A 49-year-old woman with no prior psychiatric history presents with 8 months of new-onset irritability, depressed mood, insomnia, and difficulty concentrating. She reports irregular menstrual cycles and vasomotor symptoms including hot flashes and night sweats. Her FSH is elevated at 45 mIU/mL and estradiol is low. The PMHNP considers how hormonal changes during the menopause transition contribute to her mood disturbance.