Anxiety and Mood Changes in Early Perimenopause: Why They Happen and How Nutrition Can Help
Are you feeling more anxious, overwhelmed or emotionally reactive than usual? You're not imagining it.
Many women expect the first signs of perimenopause to be hot flushes and period changes. Instead, for many, the earliest symptoms are psychological. Anxiety, irritability, low mood, brain fog, lower resilience to stress, poor concentration and feeling emotionally ‘off’ are often some of the first signs that hormones are beginning to change.
The good news? While hormonal changes are part of the picture, they are rarely the whole story. Nutrition, lifestyle habits, sleep, stress and nutrient status all influence how resilient your brain and nervous system are during this transition.
As a Clinical Nutritionist, I take a whole-person approach to supporting women through perimenopause. Rather than simply trying to suppress symptoms, we look at creating the physical foundations that allow your brain and body to adapt to changing hormones more effectively.
Why Does Anxiety Increase During Early Perimenopause?
Perimenopause typically begins during the late 30’s and early 40’s. During this stage, hormone levels fluctuate rather than simply decline, particularly oestrogen and progesterone. In early perimenopause, more oestrogen starts being produced as the ovaries become less responsive, and progesterone declines as ovulation becomes less predictable. Your periods may get heavier but still be regular during this time, or your cycle becomes shorter by one or two days. PMS may be more noticeable.
These hormonal fluctuations influence several important brain chemicals involved in mood.
Oestrogen and the Brain
Oestrogen has powerful effects on the central nervous system. It helps regulate:
serotonin - our ‘feel good’ neurotransmitter
dopamine - important for motivation, focus and reward
GABA - our main calming neurotransmitter
brain energy production
inflammation
blood flow to the brain
When oestrogen becomes unpredictable (some months may be higher, others may be ‘normal’), many women notice:
increased anxiety
low mood
reduced stress resilience
brain fog
poorer memory
sleep disturbances
Progesterone and Calm
Progesterone naturally activates GABA receptors, helping us feel calm and relaxed.
As progesterone begins to decline during perimenopause, women may experience:
feeling ‘on edge’ more often
racing thoughts, unable to switch off
increased sensitivity to stress
disrupted sleep
irritability
If you've previously coped well with life's demands but suddenly find everyday stress overwhelming, fluctuating progesterone may be contributing.
Why Nutrition Matters More Than Ever
Hormones don't work in isolation, they often influence (and are influenced by) many different areas and organs of the body. Your brain is one of them. This complex organ requires a constant supply of nutrients to produce neurotransmitters, generate energy and regulate the nervous system.
Unfortunately, many women in their 40’s are juggling children, careers, ageing parents, relationship pressures and poor sleep - all of which increase nutrient requirements while making healthy habits harder to maintain - for example a lack of sleep increases our cravings for carbohydrates, which can make us feel sluggish and more irritable as our blood sugar fluctuates.
Supporting your body nutritionally won't eliminate the hormonal fluctuations your body is going through, but it can significantly improve your ability to adapt to them.
1. Prioritise Protein at Every Meal
Protein is getting a lot of attention these days, but it can often be overlooked when it comes to women's mental wellbeing.
Protein provides amino acids, which are the building blocks used to make neurotransmitters important for regulating mood, including serotonin and dopamine, and even melatonin for sleep.
Eating adequate protein also:
stabilises blood sugar
improves energy
reduces afternoon crashes and food cravings
supports satiety
helps preserve muscle mass, important during midlife when muscle mass starts to decline
Blood sugar fluctuations can mimic or worsen anxiety by triggering stress hormones such as adrenaline and cortisol. Many women mistake these crashes for hormone related anxiety, when unstable blood sugar is playing a significant role.
Where to get it from:
Everyone’s unique protein needs are different depending on their height, weight and activity levels, however the rough guide is to aim for approximately 20-30g of protein per meal at a minimum.
If this seems like a challenge to you, start with prioritising protein at breakfast as this can help stabilise mood and energy levels for the rest of the day.
