October holds two dates I never used to connect. It's Menopause Awareness Month, and the 10th is World Mental Health Day. A few years into perimenopause, I think they belong on the same page.

For a long time I filed my moods under "busy". The short fuse at home. The flat weeks that turned up for no reason I could name.

It took me far too long to ask whether my hormones were part of the picture. If you're asking the same question, the evidence is worth knowing.

Can perimenopause affect your mental health?

It can. During perimenopause, oestrogen and progesterone rise and fall unpredictably, and oestrogen affects brain chemicals linked to mood, such as serotonin. healthdirect lists low mood, irritability, worry and brain fog among the changes women notice.

Hormones aren't the whole story. Broken sleep from night sweats can make everything feel heavier, and midlife often stacks work pressure on top of caring for parents or kids.

Your history counts too. Mood changes are more likely if you've found your mood hard to manage before, including after having a baby or in the days before your period. If that's you, it may help to talk to your GP early in perimenopause, before things build.

For some women it shows up as worry more than flatness. If that sounds like you, this guide to feeling on edge during perimenopause has more.

How menopause symptoms affect Australian women's mental health

In the 2023 National Women's Health Survey, they asked a random, representative sample of Australian women about symptoms they put down to menopause. Among women aged 45 to 64 who'd been bothered by those symptoms, 58% said their mental and emotional wellbeing had taken a hit.

The same survey had better news for later on. Across all women 65 and over, fewer than one in 10 said menopause-type symptoms had affected their mental and emotional wellbeing, compared with nearly two in five midlife women. I find that strangely comforting, because it suggests the hardest stretch may have an end point.

The report's co-authors, who include the Australasian Menopause Society and Monash University, also warn against catastrophising menopause. I agree with them. Plenty of women move through it with mild or manageable symptoms, and talking about it as a disaster can wear down the resilience we already have.

Why so many women wait to ask for help

This is the part of the survey that stopped me. Just over a third of midlife women bothered by these symptoms hadn't spoken to a doctor about them, and their reasons will sound familiar.

Source: Jean Hailes 2023 National Women's Health Survey.

Nearly two in three said their symptoms weren't bad enough. I used that line on myself for about two years. "Bad enough" keeps moving when you're tired and low, so I've stopped using it as the test.

One in four didn't think anything could be done. That's the belief I'd most like to retire. healthdirect lists counselling, cognitive behavioural therapy and mindfulness-based therapy as options, and your GP can talk you through medicines, including hormone therapy, if your symptoms are moderate or severe.

Everyday ways to look after your mental health in menopause

None of these replace proper support. They have made my heavier weeks more manageable, though, and they're a good place to start while you book that appointment.

• Keep a mood and sleep diary for a few weeks. A line a day is plenty, and it gives your GP something concrete to work with.
• Get outside and move. A 20-minute walk counts, and strength training is worth adding when you have the energy. Beyond Blue lists staying active among the everyday changes that may support your mental health in perimenopause and menopause.
• Take five quiet minutes. Mine happen on the back step with a cup of tea, breathing slowly before anyone else is up. Mindfulness and relaxation exercises may help ease stress, and they cost nothing.
• Go easy on alcohol. The wine that takes the edge off at 6pm can turn into a 3am wake-up and a flatter next day.
• Tell one person. Saying it out loud to a friend who'd been there took more nerve than everything else on this list, and it helped the most.

When to see your GP about low mood in menopause

healthdirect's guidance is clear. See your doctor if mental health symptoms last longer than two weeks, are getting worse, affect your work, relationships or daily life, or disrupt your sleep on most nights.

Your GP can help work out whether menopause, another health condition or something else is behind how you feel. They may also be able to set up a Mental Health Treatment Plan, which can give you Medicare-subsidised sessions with a psychologist. If you'd like to sort through your thoughts first, this gentle check-in on how you're really feeling is a useful read before your appointment.

If you need someone to talk to sooner, Beyond Blue is on 1300 22 4636. Lifeline is on 13 11 14, or you can text 0477 13 11 14. If you're in immediate danger, call 000.

This October, I'm giving my mind the same attention I'd give a sore knee. If yours has felt heavier lately, a GP appointment this month is a good place to start.

Shine on.

This article is general information only. It doesn't replace advice from your doctor or a mental health professional.