WHAT MY DAUGHTERS ARE TEACHING ME ABOUT PERIMENOPAUSE
By Alexis Anderson, DO
California Psychiatrist | Hormone-Informed Care for Women in Midlife
WHAT MY DAUGHTERS ARE TEACHING ME ABOUT MY OWN PERIMENOPAUSE
A few months ago, I found myself having the same conversation twice in one week. Once with a patient in her late 40s, trying to make sense of a mood that didn't feel like her own anymore. And once with one of my daughters, a young teenager just starting to get her period, asking me why she felt so weepy and short-tempered the week before it arrived.
I gave them almost the exact same answer.
That stopped me. I've spent nearly 20 years as a psychiatrist focused exclusively on women's mental health, and most of that career has lived at the perimenopause end of the reproductive timeline, the fluctuating estrogen, the mood shifts, the sense of not feeling like yourself. I did not expect to be having a version of that same conversation at the other end of the timeline, in my own house, with my own kids.
THE SAME SENTENCE, TWO DECADES APART
Here's what I keep hearing myself say, to patients and to my daughters alike: this isn't a character flaw, and it isn't just you being dramatic. Biology is part of the picture.
My cycle has become irregular over the past couple of years, the way it does for most women somewhere in their late 40s or 50s. At the same time, one of my daughters is just beginning hers, periods that are still finding their rhythm, moods that swing in ways she doesn't yet have language for. On paper, we're at opposite ends of the reproductive lifespan. In practice, we're both living through something that rhymes: a nervous system adjusting to hormones that aren't behaving predictably yet.
WHY A SIMILAR MECHANISM SHOWS UP AT BOTH ENDS
This isn't only a midlife phenomenon or only a teenage phenomenon. It's a pattern that shows up in the female brain across the reproductive lifespan. Estrogen and progesterone don't just act on the reproductive system, they act directly on the brain systems that regulate mood, stress response, and emotional regulation. When those hormones are rising and falling in a new or unpredictable pattern, whether because a cycle is just starting up or because it's winding down, the brain feels it.
I want to be careful not to overstate the parallel, because the two ends of the timeline aren't identical. For a teenager, hormone swings are only one thread in a much bigger weave. This is also a period of enormous social, psychological, and brain development, and any of those can shape mood as much as hormones do. For a woman in perimenopause, the hormonal contribution tends to be more front-and-center, though even there the research is still evolving and not every woman experiences it the same way. So it's less "the exact same thing at both ends" and more "a shared biological thread that shows up differently depending on where you are on the timeline."
WHAT I'M ACTUALLY TRYING TO GIVE MY DAUGHTERS
I'm careful about how much I say to my daughters about their own bodies, as that's theirs to navigate, not content for me to narrate. But there's one thing I am trying to hand them early: language.
Most women don't get a clear explanation of the hormone-mood connection until they're deep into perimenopause, decades after it first would have been useful. I'd like my daughters to have some version of that understanding now, that a hard mood day around their cycle might be biology worth noticing, not just something to push through or feel ashamed of. Naming it doesn't fix it, but it changes how it's carried.
WHAT I WISH I'D KNOWN AT THEIR AGE
If I'm honest, this is the part that gets me. I've spent two decades explaining hormonal mood changes to grown women, many of whom are hearing it for the first time in their 40s or 50s. Nobody explained it to me at 13. I don't think anyone explained it to most of my patients at 13, either.
Watching my daughters start this process while I'm going through my own version of it at the other end has made the whole arc feel less like three separate life stages and more like one long, continuous story, one that deserves a much earlier introduction than most of us got.
WHAT I WANT YOU TO TAKE FROM THIS
If you have a daughter who's just starting her cycle, or you're noticing your own moods shifting as your cycle changes shape in midlife, or both, at the same time, the way I am, it might help to know these aren't entirely unrelated experiences. They're connected by some of the same biology, just at different points on the timeline and with different amounts of other things going on around them. You don't need a medical background to name that for the people in your life, including yourself.
FREQUENTLY ASKED QUESTIONS
Is it normal for a teenager's cycle to be irregular at first?
Yes. It's common for cycles to take a couple of years to settle into a predictable pattern after they begin, and hormone levels during this time can fluctuate significantly. Irregularity alone in the first couple of years usually isn't a cause for concern, though it's still worth mentioning to a pediatrician or gynecologist, especially if periods are extremely heavy, absent for long stretches, or accompanied by severe pain.
How do I know if my teen's mood swings are hormonal or just typical teenage stuff?
There's rarely a clean way to separate the two. Adolescence involves both hormonal change and significant psychological and social development at the same time, and often they're feeding each other. A pattern worth paying attention to is mood changes that cluster around the same point in her cycle each month, rather than mood shifts that seem tied to a specific event or ongoing stressor. That pattern doesn't require a diagnosis, but it's useful information to name and track together.
Does my daughter having noticeable hormonal mood changes now mean she'll struggle more later, at menopause?
Not necessarily. Sensitivity to hormonal fluctuation can vary across a woman's life and isn't fixed by how she responds to her cycle as a teenager. What tends to help most, at any stage, is early awareness, knowing that hormonal shifts can affect mood is useful information whether or not it turns out to be a significant factor for her later on.
What can I actually do to help my daughter build healthy awareness of her cycle now?
Simple tracking is a good place to start, noting on a calendar or app when her period occurs and roughly how she's feeling in the days around it. This isn't about diagnosing anything; it's about giving her a pattern she can recognize herself, so that if a hard mood day shows up, she has a frame for it beyond "something is wrong with me."
This article reflects my own experience and general education about hormonal health across the reproductive lifespan. It isn't a substitute for individual medical advice. Please talk with your own clinician, or your daughter's pediatrician or gynecologist, about any specific symptoms or concerns.
About the Author
Alexis Anderson, DO, is a California psychiatrist providing hormone-informed psychiatric care for women during perimenopause and menopause. She completed adult psychiatry residency training at Yale University and child and adolescent psychiatry fellowship training at the University of California, San Francisco. Since 2008, she has provided integrated psychotherapy and psychiatric medication management in private practice. Learn more about Dr. Anderson’s approach to concierge psychiatry for women in midlife.
Looking for hormone-informed psychiatric care during perimenopause? Learn about perimenopause and menopause psychiatric care for women throughout California.