Good choices include:
eggs (3x whole eggs = 18g protein)
Greek yoghurt (½ cup = ~10g protein)
fish (100g salmon fillet = 20g protein)
chicken (80g chicken breast = 25g protein)
lean beef (70g beef fillet = 18-22g protein)
tofu (170g = 15g protein)
tempeh (100g = 20g protein)
legumes (½ cup cooked lentils = 10-12g protein, ½ cup cooked soy beans = 14g protein))
cottage cheese (½ cup serve = 10-12g protein)
2. Support Brain Energy with Creatine
Creatine isn't just for athletes and building muscle. Emerging research suggests creatine may support brain function, cognitive performance and mental health, particularly in women in midlife.
Creatine is converted into a compound called phosphocreatine which is used in the process of replenishing ATP, the body's main energy molecule. The brain has exceptionally high energy requirements utilising extensive amounts of ATP, and during periods of hormonal fluctuation or chronic stress, those energy demands increase, so creatine can step and in and help boost mental energy.
Research suggests creatine may support:
mental fatigue
memory
cognitive performance
recovery from stress
depressive symptoms (when used alongside appropriate medical care)
Women may particularly benefit because they generally consume less creatine through diet than men.
Where to get it from:
Creatine is naturally found in high protein foods such as:
beef
lamb
fish
Creatine supplements are increasingly popular, with a maintenance dose being around 3–5 g daily of creatine monohydrate for cognitive health. It is generally well tolerated for healthy adults, but supplementation should always be discussed with your healthcare practitioner, particularly if you have kidney disease or other medical conditions. Higher doses can cause gastrointestinal symptoms.
3. L-Theanine for Calm
L-theanine is a naturally occurring amino acid found in green tea. It helps promote alpha-brain wave activity in the brain, boosts calming GABA production and modulates other neurotransmitters. It can cross the blood-brain barrier and induce feelings of calm alertness and focus.
Research suggests L-theanine may:
promote relaxation
reduce perceived stress
improve attention
support sleep quality
Unlike sedatives, it generally promotes calm without causing significant drowsiness.
Where to get it from:
L-theanine is naturally found in the leaves of the tea plant Camellia sinensis. Green tea is the richest source, with matcha containing the highest concentrations. White tea and black tea also contain l-theanine but in slightly lesser amounts. It is also available in supplement form.
4. Magnesium: The Stress Nutrient
Magnesium is involved in more than 300 biochemical reactions throughout the body. Due to this it has extensive functions all over the body. It has been shown to support:
nervous system regulation
muscle relaxation
sleep
blood sugar regulation
energy production
When we are stressed, we produce more cortisol and adrenaline which are known as our stress hormones. When these hormones are produced, we utilise more magnesium and in turn excrete more through the kidneys, lowering magneisum levels. Low magnesium may worsen stress resilience, creating a frustrating cycle.
Where to get it from:
pumpkin seeds, chia seeds
almonds
leafy greens including spinach, Swiss chard and kale
cashews
dark chocolate
legumes
5. Omega-3 Fatty Acids for Brain Function
The brain is approximately 60% fat, making dietary fats essential for healthy brain function. Key omega-3 fats important for brain health include EPA and DHA. EPA has anti-inflammatory actions, and DHA is found in highest concentrations in the brain and is important for brain cell membranes and nerve communication.
Together they play important roles in:
brain cell communication
mood regulation
inflammation
cognitive function
Research suggests higher intakes of omega-3 fats are associated with lower rates of depression, while EPA-rich supplements may be beneficial for some people experiencing depressive symptoms as part of an overall treatment plan.
Where to get it from:
Omega 3-fats EPA and DHA can be obtained from oily fish (salmon, mackerel, anchovies, sardines, herring), seafood and algal oil. Plants such as chia seeds, flax seeds and walnuts contain ALA omega-3 fats which are converted in our bodies to EPA and DHA, but quite poorly, therefore they should not be relied upon for our EPA and DHA needs. If you do not eat fish, a fish oil or algal oil supplement might be a better option for you.
6. B Vitamins for Mood and Energy
There are a number of different B vitamins in this group and together they are essential for:
neurotransmitter production
methylation
energy production
nervous system function
Vitamin B3, B6, folate (B9) and vitamin B12 are particularly important for producing serotonin and dopamine.
