Perimenopause is the natural transition leading into menopause, marked by erratic fluctuations in estrogen and progesterone. These unpredictable shifts can trigger emotional, cognitive, and physical changes – often years before menopause officially begins. We spoke with Megan Spence, PsyD, PMH-C, a licensed clinical psychologist, about the whole-body experience of perimenopause, including mood and memory changes, the structural and social factors that place some groups at higher risk, available hormonal and non-hormonal treatments, lifestyle strategies that may help, and when – and how – to ask for support. Your symptoms matter, and you deserve informed, compassionate care.