--- title: Perimenopause mood swings and crying: causes and help description: Perimenopause mood swings and crying happen as estrogen swings erratically. Here's why it happens, how long it lasts, and what can help right now. url: https://niyora.com/symptoms/perimenopause-crying/ --- - [Niyora](https://niyora.com/) - [Symptoms](https://niyora.com/symptoms/) - Perimenopause mood swings and crying: causes and what helps Symptom # Perimenopause mood swings and crying: causes and what helps Crying more often in perimenopause is common, and it's usually tied to estrogen swinging erratically rather than falling in a steady curve, the same hormone-sensitivity pattern seen in PMDD. It doesn't follow your old PMS rhythm, so it can show up at unpredictable times as your cycle changes shape. HRT, SSRIs and therapy can all help when it's hard to get through, but a doctor needs to be part of that decision. Updated 14 October 2026 Niyora editorial Moderate evidence ## At a glance - Crying more in perimenopause is usually linked to estrogen swinging erratically, not falling in a steady curve. - It doesn't follow the usual PMS calendar, because your own cycle is becoming unpredictable. - A history of depression or PMDD makes you more likely to notice mood symptoms again now. - HRT, SSRIs and CBT can all help, but the type and dose matter, and a doctor should guide the choice. - Crying or low mood that takes up a week or more of most months is worth getting checked out. ## Strength of evidence Moderate evidence - None - Limited - Mixed - Moderate - Strong The hormone-sensitivity model comes from reviews and hormone research ( [1], [4], [7]). A meta-analysis found no abnormal hormone levels in perimenopausal depression, pointing to reactivity, not deficiency ( [5]). HRT dose effects on mood come from a crossover trial ( [6]); vitamin D evidence is still preliminary ( [3]). ## Why does perimenopause cause crying? Perimenopause crying happens mainly because estrogen stops rising and falling on a predictable monthly schedule and starts swinging unpredictably, sometimes up and down within the same week. That erratic pattern, not a steady decline, is what unsettles mood for many women. Progesterone drops too, but it's the unpredictable swings in estrogen that researchers link most closely to mood changes in this transition ( [7]). Some women's brains react more strongly to any hormone shift, whether it's rising or falling. A recent review describes this as a hormone-sensitivity model: the hormone levels themselves are normal, but the brain's response to their movement is stronger in some women than others ( [4]). This is the same mechanism thought to drive PMDD, and researchers have found that women with a history of [PMDD crying](https://niyora.com/symptoms/pmdd-crying/) or cycle-linked depression are more likely to notice mood symptoms again as perimenopause begins ( [1]). In short, three things are driving it: - Estrogen swinging erratically instead of falling in a steady curve. - A brain that reacts more strongly to that swing than others do. - A past history of PMDD or cycle-linked depression, which raises the odds of noticing it now. Crying in perimenopause isn't a sign that something is wrong with you. It's a brain working through hormone turbulence that is, for now, outside your control. ## How is perimenopause crying different from PMS? PMS crying follows a pattern: it shows up in the week or two before your period and eases once bleeding starts. Perimenopause crying doesn't keep that rhythm, because the cycle itself is changing. | Feature | PMS | Perimenopause | | --- | --- | --- | | Timing | Last 1–2 weeks before your period | Any day, as cycles become unpredictable | | Hormone pattern | A steady rise and fall each cycle | Estrogen swings up and down erratically ( [4]) | | Resolves when | Within a few days of your period starting | Doesn't reliably ease, can carry across cycles | | Your periods | Regular | Can shorten, lengthen, or skip some months | If you've always had [crying before your period](https://niyora.com/pms/crying/) or noticed it worse in the [luteal phase](https://niyora.com/cycle/luteal-phase-crying/), perimenopause can bring that same sensitivity back, just without the predictable calendar you used to rely on. One review found that an important subset of women with a past mood disorder tied to