9/29/2026
The Menopause Transition is Mental, Too
Dr. Monica Christmas of UChicago Medicine and The Menopause Society explains the physical and mental health impacts women can experience during perimenopause and menopause
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For women in their 40s and early 50s, perimenopause can show up in ways they never expected. Anxiety. Depression. Irritability. Brain fog. Rage. Insomnia. Hot flashes. Night sweats. Just to name a few.
About 1.3 million American women enter menopause each year, and roughly 40% experience mood symptoms during the transition. But those symptoms rarely arrive in a neat, predictable pattern. Hormones fluctuate. Sleep suffers. Anxiety spikes. Concentration gets harder. And because it all happens during a life stage when many women are at the peak of their careers while also juggling children, aging parents, relationships, and their own health, figuring out what’s going on – and how and where to get trusted support – can be complicated.
Too often, the pieces get treated separately.
In this episode of ieso Conversations, Dr. Monica Christmas joins host Kristen Sills, Director of Marketing at ieso, and Arielle Pulverman, PhD, Head of Clinical Product at ieso, to unpack what really happens during the menopause transition and why physical and mental health can’t be understood in isolation.
Dr. Christmas is an Associate Professor of Obstetrics and Gynecology at the University of Chicago, where she directs the Menopause Program and the Center for Women’s Integrated Health. She also serves as Associate Medical Director of The Menopause Society. Arielle is a health psychologist and co-founder of Bruin Health, who previously built a consumer perimenopause product at Otsuka Precision Health.
Together, they take on the questions women are actually asking: Is this anxiety, or is it perimenopause (or both!)? Why am I suddenly so irritated at everything and everyone? Do I need HRT? Can brain fog mean something more serious? And how do you know when a symptom is part of the menopause transition versus something else entirely?
They also get into the explosion of menopause marketing and influencer advice, why women can sometimes end up trusting their TikTok and Instagram feed more than their doctors, the effect of menopause symptoms on work and relationships, and what better care to support this transition can look like when physical and behavioral health work together.
Inside this conversation:
- The difference between perimenopause and menopause, and why symptoms can begin years before a woman's final period
- How hormone fluctuations can affect mood, sleep, cognition, and emotional regulation (and why lab tests rarely help)
- Brain fog, the dementia fear, and the health risks that deserve more attention
- How a history of anxiety, depression, postpartum depression, PMS, or PMDD can raise the chance of having an exacerbation during this transition
- A look at rage, one of the most reported and least studied perimenopausal experiences
- The HRT boom, health influencers, and the challenge of finding trustworthy information
- Why not every midlife symptom should be blamed on menopause
- Why menopause care needs stronger behavioral health support and more integrated care
Follow the guests:
➡️ Dr. Monica Christmas at UChicago Medicine and The Menopause Society
➡️ Arielle Pulverman, PhD on LinkedIn
➡️ Kristen Sills on LinkedIn
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