Does melatonin help with mood swings during perimenopause?

Mood swings during perimenopause can feel destabilizing, and understanding what is driving them makes it easier to think clearly about what might help. Melatonin is not a mood stabilizer in the conventional sense, but there are genuine biological reasons why restoring healthy melatonin signaling can support emotional stability during this transition.

Mood is deeply intertwined with circadian rhythm. The daily oscillation of light and darkness drives not just sleep and wakefulness but also the rhythmic release of neurotransmitters including serotonin and dopamine. Serotonin, the neurotransmitter most associated with mood stability, follows a diurnal pattern that is coordinated by the circadian system. Melatonin and serotonin are biochemically related. Melatonin is synthesized from serotonin in the pineal gland, and their rhythms are linked. When melatonin production is disrupted, as Toffol et al. (2014) confirmed it is during perimenopause, the entire circadian-neurochemical system becomes less stable. This can manifest as heightened emotional reactivity, low mood, and unpredictable shifts in how you feel throughout the day.

Sleep deprivation compounds this considerably. Even in healthy adults, one night of poor sleep measurably increases amygdala reactivity, the brain region that generates emotional responses, and reduces prefrontal cortex regulation of those responses. In practical terms, sleep deprivation makes it harder to pause before reacting and easier to feel overwhelmed by things that would be manageable on a rested night. If disrupted sleep is contributing to mood swings during perimenopause, improving sleep through melatonin supplementation may reduce that emotional volatility.

The most relevant clinical evidence comes from Bellipanni et al. (2001), who gave perimenopausal women 3 mg of melatonin nightly for six months and observed significant improvements in mood and overall psychological wellbeing. The women in the study also reported reductions in depressive symptoms and anxiety. This is a meaningful finding, though the study was small and has not been replicated at a larger scale. The results are consistent with what the circadian-mood mechanism would predict, but they should be interpreted with appropriate caution.

It is also worth being honest about what is driving perimenopausal mood swings in the first place. Estrogen has direct effects on serotonin synthesis and receptor sensitivity in the brain. Fluctuating and declining estrogen creates instability in the same neurochemical systems that melatonin helps regulate through the circadian pathway. Melatonin is not going to replace estrogen's direct neurological effects, but it may help stabilize one of the upstream systems that modulates mood over the course of each day.

Studies have used doses ranging from 0.3 mg to 3 mg. Talk to your healthcare provider about the right dose for your situation. Melatonin is sold over the counter in the US and is not regulated as a drug, so quality varies. Look for third-party tested products with verified potency.

Timing matters with melatonin for mood support. Taking it at a consistent time each evening, typically 30 to 60 minutes before your intended sleep time, helps anchor the circadian rhythm more reliably than taking it at random times. Consistency is more important than dose size when it comes to circadian entrainment. Pairing this with consistent wake times, even on weekends, reinforces the circadian signal that melatonin helps establish, which in turn supports more stable mood rhythms throughout the day.

Drug interactions to be aware of include warfarin, immunosuppressant medications, antidiabetic drugs, and CNS depressants. These interactions are relevant both for safety and because some of these medications can themselves affect mood.

Monitoring mood patterns alongside sleep and cycle data is one of the most useful things you can do during perimenopause. When mood shifts are tracked over time alongside cycle day, sleep quality, and other symptoms, patterns emerge that can guide both self-care decisions and more productive provider conversations. PeriPlan is designed to support exactly this kind of daily tracking across multiple symptom domains.

When to talk to your doctor: Mood variability during perimenopause is common, but some presentations need clinical attention. If you are experiencing persistent low mood lasting more than two weeks, hopelessness, loss of interest in things you normally enjoy, or any thoughts of self-harm, please contact your healthcare provider promptly. Perimenopausal depression is a real and treatable condition, and it warrants more than a supplement trial.

This content is for informational purposes only and does not replace medical advice. Always consult your healthcare provider about your specific situation.