their cycle are especially likely to feel this again as estrogen becomes erratic in the early transition ( [1]). Right now Riding out a crying spell right now - 1 Let the tears come instead of holding them back; it's a release, not a failure. - 2 Splash cold water on your face or press a cold pack to your wrists for 30 seconds. - 3 Step outside for five minutes and let the light and air change the moment. - 4 Write one line about what set it off so you can look back once you're calmer. - 5 Text someone just to say you're having a hard few minutes, nothing more needed. Niyora walks you through this when it happens: - Calm down - - See it another way - - Choose what to say ## How long does perimenopause crying last? There's no fixed timeline, because perimenopause itself doesn't run on one. It can last several years, and mood symptoms tend to track the stretch when cycles are at their most unpredictable, not yet stopped but no longer regular. Hormone levels during this time aren't abnormal. A meta-analysis of 63 studies found no measurable difference in reproductive hormone levels between women with perimenopausal depression and women without it ( [5]). What differs is the erratic pattern, and how strongly a woman's brain reacts to it. Women with a lifetime history of depression may enter this transition earlier. In the Harvard Study of Moods and Cycles, women with more pronounced depressive symptoms who also used antidepressants had nearly three times the risk of an earlier perimenopausal transition than women with no depression history (hazard ratio 2.7, 95% CI 1.5–4.8) ( [2]). For most women, crying spells ease once hormones settle after the final period. If you want a clearer sense of whether your mood still lines up with your cycle, [the PMS quiz](https://niyora.com/quiz/) can help. ## Can HRT or antidepressants help? Guidelines list a few options, and a doctor decides which, if any, fits your situation. None of these cure the transition, but they can ease how hard it feels. | Option | What it does | Evidence strength | | --- | --- | --- | | HRT (estrogen with a progestin or progestogen) | Replaces the erratic estrogen pattern with a steadier level | Dose dependent: a randomized trial found a higher estrogen dose caused significantly more tension, irritability, and low mood during the progestin phase than a lower dose (P<0.001) ( [6]) | | SSRIs | Can ease mood symptoms tied to reproductive hormone shifts | Established in reproductive psychiatry reviews ( [7]) | | CBT | Gives you tools to work through the thoughts that come with low mood | Recommended alongside medical options ( [1]) | | Vitamin D | Studied as a possible support for perimenopausal depression | Still limited; a systematic review is underway ( [3]) | The dose and the specific hormone combination matter as much as whether you try HRT at all. That's why a doctor might adjust a prescription rather than rule hormone treatment out entirely. No one should start or stop a medication without that conversation. ## What helps in the moment? When the crying starts and you don't know exactly why, you don't need to work out the hormones right then. A few things can help you get through it. - Let the tears come instead of fighting them. Holding them back often makes the tight feeling in your chest worse. - Splash cold water on your face or press something cold to your wrists for 30 seconds. It can slow a racing heartbeat. - Step outside, even for five minutes. A change of light and air can shift the moment. - Write down what set it off, even one line. Looking back later, it often turns out smaller than it felt. - Text someone just to say you're having a hard few minutes and don't need anything back. For more ways to work through a crying spell that won't let up, see [how to stop crying](https://niyora.com/blog/how-to-stop-crying/). In the moment If you want somewhere to put what happened once the crying passes, Niyora is a PMS and PMDD support app. Its Moon feature lets you write down what happened, see it from another angle, and decide what, if anything, you want to say, once you're calmer. ## When does perimenopause crying need medical help? Crying that comes with hormone swings is common in perimenopause, and it fits the hormone-sensitivity pattern described earlier. A few signs are worth tracking: - Crying or low mood most days for two weeks or