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These are among the most common — and often most frustrating — symptoms of the menopausal transition, and they’re an area where some patients notice meaningful benefit from acupuncture. Declining estrogen can affect the brain chemicals linked to mood and cognitive clarity, and research suggests acupuncture may have a modest regulatory effect on these systems. It’s not a replacement for mental health support if you need it, and the evidence for acupuncture and perimenopausal mood changes is still emerging — but as part of an overall approach to the transition, many patients find it helpful.