Low levels may contribute to:
fatigue
poor concentration
low mood
Where to get it from:
B vitamins are found in a wide variety of plant and animal foods, such as :
leafy greens
eggs
seafood
legumes
wholegrains
meat
Vitamin B12, which is crucial for processes such as DNA production, making red blood cells and healthy nerve function, can only be obtained through animal products. If you are a vegan, or do not eat much meat, eggs or dairy, I recommend getting your B12 levels checked and supplementing if necessary.
7. Iron: Key for Fatigue
Heavy or irregular periods are common during early perimenopause. For some women, this can gradually deplete iron stores, the more depleted we are, the heavier periods can become and the more depleted get in a vicious cycle.
Low iron can contribute to:
fatigue
poor concentration
reduced exercise tolerance
low mood
restless legs
Where to get it from:
Iron is found in liver, red meat, seafood, eggs, legumes, beans, leafy greens and pumpkin seeds. If you do not think you are getting enough iron, it is important to investigate iron status with appropriate pathology testing rather than supplementing blindly, as excess iron can also be harmful.
8. Vitamin D
Vitamin D, or the sunshine vitamin, acts more like a hormone than a vitamin. It plays an important role in mood, immunity and hormone balance, with low levels being associated with:
depression
poorer immune health
fatigue
Where to get it from:
Vitamin D mainly comes from sunlight and is hard to obtain from food alone. Deficiency is common, especially in the winter months when daylight hours are limited, and in those with limited sun exposure (such as those working inside most of the day). Testing can help determine whether supplementation is appropriate and how much to supplement with.
Lifestyle Habits That Make a Difference
Nutrition is a great help but it is only one piece of the puzzle. Some of the biggest improvements I see my clients come from combining nutrition with sustainable lifestyle changes.
Strength Training
Resistance training helps:
improve insulin sensitivity
preserve muscle mass
support bone health
improve mood
increase confidence
Aim for two to three sessions each week where possible. Seek assistance from a physiotherapist or exercise physiologist to do this safely if you have not done strength training before.
Daily Movement
Walking, cycling, swimming and yoga all support:
stress reduction
improved blood sugar control
better sleep
emotional wellbeing
blood flow to the brain
Even 20–30 minutes of movement most days can make a meaningful difference - whatever you can manage to fit in.
Prioritise Sleep
Sleep is so important for mental wellbeing, however disruption to sleep is unfortunately incredibly common during perimenopause. This can be frustrating as poor sleep also increases:
cortisol (reducing stress tolerance)
appetite (increasing carbohydrate cravings)
insulin resistance
anxiety
emotional reactivity
Creating a consistent, calming sleep routine and addressing underlying contributors with your natural health practitioner can significantly improve overall wellbeing.
Support Your Nervous System
Your nervous system responds to far more than hormones. It picks up positive and negative inputs all day long, from a moment of laughter with the kids at bedtime, to a worrying news article you read when you woke up.
Daily practices that help calm down our nervous system and improve stress resilience include:
mindful breathing or meditation
spending time in nature
reducing screen exposure before bed and upon waking
enjoyable hobbies
meaningful social connection
One of the most overlooked aspects of health is making space for joy. Creativity, laughter, play and activities that genuinely energise you are not luxuries, they help regulate the nervous system and buffer the effects of chronic stress.
When Supplements Can Help
Supplements can be incredibly valuable but they're most effective when chosen for your individual needs.
Rather than spending your hard-earned cash on multiple supplements recommended by friends or social media, a personalised approach considers your symptoms, diet, medications, health history and pathology testing where appropriate, to work out what is right for you.
Always speak with your healthcare practitioner before starting supplements, especially if you take prescription medications, have existing health conditions or are pregnant or breastfeeding.
You don’t have to just put up with your symptoms
Many women are told anxiety and mood changes are simply part of perimenopause and getting older.
While hormonal changes do happen, struggling with them doesn't have to become your new normal.
Supporting your body through good nutrition, stabilising blood sugar, replenishing key nutrients, caring for your nervous system and addressing lifestyle factors can make a profound difference to how you experience perimenopause.
If you're noticing increasing anxiety, mood changes, brain fog or simply don't feel like yourself anymore, a personalised nutrition and lifestyle plan may help uncover some of the contributing factors and support you through this next chapter with greater confidence and resilience. Check-out my consultations and packages here, or click here to organise a complimentary 15-minute chat to see how I can help you.
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