more. - Episodes that don't ease even on calmer days. - Thoughts that you can't go on like this, or thoughts of hurting yourself. Because your cycle length itself may be changing, the usual day by day pattern can be harder to see than it used to be. Tracking symptoms by date rather than by cycle day can help you and a doctor spot whether hormones, something else, or both are driving it. [Perimenopause mood changes](https://niyora.com/perimenopause-mood/) covers the wider picture if you want to see how this fits with anxiety or anger too. When to see a doctor If this takes a week of every month, or you have thoughts of hurting yourself, see a GP or gynecologist, and bring two months of daily notes. From the research library ## Research on perimenopause 259 studies in the library look at perimenopause in PMS and PMDD. They were published from 1975 to 2026, and each one has a short summary of what was tested and found. 259 studies, 1975 to 2026 How strong the studies are Strong study design 16 Moderate study design 95 Early or limited evidence 148 - [Systematic review, 2026Why do some women experience mood changes linked to their menstrual cycle?Evidence shows these women have normal hormone levels but heightened sensitivity in their brains and cells to hormone changes. This explains PMDD and some postpartum and perimenopausal mood problems, and has led to new treatments.Strong study design](https://niyora.com/research/papers/not-broken-just-sensitive-a-systematic-review-of-hormones-mood-and-the-female-2026/) - [Guideline, 2024How should Xiangshao Granules be prescribed for premenstrual tension syndrome?Experts from 29 major hospitals have created standardized guidelines on how to use Xiangshao Granules for premenstrual tension, including dosage and timing. These recommendations come from multidisciplinary experts' review of current evidence.Strong study design](https://niyora.com/research/papers/expert-consensus-on-clinical-application-of-xiangshao-granules-2024/) - [Systematic review, 2023Does saffron help with PMS, labor pain, and menopause symptoms?Yes, saffron improves mood and reduces psychological symptoms of PMS and menopause, and helps reduce labor pain and recovery time, though limited studies exist.Strong study design](https://niyora.com/research/papers/efficacy-of-saffron-crocus-sativus-l-in-premenstrual-syndrome-labor-childbirth-2023/) - [Cohort study, 2023Do women with premenstrual disorders go through menopause earlier and have worse hot flashes?Yes. Women with premenstrual disorders went into menopause about 2.67 times earlier and were more likely to have moderate or severe hot flashes (68.3% versus 55.3%).Strong study design](https://niyora.com/research/papers/premenstrual-disorders-timing-of-menopause-and-severity-of-vasomotor-symptoms-2023/) - [Review, 2018Which women are most likely to experience hot flashes during menopause?Up to 80% of women experience hot flashes during menopause, lasting about 10 years on average. Black and Hispanic women are more likely to experience them, while Asian women are less likely.Strong study design](https://niyora.com/research/papers/vasomotor-symptoms-across-the-menopause-transition-differences-among-women-2018/) - [Review, 2017Can combining different types of treatments help PMS more than using one approach alone?Yes. An integrative approach combining medicines, supplements, mind-body techniques, acupuncture, and lifestyle changes can effectively address PMS.Strong study design](https://niyora.com/research/papers/integrative-women-s-health-2017/) ### Clinical trials - [Transcutaneous Auricular Neurostimulation (tAN) for Premenstrual Dysphoric Disorder (PMDD) and PerimenopauseRecruiting now, United States](https://niyora.com/research/trials/transcutaneous-auricular-neurostimulation-tan-for-nct07688720/) - [CREST: Samphire Guided Care Program on Wellbeing, Work Productivity, and Quality of LifeRecruiting now, United States](https://niyora.com/research/trials/crest-samphire-guided-care-program-on-wellbeing-work-nct07679074/) - [Examining the Impact of Phytoestrogens Supplementation on the Gene Expression, and Premenstrual Syndrome in Primenopausal WomenBy invitation, Jordan](https://niyora.com/research/trials/examining-the-impact-of-phytoestrogens-supplementation-on-nct07310485/) [See all 259 studies on perimenopause and