Perimenopause is a transitional time that often begins in a woman’s late 30s or early 40s and lasts until menopause. One is officially in menopause after 12 consecutive months without a period. On average, during perimenopause the monthly cycle will be disrupted and gradually lengthen out for a period of months or years before it stops completely. During this time, hormones including estrogen and progesterone are dropping, which subsequently leads to decreases in serotonin, disruptions in sleep, and can increase feelings of sadness and anxiety. In fact, some women may be diagnosed with depression or anxiety for the first time during perimenopause, not only due to biological changes but also because this is often one of the busiest times in a woman’s life between family and work responsibilities.