Perimenopause & Mental Health: Why World Perimenopause Day Matters More Than Ever

A sophisticated and diverse group of women sits together in thoughtful conversation inside the welcoming Macvelly Wellness space. Natural light pours in through the window, creating a hopeful and calming atmosphere as they discuss life’s transitions with openness and support.

Today is World Perimenopause Day 2025, a time when the global spotlight turns to women’s midlife health. While awareness has certainly grown, the depth of understanding too often remains shallow. For far too long, perimenopause has been reduced to hot flashes and night sweats, dismissed as an inevitable and uncomfortable passage.

At Macvelly Wellness, we know this is only part of the story. Perimenopause is a complex, multi-system transition that touches every aspect of a woman’s life — from her mental clarity to her metabolic health — with unique challenges for every individual, especially women of color.

This World Perimenopause Day, we are urging a deeper dive into why comprehensive awareness matters more than ever. It’s time to move beyond hot flashes, to explore the profound connection between hormones and mental health, to understand perimenopause as a metabolic event, and to amplify the untold stories of women navigating this journey.

Beyond Hot Flashes: The Mental Health Connection

For many women, the most debilitating perimenopausal symptoms aren't physical, but psychological. The erratic fluctuations and eventual decline of estrogen and progesterone orchestrate a profound impact on brain chemistry, often leading to distressing mental health challenges:

• Estrogen's Neurotransmitter Link: Estrogen directly influences neurotransmitters vital for mood regulation, such as serotonin, dopamine, and norepinephrine. As estrogen levels become unpredictable, so does their stabilizing effect. This can lead to increased vulnerability to mood swings, irritability, anxiety, panic attacks, and new onset or worsening depression. Research consistently demonstrates that perimenopausal women have a significantly higher risk of experiencing depressive symptoms compared to pre-menopausal women.

• Progesterone's Calming Loss: Progesterone, a natural calming agent, interacts with GABA receptors in the brain, promoting relaxation and sleep. Its decline can result in heightened anxiety, restlessness, and insomnia, further exacerbating mood disturbances.

• Cognitive Impact: "Brain fog," difficulty concentrating, and memory lapses are not imagined. Estrogen plays a role in cognitive function, and its instability can lead to these frustrating symptoms, impacting work performance and daily life.

• The Stress Loop: The physical discomforts (like night sweats) and emotional challenges of perimenopause create chronic stress, elevating cortisol. High cortisol can further disrupt sleep, increase anxiety, and depress mood, trapping women in a difficult cycle.

Why it matters: Many women are misdiagnosed or given inappropriate treatments without recognizing the hormonal root of their mental health struggles. Validating these experiences is crucial for effective support and treatment.

A split-screen portrait of the same woman: on the left, she appears calm, composed, and smiling; on the right, her image is darker and somber, reflecting distress. This contrast symbolizes the hidden emotional struggles of perimenopause, including mood swings, anxiety, and irritability. The image highlights how outward appearances may differ from inner experiences, underscoring the importance of understanding and supporting women’s mental health during perimenopause.

A Metabolic Event, Not Just a Hormonal Shift

While hormonal changes are central, perimenopause is also a significant metabolic event that fundamentally alters how a woman's body processes energy, stores fat, and manages blood sugar. This often explains the perplexing midlife weight gain, particularly around the abdomen.

• Insulin Resistance: Declining and fluctuating estrogen levels can reduce insulin sensitivity, leading to insulin resistance. This means the body's cells don't respond as efficiently to insulin, prompting the pancreas to produce more. High insulin levels signal the body to store fat, particularly visceral fat around the organs – the notorious "meno-belly." This also increases the risk of pre-diabetes and Type 2 Diabetes.

• Magnesium Depletion: Essential for over 300 enzymatic reactions, magnesium plays a critical role in glucose metabolism and insulin signaling. Stress, declining estrogen, and inadequate diet can lead to magnesium deficiency, further exacerbating insulin resistance and contributing to weight gain and fatigue.

• Changes in Energy Expenditure: Hormonal shifts, combined with often less efficient sleep and increased fatigue, can impact metabolism and energy expenditure, making weight management more challenging.

Why it matters: Understanding perimenopause as a metabolic event empowers women to adopt targeted nutritional and lifestyle strategies, moving beyond calorie restriction alone to address underlying metabolic dysfunction.

A woman in her 40s looks down at her midsection with concern, gently holding her stomach. She is dressed casually in a gray t-shirt and jeans, standing in a bright, natural light setting. The image conveys the frustration and confusion many women experience with sudden midlife weight gain during perimenopause.

Women of Color: The Untold Story

While perimenopause affects all women, the experience is not universal. For women of color, particularly Black, Hispanic, and Indigenous women, there are significant disparities and unique challenges that demand urgent attention:

• Earlier Onset & Longer Duration of Symptoms: Research indicates that Black and Hispanic women may experience perimenopausal symptoms earlier and for a longer duration compared to White women.

• Greater Severity of Symptoms: Studies, such as the Study of Women's Health Across the Nation (SWAN), have shown that Black women often report more frequent and intense hot flashes and night sweats. They also experience greater sleep disturbances.

• Increased Health Disparities: Women of color often face higher rates of conditions like hypertension, diabetes, and obesity—conditions that can be exacerbated by perimenopausal metabolic changes and disproportionately impact cardiovascular health. Systemic racism and chronic stress from discrimination can also elevate cortisol levels and influence symptom severity.

• Access & Trust in Healthcare: Historical and ongoing inequities in the healthcare system mean women of color may encounter barriers to accessing knowledgeable providers, experience bias, or face skepticism about their symptoms, leading to delayed diagnosis and inadequate treatment. They may also be less likely to be offered appropriate interventions like Hormone Replacement Therapy (HRT).

Why it matters: A one-size-fits-all approach to perimenopause leaves many women behind. Amplifying the voices and experiences of women of color is essential for equitable healthcare, culturally competent care, and ensuring all women receive the tailored support they deserve.

A woman of color sits in a medical office with a healthcare provider, looking frustrated while scrolling on her phone. Floating search queries like “perimenopause symptoms” and “why do I feel so tired” highlight her struggle to find reliable answers. A table nearby holds supplement bottles, underscoring the confusion many women face when seeking help for midlife health changes.

This World Perimenopause Day 2025: Let's Demand More

The global conversation around perimenopause must evolve beyond symptom management. It’s time for holistic empowerment. On World Perimenopause Day 2025, let’s commit to:

🌸 Deeper Education – for women, their families, and healthcare providers, so that knowledge leads to action.

🌸 Destigmatization – normalizing these experiences so no woman feels she has to suffer in silence.

🌸 Equitable Care – ensuring all women, regardless of race, culture, or background, have access to informed, compassionate, and personalized treatment.

🌸 Proactive Strategies – seeing perimenopause not as decline, but as an opportunity to optimize health, resilience, and successful aging.

Perimenopause is not just a stage of life—it is a turning point. Together, let’s raise our voices, break the silence, and demand better care, better education, and better futures for women everywhere.

At Macvelly Wellness, we champion an integrated approach to perimenopause, recognizing its multifaceted nature. Our Direct Primary Care model offers the unhurried time and personalized attention needed to address your unique hormonal, metabolic, and mental health challenges. We are here to listen, educate, and partner with you to navigate this significant life stage with confidence and vitality.

You are not alone. Your symptoms are real. Your health matters. Contact Macvelly Wellness today to embark on a personalized perimenopause journey.