When Hormones Shift: Mood, Neurotransmitters, and the Truth Beneath the Surface

Many of you know that my practice is primarily comprised of clients who were assigned female at birth—people who currently cycle or who have cycled in the past. A common concern people bring into my office is mood changes at certain points in their cycle or during specific phases of life. We talk a lot about feeling “hormonal.” And honestly, I suspect a man coined that term a long, long time ago—and it stuck.

Because when we think about these times—the days or weeks leading up to our period, postpartum, perimenopause, and menopause—we’re often talking about periods when hormones pause, drop, or shift. So we’re not really “hormonal” in the way the term implies. In many cases, hormones are actually lower, or one or more key hormones are declining—and that shift is what can drive emotional changes.

This can feel incredibly dysregulating. We may not feel like ourselves. Our partners may notice it. We might snap at our kids or coworkers, and that doesn’t feel good. But I’d love to offer a small perspective shift: instead of only focusing on what’s “wrong,” let’s consider what our hormones normally do for us—and what happens when they take a step back.

Estrogen: Motivation, Connection, and Cognitive Glow

I had a gynecology professor in medical school who used to say that estrogen is like a veil women wear—giving us the drive and motivation to care for others, to anticipate everyone’s needs, to think ten steps ahead (not always because we want to, but because we’re wired to plan), to smooth things over, to be polite, to apologize even when we’ve done nothing wrong.

While that description is poetic (and a bit gendered), there is a biological basis to this idea. Estrogen has profound effects on the brain, especially on mood, cognition, and emotional regulation.

Estrogen and Neurotransmitters

Estrogen interacts with multiple neurotransmitter systems, including:

Serotonin: Estrogen increases serotonin synthesis, decreases serotonin breakdown, and upregulates serotonin receptors. This is one reason many people feel more optimistic, socially connected, and emotionally resilient during the mid-follicular and ovulatory phases of the cycle, when estrogen is higher.

Dopamine: Estrogen also influences dopamine pathways involved in motivation, reward, and focus. Higher estrogen levels are associated with improved executive function, working memory, and drive.

Norepinephrine: Estrogen modulates norepinephrine, which affects alertness, energy, and stress response. This can contribute to the “get things done” feeling many experience mid-cycle.

When estrogen drops—such as in the late luteal phase, postpartum, or during perimenopause and menopause—people may notice low mood, reduced motivation, brain fog, and decreased tolerance for stress. It’s not a character flaw. It’s neurochemistry.

Progesterone: Calm, Safety, and Sleep

Then there’s progesterone—often described as our serene calm. Progesterone helps us feel grounded, soothed, and able to sleep deeply. It plays a critical role in preparing the body for pregnancy, but its neurological effects are just as important.

Progesterone and GABA

Progesterone is metabolized into allopregnanolone, a neurosteroid that strongly modulates GABA-A receptors. GABA is the brain’s primary inhibitory (calming) neurotransmitter. When progesterone and allopregnanolone are at healthy levels, many people experience:

• Reduced anxiety

• Improved sleep quality

• A sense of emotional buffering

• Less reactivity to stress

However, rapid fluctuations in progesterone—especially in the late luteal phase or postpartum—can feel destabilizing. Some individuals are particularly sensitive to changes in allopregnanolone, which is thought to play a role in PMDD (premenstrual dysphoric disorder).

In perimenopause, progesterone is often the first hormone to decline, leading to symptoms like insomnia, anxiety, irritability, and a feeling of being “wired but tired.”

Testosterone: Drive, Boundaries, and Vitality

Although often framed as a “male hormone,” testosterone is essential for people of all sexes. In those assigned female at birth, testosterone supports:

• Libido and sexual desire

• Physical energy and muscle mass

• Cognitive clarity and confidence

• Assertiveness and boundary-setting

Low testosterone can contribute to fatigue, low motivation, decreased libido, and a sense of diminished vitality. On the other hand, very high testosterone may be associated with irritability or agitation in some individuals, though context and balance with other hormones matter greatly.

Cortisol and the Stress-Hormone Feedback Loop

No conversation about mood and hormones is complete without cortisol. Chronic stress can alter the hypothalamic-pituitary-adrenal (HPA) axis, affecting cortisol rhythms and feedback loops with sex hormones.

High or dysregulated cortisol can:

• Suppress progesterone production

• Alter thyroid hormone conversion

• Impact serotonin and dopamine signaling

• Increase anxiety, insomnia, and mood instability

This is why stress management is not just a “nice add-on” in hormonal health—it is foundational.

Hormonal Transitions and Emotional Truth

So when these hormones shift, pause, or drop, it’s easy to see how frustration, irritability, and emotional intensity can surface. And, dare I say, sometimes truth comes to the surface too.

No one should have to suffer through these phases—and there are absolutely things we can do to support hormone imbalances, adrenal dysfunction, depression, anxiety, or PMDD. But I also think there’s value in paying attention to what emerges during these times.

When estrogen and progesterone are lower, we may be less inclined to smooth things over. We may feel less compelled to prioritize everyone else’s comfort at the expense of our own. We may notice resentment, unmet needs, or misaligned boundaries more clearly.

This doesn’t mean we should unleash every thought without care. But it does mean these moments can be invitations to:

• Reassess boundaries

• Communicate needs more clearly

• Notice where we are overextending

• Reconnect with our authentic desires

The Clinical Perspective: Supporting Mood Through Hormones and Beyond

From a clinical perspective, mood symptoms related to hormonal shifts are real and treatable. Depending on the individual, this may include:

• Lifestyle interventions (sleep, nutrition, blood sugar regulation, movement)

• Stress reduction and nervous system regulation

• Targeted supplementation or herbal medicine

• Hormone therapy when appropriaten- Psychotherapy or psychiatric care when indicated

Research shows that stabilizing blood sugar, improving sleep, reducing inflammation, and supporting gut health can significantly influence neurotransmitter production and hormonal signaling.

Reframing “Hormonal”

The word “hormonal” is often used to dismiss, belittle, or trivialize emotional experiences. But hormones are not just about reproduction—they are powerful neuromodulators that shape cognition, mood, energy, and behavior.

Feeling more sensitive, more irritable, or more introspective during certain phases of life is not a weakness. It is a reflection of shifting biology interacting with lived experience.

So the next time you notice a mood shift during your cycle, postpartum, or during perimenopause or menopause, consider this: What is my body trying to tell me? What support do I need? What truth might be surfacing?

Can we pause, breathe, and communicate thoughtfully—while still honoring our intuition? Sometimes these moments are invitations to stand up for ourselves, set boundaries, or speak a truth we’ve been smoothing over for too long.

If you want support navigating mood changes across your cycle or life transitions, this is exactly what I do in my practice. You’re not broken—and you’re not alone.