Hormones & Mental Health: Understanding the Mind-Body Connection in Women’s Mid-life Transitions
You might be familiar with some common symptoms of peri-menopause such as irritability and mood swings, increased anxiety, hot flashes, and heart palpitations. But how do you know if these changes are simply part of menopause—or something more serious? And if you need help, where should you start? Should you see your OB/GYN, a mental health specialist, or someone else entirely?
Well, it depends. Right now, I’m going to get personal and very honest with you and tell you my story in hopes that it inspires you to seek the answers and support you need, whatever that may be.
Several years ago, I started waking in the middle of the night with severe panic attacks. I would wake drenched in sweat, heart racing, and feeling a tightening in my chest. It felt as if my body had a rush of adrenaline, and as I got out of bed to shake it off, I would suddenly feel chilled and start shivering. My gut would be hit with the sudden need to rush to the toilet. I couldn’t tell if my systems were shutting down or going into overdrive. As my mind raced with terrifying thoughts of having a heart attack and I started Googling my symptoms (which I don’t recommend!), I finally had my husband drive me to the ER. After several nights of this (including multiple ER visits), I finally followed up with my doctor and started taking an anti-anxiety medication.
In my mind, the anxiety was justified. On the surface, we were well into the COVID pandemic, I was studying for my board exams, and I was a military wife raising two boys largely on my own while my husband frequently traveled for the needs of the Army. Fortunately, the medication helped. I passed my board exams, started counseling, my husband slowed down to spend more time with the family, and my two amazing sisters kept me going. Because of the support I received, I had the clarity to sort through what I was experiencing. Then, about a year and a half later, as I sat inside my air-conditioned house, melting into a human puddle in an otherwise chilly room, it hit me—was I in perimenopause? So, I started to do my homework …
Mental Health Symptoms Linked to Hormonal and Metabolic Changes
We know that estrogen, progesterone and FSH (follicle stimulating hormone) have a strong brain-body connection impacting mood, cognition and mental well-being, as do cortisol, insulin and thyroid hormones. During menopause, both estrogen levels and the brain’s estrogen receptors change. In many cases, the brain adapts to these fluctuations. But for some women, these hormonal shifts can be harder to regulate, leading to noticeable mood changes. Common symptoms during the menopausal transition are:
Mood swings and irritability – Linked to fluctuating estrogen and stress response changes.
Brain fog and difficulty concentrating – Possibly due to declining estrogen’s impact on neurotransmitters like acetylcholine.
Insomnia or disrupted sleep patterns-sometimes caused by night sweats or racing thoughts.
Low motivation (to name a few).
In addition to the hormonal impact, women often experience the compounding effects of increased stressors in mid-life, such as caring for children, managing aging parents, and navigating careers. This makes it difficult to distinguish between situational stress, mental health conditions, and menopause-related mood changes. Sleep disturbances, commonly triggered by hot flashes and night sweats, can exacerbate anxiety and depression as well.
When It’s More Than Just Hormones: Red Flags for Serious Mental Health Issues
It’s essential to differentiate between hormone-driven mood changes and symptoms that signal a deeper issue requiring professional care. Serious concerns include:
Persistent depression lasting more than two weeks
Severe anxiety or panic attacks interfering with daily life
Suicidal thoughts or self-harm
Drastic personality changes or psychosis-like symptoms
These symptoms may indicate major depressive disorder, anxiety disorders, or bipolar disorder rather than hormonal fluctuations alone. If symptoms are intense or interfere with daily life, it’s crucial to seek professional evaluation.
Seeking Help: Where to Start and What to Ask
If you suspect your symptoms are linked to hormonal shifts, consider reaching out to:
Primary care doctors or OB/GYNs for hormone assessments
Endocrinologists for thyroid, insulin, and metabolic disorders
Mental health professionals for therapy and psychiatric evaluation
Lifestyle medicine coaches and functional medicine practitioners for holistic support
Tracking symptoms, advocating for yourself in medical settings, and exploring treatments like therapy, medication, hormone replacement therapy, or lifestyle interventions can help you regain balance.
Conclusion: Embracing a Proactive Approach
Mental health struggles during hormonal transitions are real—and manageable. In my case, I was navigating both, and research suggests my personal history may have increased my risk of anxiety during menopause. But let’s be clear: depression isn’t something you can just “snap out of.” Your brain health matters, and tending to it is just as important as caring for your body.
There’s no one-size-fits-all solution, but you can take charge of your well-being. Educate yourself about the menopausal experience and its impact on mental health. Track your mood, sleep, and stress patterns to identify triggers. Prioritize lifestyle changes—move your body, nourish yourself well, and make time for joy. Most importantly, don’t go through it alone. Reach out to others, lean on your support system, and talk to your healthcare provider. You don’t have to suffer in silence.
As a health and wellness coach, I help women navigating metabolic and hormonal health challenges by focusing on nutrition and sustainable lifestyle strategies. I encourage every woman to advocate for herself, seek support, and stay informed—because knowledge is power. Most of all, connect with other women who understand your journey, whether it’s for learning, encouragement, or a much-needed laugh. Prioritizing your physical and mental health can help you move through this transition with clarity and confidence.
If you’d like support on your journey, I offer monthly group coaching and one-on-one sessions. Let’s chat! Visit www.balancedwell-being.com to learn more and schedule a free discovery call.
If you need additional support and professional mental health services, visit All of You Counseling in Manassas, VA.
References for further reading:
Harvard Health - Women’s Hormones and Mental Health
National Institute of Mental Health
