years; in 1 in 3, these can be severe.
Over 10% of women stop work due to menopausal symptoms.
Women aged 45 - 54 are the fastest-growing group in the Australian workforce, making the impact of untreated symptoms a significant economic and social issue.

And...

Up to 60% experience sleep disruption, which worsens mood and cognitive clarity (Sleep Health Foundation, 2025).

If you’ve been blaming yourself for “not coping,” stop. This isn’t weakness, it’s physiology.

Why Therapy Can Help

What if you could calm your stress response, improve your sleep, and feel like yourself again? These can be your goals for therapy if that's what you want!

Evidence shows interventions like Cognitive Behavioural Therapy (CBT) can:

Reduce anxiety and depressive symptoms (Jean Hailes, 2023).
Improve sleep quality (Jean Hailes, 2023).
Boost overall life satisfaction (Ye et al., 2022).

A major meta-analysis found CBT significantly improves quality of life for menopausal women (Jean Hailes, 2023).

And if CBT does not sound like a fit, there are many other therapy styles that Psychologists can be trained in, such a Acceptance Commitment Therapy (ACT), Narrative Therapy and more!

Mid shot of a woman talking to her therapist about menopause. They are both smiling.

The Stress-Hormone Loop: Are You Stuck in It?

Have you noticed how stress makes your symptoms worse and your symptoms make you more stressed? That’s the HPA axis at work. Therapy helps support you by teaching you how to regulate your nervous system and reclaim control (Jean Hailes, 2023).

What Does That Look Like in Practice?

Therapy can take a variety of different forms, however it can often look like:

Mindfulness-based interventions to quiet the amygdala and lower cortisol.
Behavioural activation to restore motivation and pleasure.
Cognitive reframing to challenge unhelpful thoughts that fuel anxiety.

Ask yourself: What would change if you had tools to manage your mental health, not just your symptoms?

Your next steps might look like:

Talk about it... with friends, partners, colleagues. Silence can breed shame. You deserve to be heard and validated.
Book a session... a Psychologist can tailor strategies to your unique needs. Explore our Find a Psychologist page to connect with a Psychologist of your choice.
Ask your GP about a Mental Health Treatment Plan... you may be eligible for Medicare rebates for psychology sessions. For more information see our page discussion what is a Mental Health Care Plan?
Prioritise YOU... sleep hygiene, movement, and therapy can support you during this time.

Perimenopause and menopause is not an ending, it’s a psychological metamorphosis. With the right support, this chapter can be one of power, clarity, and growth.

You are not broken. You are not invisible. You are evolving and you deserve to thrive.

And now, the question I want to leave you with:

Your mind, like your body, can benefit from care and compassion especially during life’s transformative seasons. What would it look like to give it the attention it deserves?

The information in this blog post is for general educational purposes only and does not replace professional psychological advice. If you are experiencing psychological distress please seek support from a qualified mental health professional. In an emergency contact 000.

References

Balance Health. (2024, October 24). 7 million women in Australia are in peri-menopause or menopause.

Cleveland Clinic. (n.d.). Hypothalamic-pituitary-adrenal (HPA) axis.

Harvard Health Publishing. (2022, August 1). Menopause and mental health.

Jean Hailes for Women’s Health, Australasian Menopause Society, & Women’s Health Research Program Monash University (2023). The impact of symptoms attributed to menopause by Australian women.

Sleep Health Foundation (2025). Sleep disruption and midlife women: A national report.

Ye, L., Davis, S. R., & Women’s Health Research Program (2022). The Australian Women’s Midlife Years (AMY) Study: Understanding the contemporary menopausal experience in Australian women.