Jane Robertson is a GP with an interest in the menopause
It is worth remembering that the psychological symptoms of the perimenopause can began in your early or mid 40's.
These symptoms often include irritability, PMS-type symptoms, or a lowering of mood/increase with anxious feelings, or feelings of self doubt/lack of confidence. It may be just one or two of these symptoms or it may be many of these and they may well vary enormously from month to month or be fairly consistent.
They can happen before any changes in your menstrual cycle and way before any sweats/flushes or other perimenopausal symptoms. It is common to put these feeling down to stress at work or a busy family life and to try and dismiss them or ignore them but may often indicate the start of the perimenopause.
Friends or relatives (or indeed your GP!) may unhelpfully say something like “but you’re far too young for the perimenopause” but these symptoms are commonly recognised to be part of the perimenopause and can really improve with the right dose and type of HRT.