menopause](https://niyora.com/research/topics/comorbidity-perimenopause/) ## Questions people ask Is crying a lot a normal part of perimenopause? + Yes, crying more often is a common part of perimenopause. It usually comes from estrogen swinging up and down unpredictably rather than following its old monthly rhythm. That doesn't mean nothing is wrong when you feel it, but the pattern itself fits what many women experience during this transition. Why do I cry over small things during perimenopause? + Perimenopause crying over small things usually happens because your brain is reacting to a hormone shift, not because the thing itself is actually that big. Some women's brains respond more strongly to any change in estrogen, rising or falling, which can make a minor frustration feel heavier than it would otherwise. Is perimenopause crying a sign of depression? + Perimenopause crying isn't automatically depression, but the two can overlap. If low mood, loss of interest, or crying last most days for two weeks or more, that pattern fits depression rather than hormone swings alone. Mention it to a doctor so it can be looked at properly. How is perimenopause crying different from PMDD crying? + PMDD crying follows the same week or two before every period and eases once bleeding starts. Perimenopause crying can show up at unexpected times because cycles are already changing shape. Some women with a PMDD history notice both patterns overlapping as the transition begins. Can perimenopause crying go away on its own? + Perimenopause crying often eases once hormones settle after your final period, but that can take time, since the transition itself lasts years for many women. Until then, HRT, antidepressants, or therapy can help if the crying is frequent or hard to manage, with a doctor guiding the choice. ## Sources - 1. [Premenstrual Mood Symptoms in the Perimenopause](https://doi.org/10.1007/s11920-021-01285-1), Current psychiatry reports, 2021 - 2. [Depression and its influence on reproductive endocrine and menstrual cycle markers associated with perimenopause: the Harvard Study of Moods and Cycles](https://doi.org/10.1001/archpsyc.60.1.29), Archives of general psychiatry, 2003 - 3. [Association analysis between vitamin D level and depression in women perimenopause: A protocol of systematic review and meta-analysis](https://doi.org/10.1097/md.0000000000020416), Medicine, 2020 - 4. [Not Broken, Just Sensitive- A Systematic Review of Hormones, Mood and the Female Mind Across the Reproductive Lifespan](https://doi.org/10.53365/nrfhh.2310), Natural Resources for Human Health, 2026 - 5. [Variation in genes and hormones of the hypothalamic-pituitary-ovarian axis in female mood disorders - A systematic review and meta-analysis](https://doi.org/10.1016/j.yfrne.2021.100929), Frontiers in neuroendocrinology, 2021 - 6. [Increase of estrogen dose deteriorates mood during progestin phase in sequential hormonal therapy](https://doi.org/10.1210/jc.2002-020755), The Journal of clinical endocrinology and metabolism, 2003 - 7. [Reproductive Steroid Regulation of Mood and Behavior](https://doi.org/10.1002/cphy.c150014), Comprehensive Physiology, 2016 Ask AI about this page Copy prompt ChatGPT ↗ Claude ↗ Perplexity ↗ Google AI Mode ↗ Grok ↗ On this page - [Why does perimenopause cause crying?](#why-does-perimenopause-cause-crying) - [How is perimenopause crying different from PMS?](#how-is-perimenopause-crying-different-from-pms) - [How long does perimenopause crying last?](#how-long-does-perimenopause-crying-last) - [Can HRT or antidepressants help?](#can-hrt-or-antidepressants-help) - [What helps in the moment?](#what-helps-in-the-moment) - [When does perimenopause crying need medical help?](#when-does-perimenopause-crying-need-medical-help) - [Research](#research) - [Questions](#faq) Niyora PMS & PMDD support For the hard moment before your period. Private, no account. [Get it on iPhone](https://apps.apple.com/app/niyora-pms-emotions/id6764561688) ## Keep reading Condition Perimenopause mood swings: rage, anxiety and low mood Guide All symptoms Guide Crying Symptom PMDD crying spells: what they feel like and what helps Symptom Uncontrollable crying during your period: why it happens Cycle guide Luteal phase crying: what's behind it and what helps Article How to stop crying when you can't stop, and what helps Guide PMS calculator Guide Take the two-minute check