Perimenopause is the transitional stage before menopause, often starting in a woman’s 40s. During this time, hormonal fluctuations , especially in estrogen and progesterone, can affect mood, sleep, and cognition . Common mental health symptoms include: Mood swings or irritability Heightened anxiety or panic attacks Depression or low motivation Brain fog or difficulty concentrating Sleep disturbances Recognizing these signs early is key to maintaining emotional wellbeing durin