Understanding Anxiety in Perimenopause and Menopause
We’ve all experienced anxiety at some point in our lives. Perhaps you’ve had to give a school speech, present at work, or maybe you don’t like to fly. Situational anxiety tends to be short-lived and often fades once the stressful event is over. However, for others, anxiety becomes chronic and a generalized part of daily life. It can stem from social situations, ongoing stressors, environmental factors, or even chemical imbalances in the brain—such as changes in serotonin, dopamine, norepinephrine, and gamma-aminobutyric acid (GABA).
Anxiety and the Menopausal Transition
The transition into perimenopause and eventually menopause can bring on new or intensified anxiety. A study by the NIH found that, “women with low anxiety at baseline were more likely to report high anxiety symptoms in early or late perimenopause or postmenopause compared to when they were premenopausal.” This study suggests that increased anxiety during this period isn’t necessarily linked to external stressors like work pressure, family dynamics, or financial concerns.
For women who already experienced anxiety before perimenopause, this condition often persists through menopause, though it may not always intensify. In other words, anxiety doesn’t always increase—it may simply continue as a chronic issue.
The Role of Hormones in Anxiety
Fluctuating reproductive hormones, especially estrogen, play a key role in the onset of anxiety during perimenopause and menopause. Estrogen influences mood, and as its levels change, it can make women more vulnerable to anxiety. Additionally, cortisol, often called the "stress hormone," tends to rise with age, further contributing to heightened anxiety.
Seven Ways to Manage Anxiety
While anxiety may feel overwhelming, there are many strategies to help manage it effectively:
Self-care: Make time for activities that bring you joy and relaxation, whether it’s getting a massage, reading, gardening, or anything else that allows you to unwind and recharge.
Meditation and Relaxation: Use tools like the Calm app or channels on YouTube, such as The Mindful Movement, to practice meditation, deep breathing, or calming exercises.
Sleep: Aim for at least 8 hours of sleep each night. Establish a nighttime routine that helps you unwind, such as turning off electronic devices, to improve the quality of your sleep.
Cognitive Behavioral Therapy (CBT): This approach helps challenge negative thought patterns, addressing both rational and irrational thoughts that contribute to anxiety.
Medication: In some cases, antidepressants or other medications may be beneficial. This is a conversation worth having with your trusted healthcare provider. You can find mental health professionals at Psychology Today or Grow Therapy.
Exercise: Physical activity releases dopamine, a neurotransmitter that improves mood and motivation, helping to manage anxiety.
Hormone Replacement Therapy (HRT): For some women, regulating hormone levels through HRT can be an effective way to manage anxiety during perimenopause and menopause. Again, speak with your healthcare provider.
Final Thoughts
Anxiety can be managed at any stage in life, even during the challenging years of perimenopause and menopause. With the right strategies and support, it’s possible to find relief and regain a sense of control over your mental health.
Kelly Rigo is the creative force behind Menopause Evolution.