Menopause is becoming more openly discussed, helping many people recognise experiences that may previously have felt confusing or difficult to explain. Although it is often associated with the late 40s or early 50s, symptoms can begin earlier, during perimenopause, sometimes years before periods stop.
For some, this stage of life brings physical changes alongside shifts in mood, confidence, identity and relationships. Understanding these changes can help people feel less alone and more able to seek support.
What is perimenopause, and when can it begin?
Perimenopause is the transitional period leading up to menopause, when hormonal changes can affect menstrual cycles and emotional and physical wellbeing. Symptoms may include anxiety, low mood, irritability, sleep difficulties, brain fog and changes in confidence or sexual desire.
Although menopause most commonly occurs between 45 and 55, it can happen earlier. If you experience symptoms before the age of 45, speaking to your GP can help clarify possible causes and appropriate support.
What does the latest research tell us?
A study published in Nature Medicine in October 2026 analysed more than 300 million laboratory tests and identified distinct, step-like changes in several physiological systems around the final menstrual period. The researchers also found evidence of changes in some biological measures beginning more than a decade earlier. These findings offer new insight into the wider effects of the menopausal transition, although they do not mean everyone will experience symptoms in the same way.
The psychological impact of menopause
Menopause can affect more than physical health. Changes in sleep, mood and concentration may influence how someone feels about themselves and manages everyday life. Some people experience increased anxiety or emotional sensitivity, while others describe feeling unlike their usual selves.
This period can also bring questions about ageing, identity, relationships and expectations for the future. When these experiences occur alongside work pressures, caring responsibilities or relationship difficulties, they can feel particularly overwhelming.
Recognising the possible connection between hormonal changes and emotional wellbeing can be reassuring. It is equally important not to assume that every emotional difficulty is caused by menopause, as other factors may also need attention.
How psychotherapy can help
Psychotherapy offers a space to explore the emotional impact of this transition. It can help people make sense of changes in mood, understand the pressures they are experiencing and consider how menopause may be affecting their relationships and sense of self.
For some, this involves exploring anxiety, loss of confidence or changes in identity. For others, it may provide an opportunity to reflect on shifting family roles, intimacy or the demands of caring for others while managing their own needs.
Therapy does not replace medical assessment or treatment, but it can complement appropriate healthcare and provide valuable emotional support.
Finding support
Menopause can be a significant life transition, but you do not have to navigate its emotional challenges alone. If you are experiencing symptoms, speaking to your GP can help you understand the options available to you.
If the changes are affecting your emotional wellbeing or relationships, psychotherapy may also offer a space to reflect, understand your experience and find a way forward. Having your experience taken seriously is an important starting point.
