PERIMENOPAUSE/MENOPAUSE
What is perimenopause? Menopause?
Perimenopause is the transitional period leading up to menopause, when the ovaries gradually produce less estrogen and hormone levels begin to fluctuate — often unpredictably. It typically starts in a woman's 40s (though it can begin earlier) and can last anywhere from a few years to a decade. Menopause itself is a single point in time, officially marked after 12 consecutive months without a menstrual period, usually around age 51 in the U.S.
Why Menopause-Related Mental Health Is Often Missed
Perimenopause can begin years before menstrual periods actually stop, and its psychiatric symptoms — anxiety, low mood, irritability, cognitive fog — are frequently misattributed to stress, aging, or an unrelated primary psychiatric diagnosis. Many patients are treated for depression or anxiety without anyone connecting the change to a hormonal transition, which can mean treatment plans miss the underlying driver. Dr. Borman's clinical background, including prior training in Obstetrics and Gynecology, is used specifically to evaluate whether hormonal shifts may be contributing to psychiatric symptoms — and to coordinate care with a patient's OB/GYN or primary care provider where appropriate.
Conditions & Symptoms Treated
New or worsening anxiety during perimenopause
Depression related to hormonal transition
Mood swings and irritability linked to fluctuating estrogen and progesterone
Sleep disruption contributing to mood or cognitive symptoms
"Brain fog," difficulty concentrating, and memory changes during perimenopause
Worsening of pre-existing anxiety, depression, or ADHD during the menopause transition
Approach to Treatment
Evaluation includes a full psychiatric history along with a discussion of menstrual and hormonal history, since perimenopause can present very differently from patient to patient. Treatment options may include medication management, hormone therapy, and lifestyle-focused strategies — always tailored to the individual rather than a one-size-fits-all protocol.
You Don't Have to Just "Push Through It"
If you're in your 40s or 50s and noticing new anxiety, mood swings, or a mental fog that doesn't match how you've always felt, that's worth a real evaluation — not a dismissal as "just getting older." These symptoms are common, but common doesn't mean they have to go untreated.