Expert reviewed
Dr Priya Raman, Clinical Psychologist
Reviewed for clinical accuracy against current UK guidance.
"My tolerance for nonsense disappeared before anything else did." We hear a version of that sentence constantly. Anger in perimenopause is often described as sudden, disproportionate and immediately followed by guilt.
Hormonal, situational, or both
Oestrogen influences serotonin activity, and fluctuation — rather than a steady decline — is what tends to destabilise mood. But this stage also lands in the middle of demanding careers, teenagers, ageing parents and years of absorbed low-level load. Both things are true at once.
What helps
- Naming the pattern out loud with the people closest to you
- Protecting sleep first — irritability and broken sleep amplify each other
- Strength training and daylight, which have reasonable evidence for mood
- Talking therapy, which NICE specifically supports for low mood at this stage
If low mood, hopelessness or anxiety are persistent, or you have any thoughts of harming yourself, contact your GP or local urgent mental health service now. That information should never sit behind a paywall, and on Posteri it never will.
Sources & further reading
- NICE guideline NG23, section on psychological symptoms
- Royal College of Psychiatrists: Menopause and mental health
Last reviewed 29/05/2026. We review clinical content at least every 12 months.
This article is educational information, not medical advice. If something feels urgent, contact your GP or emergency services.