When the Season Changes and So Do You
September 2026 | Women's Health | Perimenopause & Seasonal Wellness
By Dr. Karen Miller, LCSW-S, LICSW, BCD | Karen Miller Leadership & Consulting
Understanding the Connection Between Fall, Hormones & Mental Health in Midlife
Fall has officially arrived. The mornings are getting cooler, the days are becoming shorter, and many of us are settling into new routines. While we often welcome this season as an opportunity to slow down and reset, have you ever considered how seasonal changes may affect your mental and physical health?
For women navigating midlife, there may be two transitions happening simultaneously: the changing seasons and the hormonal changes associated with perimenopause.
As a clinical therapist, I believe we need to have more conversations about the relationship between our mental health and physical well-being. Too often, women attribute fatigue, irritability, anxiety, and difficulty concentrating to everyday stress without considering other contributing factors.
But what happens when your body is changing at the same time as your environment?
1. When Hormones and Seasonal Changes Overlap
During perimenopause, estrogen and progesterone levels fluctuate. These changes can affect sleep, mood, energy, and emotional well-being. The Menopause Society recognizes that mood symptoms during this transition may involve hormonal fluctuations, disrupted sleep, and life stressors.
At the same time, fall brings shorter days and reduced sunlight. Changes in daylight can influence our circadian rhythms, which help regulate sleep and wakefulness. For some individuals, seasonal changes can contribute to depressive symptoms.
Consider what happens when these experiences overlap. You may already be struggling with night sweats or interrupted sleep, and now you're noticing less energy, changes in motivation, or difficulty maintaining your usual routine.
It's important to recognize that these symptoms may have multiple contributing factors rather than assuming they are all hormonal or psychological.
2. Is It Perimenopause, Seasonal Depression, or Everyday Stress?
This is where understanding your symptoms becomes important.
Three areas to pay attention to
Sleep and energy
Are you having trouble falling asleep or staying asleep? Are night sweats interrupting your rest? Do you feel tired even after a full night's sleep?
Mood and concentration
Are you experiencing irritability, increased anxiety, difficulty concentrating, or a persistent loss of interest in activities you normally enjoy?
Seasonal patterns
Have you experienced similar mood changes during previous fall or winter seasons? Do your symptoms become more noticeable as daylight decreases?
Seasonal Affective Disorder (SAD) is a form of depression associated with a recurring seasonal pattern, often beginning in late fall or early winter. However, occasional low energy or mood changes during fall do not automatically indicate SAD.
Recognizing when symptoms began, how long they last, and how much they interfere with your daily life can help you and your healthcare provider better understand what you're experiencing.
3. Five Ways to Support Your Mental and Hormonal Health This Fall
1. Prioritize natural daylight
Make time to get outdoors during daylight hours. Morning light can help support your body's sleep-wake cycle. Consider incorporating a morning walk or spending time outside during your lunch break.
2. Reevaluate your sleep routine
If you're experiencing perimenopausal symptoms, sleep may already be challenging. Establish consistent sleep and wake times, maintain a comfortable bedroom temperature, and discuss persistent sleep disturbances with your provider.
3. Track your symptoms
Keep a simple journal documenting your mood, sleep, menstrual cycle, energy, and significant stressors. Look for patterns rather than focusing on isolated symptoms.
4. Maintain movement and connection
Physical activity and social connection can support emotional well-being. Consider walking with a friend, joining an exercise class, or scheduling regular opportunities to connect with people who support you.
5. Know when to seek additional support
If changes in mood, sleep, or energy persist or begin interfering with your daily functioning, speak with your healthcare provider. Mental-health screening and an appropriate medical assessment can help identify contributing factors.
Clinician Notes: You Don't Have to Push Through Every Season
One of the conversations I want women to become more comfortable having is the conversation about what they need as their bodies and lives change. We often expect ourselves to maintain the same energy, productivity, and emotional capacity regardless of what we're experiencing physically or psychologically. But awareness requires more than simply recognizing that something has changed. It requires a willingness to respond differently. You may need more intentional rest. You may need to adjust your routines, establish new boundaries, or have a conversation with your healthcare provider about symptoms you've been dismissing. And sometimes, you may need to acknowledge that the strategies that supported you in one season of life may not be sufficient for the season you're entering.
A changing season doesn't mean you're losing yourself. It may mean you need to understand yourself differently.
Your Fall Action Step
For the next two weeks, pay attention to four things: your sleep, mood, energy, and any hormonal symptoms you may be experiencing. Notice what's changing, what's remaining consistent, and what deserves further attention. If symptoms are persistent, worsening, or affecting your ability to function, don't wait for the season to pass before seeking support. Your mental and physical health deserve attention in every season.
References
The Menopause Society - Menopause Symptoms:
https://menopause.org/patient-education/menopause-topics/symptoms
ACOG- Mood Changes During Perimenopause:
ACOG - Sleep Health and Disorders:
https://www.nimh.nih.gov/health/publications/seasonal-affective-disorder
NIMH - Seasonal Affective Disorder:
https://www.nimh.nih.gov/health/publications/seasonal-affective-disorder
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