Menopause & midlife

Crying Spells in Perimenopause: Hormones and Tears

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Crying spells in perimenopause are common and usually normal: fluctuating estrogen makes mood circuits more reactive, so tears come easily and then ease as hormones settle. Low mood or tearfulness that lasts most days for 2 weeks or more, or loss of interest, points to depression and is worth reviewing with a clinician.

Last updated: July 2026

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Why do I cry so easily in perimenopause?

Estrogen helps regulate serotonin and other chemicals that steady mood, so when it swings during perimenopause, feelings can surface faster and stronger. This is why a sad advertisement or a small frustration can bring sudden tears. According to the World Health Organization, the menopause transition usually begins between ages 45 and 55 1, and mood reactivity often tracks the same hormonal turbulence as hot flashes and broken sleep.

Poor sleep amplifies tearfulness, so losing even 1 or 2 hours a night to sweats can compound the effect. Hormone-linked tearfulness is also not unique to midlife: many people first notice it premenstrually as teenagers, again in the postpartum weeks, and once more as cycles and estrogen become erratic across the perimenopausal transition 2. Recognizing the pattern can make the tears feel less bewildering.

Is crying over everything a sign of depression?

Frequent tears are not the same as clinical depression, but the two can overlap. A crying spell that passes and leaves you otherwise engaged with life differs from low mood that lingers most of the day, most days, for 2 weeks or longer.

Depression more often brings loss of interest, hopelessness, guilt, appetite changes, or trouble functioning — not tears alone. The UK's NICE menopause guideline recognizes low mood as a genuine feature of the transition and suggests it be taken seriously rather than dismissed 3. If you are weighing this, our guide on whether you might be depressed walks through the signs, and anxiety symptoms in adults covers the overlap with worry.

How long do these mood swings last?

Mood swings tend to be loudest during perimenopause itself, when hormone levels are most erratic, and often steady after periods stop. Vasomotor symptoms like hot flashes and night sweats last a median of about 7 years in one large cohort study 4, and mood reactivity frequently rises and falls alongside them.

That means tearfulness is usually a phase, not a permanent change, often easing within 1 to 2 years of the final period. Sleep, stress, and life load all shape how intense it feels month to month. For the broader timeline, see how long menopause symptoms last and menopause symptoms overall.

What actually helps with hormonal crying spells?

Several approaches can ease mood reactivity, and they are not either-or. Regular sleep, movement, less alcohol, and stress skills form a foundation that steadies the nervous system. Cognitive behavioral therapy is recommended by the Menopause Society for menopause-related symptoms and can lower distress without medication 5.

When low mood is more entrenched, talking therapy, antidepressants, or menopausal hormone therapy may each play a role, decided case by case. Practical tools like calming anxiety in the moment and sleeping better under stress can help day to day. Most people move through the transition without a mood disorder, but support is reasonable at any point.

When perimenopausal crying spells need a therapist

A clinician — a therapist, primary care clinician, or menopause specialist — can help tell ordinary tearfulness from depression, screen for a mood condition when the pattern warrants it, and match support to what you are actually experiencing. Tearfulness paired with hopelessness, an inability to function, or thoughts of self-harm calls for prompt help rather than waiting to see whether it passes.

Gale can help you prepare for that conversation. Noting when the crying began, how often it strikes, how it tracks with your cycle and your sleep, and what still brings relief can make a first visit more focused and useful.

Common questions

Yes, for many people. Fluctuating estrogen makes the brain's mood systems more reactive, so tears can come without an obvious trigger. On its own, occasional unexplained crying that passes is usually a normal part of the transition, especially when sleep is disrupted.

The main clue is duration and reach. Hormonal tearfulness comes in spells and lifts, leaving you otherwise engaged. Depression brings low mood most of the day, most days, for two weeks or more, often with loss of interest, hopelessness, or trouble functioning. That pattern is worth reviewing with a clinician.

It can help some people, particularly when tearfulness travels with hot flashes and poor sleep, because easing those often lifts mood. Hormone therapy is not an approved treatment for depression itself, though, and whether it fits depends on your health history and symptoms, decided with a clinician.

Consider a visit if the tearfulness is frequent and distressing, lasts most days for two weeks or more, disrupts work or relationships, or comes with hopelessness. Thoughts of harming yourself are a reason to seek help right away by calling or texting 988.

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When perimenopausal mood changes need review

  • —Low mood or tearfulness most days for two weeks or more is a reason to seek clinician review
  • —Loss of interest in things you used to enjoy, alongside crying spells, is a reason to seek clinician review
  • —Feeling hopeless, worthless, or unable to function is a reason to seek prompt clinician review
  • —Thoughts of harming yourself are a mental-health emergency — call or text the 988 Suicide and Crisis Lifeline right away

If you have thoughts of harming yourself, call or text the 988 Suicide and Crisis Lifeline, or go to the nearest emergency room.

This article is general health education, not medical advice. Whether your mood changes reflect the menopause transition or a treatable mood condition should be assessed by a clinician such as a primary care clinician or behavioral health clinician who knows your history.

References

  1. 1.World Health Organization (2024). Menopause (fact sheet). World Health Organization (WHO). link ✓The World Health Organization states the menopause transition usually occurs between ages 45 and 55, placing perimenopausal mood changes in a defined life stage.
  2. 2.Harlow SD, Gass M, Hall JE, et al. / STRAW+10 Collaborative Group (2012). Executive summary of the Stages of Reproductive Aging Workshop +10: addressing the unfinished agenda of staging reproductive aging. Menopause. doi:10.1097/gme.0b013e31824d8f40 ✓The STRAW+10 staging framework describes how menstrual cycles and estrogen become erratic across the perimenopausal transition, grounding the pattern of hormone-linked tearfulness.
  3. 3.National Institute for Health and Care Excellence (2026). Menopause: identification and management (NG23). National Institute for Health and Care Excellence (NICE). link ✓NICE menopause guidance recognizes low mood and mood changes as genuine features of the menopause transition that merit attention rather than dismissal.
  4. 4.Avis NE, Crawford SL, Greendale G, et al. / Study of Women's Health Across the Nation (SWAN) (2015). Duration of menopausal vasomotor symptoms over the menopause transition. JAMA Internal Medicine. doi:10.1001/jamainternmed.2014.8063 ✓The SWAN cohort found vasomotor symptoms last a median of about 7 years, the same hormonal window in which mood reactivity commonly rises and falls.
  5. 5.The North American Menopause Society (Menopause Society) (2023). The 2023 nonhormone therapy position statement of The North American Menopause Society. Menopause. doi:10.1097/GME.0000000000002200 ✓The Menopause Society 2023 nonhormone therapy position statement supports cognitive behavioral therapy for menopause-related symptoms.

5 sources, numbered by first appearance. General health information, not medical advice. AI-assisted editorial content — every citation independently verified. Editorial policy

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