Root Causes of Anxiety & Depression in Perimenopause

For many women, the transition into perimenopause and menopause doesn’t just come with hot flashes and sleep disruptions — it can also bring unexpected emotional changes. Anxiety, low mood, irritability, or even feelings of hopelessness can creep in, often without warning. These symptoms are often the result of deeper imbalances in the body that can be supported and corrected.

Rather than seeing anxiety and depression as random or inevitable parts of aging, functional nutrition takes a deeper look at why these symptoms are showing up in the first place. Let’s explore some of the common root causes of emotional changes during perimenopause and menopause — and what you can do about them.

Hormonal Imbalances: Are Your Estrogen & Progesterone Levels Out Of Sync?

As women move through their 40s and beyond, levels of progesterone — a calming, mood-stabilizing hormone — naturally decline. When progesterone becomes too low relative to estrogen, a state known as estrogen dominance can occur. This imbalance is often linked with increased anxiety, irritability, and difficulty sleeping.

Low estrogen levels can also affect mood by altering serotonin and dopamine production — key neurotransmitters responsible for emotional well-being.

The Gut-Brain Connection

Over 90% of serotonin is produced in the gut, not the brain. When the gut is inflamed or imbalanced — a condition known as dysbiosis — it can affect how neurotransmitters are produced and used. Women with a history of digestive issues such as bloating, constipation, food sensitivities, or IBS may be more likely to experience emotional symptoms as hormone levels fluctuate.

Poor gut health also contributes to systemic inflammation, which has been linked to both depression and anxiety in numerous studies.

Missing Nutrients

Key nutrients like magnesium, B vitamins, vitamin D, and omega-3 fatty acids play essential roles in mood regulation and hormone metabolism. Unfortunately, these are also the nutrients many women are deficient in — especially during periods of stress or hormonal shifts.

Magnesium, for example, helps calm the nervous system, supports progesterone production, and reduces the physical effects of stress. A deficiency can contribute to both anxiety and disrupted sleep.

Blood Sugar Imbalance and Cortisol Spikes

Blood sugar swings can cause symptoms that mimic anxiety — racing heart, irritability, shakiness, and fatigue. Over time, unstable blood sugar can also place excess stress on the adrenal glands, leading to cortisol dysregulation. Cortisol, our main stress hormone, can interfere with both progesterone production and mood stability when it’s chronically high or low.

So What Can You Do?

If you're experiencing increased anxiety or low mood, here are a few first steps:

Focus on a whole-food, blood sugar-balancing diet

Include protein, healthy fats, and fibre at each meal. Avoid skipping meals or relying on sugar and caffeine to get through the day.

Support your gut

Eat fermented foods like sauerkraut or kefir (if tolerated), increase fibre from vegetables, and consider a quality probiotic under the guidance of a practitioner.

Optimize nutrient intake

Include magnesium-rich foods (leafy greens, pumpkin seeds, dark chocolate), omega-3s (wild salmon, flax), and consider testing nutrient levels to identify deficiencies.

Prioritize stress reduction and sleep

Try gentle practices like breath work, stretching, prayer or journaling before bed. Rest is essential for hormone recovery.

Get to the root with testing

Functional testing such as hormone panels and GI-MAP (gut testing) can uncover the underlying causes of your symptoms. We offer DUTCH hormone testing and comprehensive gut assessments to give you personalized insight into your body’s needs.

You Don’t Have to Do This Alone

If you’re tired of feeling anxious, overwhelmed, or unlike yourself, it’s time to dig deeper. Our team of holistic nutritionists specializes in helping women navigate perimenopause and menopause with clarity, compassion, and proven tools. We’re here to support your journey and help you feel like you again.

Book an initial appointment today or email us to inquire about gut or hormone testing options.

Let’s get to the root — together.

Asher Kleiber

Registered Holistic Nutritionist

Featured