Home Mental Health & Well-Being Perimenopause Causes Anxiety. Here’s How to Manage Mental Shift

Perimenopause Causes Anxiety. Here’s How to Manage Mental Shift

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Perimenopause is a transitional period before menopause that can bring about significant changes to your body and mind. It’s a time when your hormones are shifting, and this can lead to a variety of symptoms, including anxiety.

Understanding the impact of perimenopause on mental health is crucial, as it can help you navigate this phase with greater ease and knowledge. If you’ve been feeling more anxious lately and are in the age range where perimenopause typically occurs, it’s possible that the two are connected.

Understanding perimenopause

Perimenopause is the stage of a woman’s life that precedes menopause, marking the end of the reproductive years. It’s characterised by a decline in oestrogen and progesterone, the hormones responsible for regulating menstruation and ovulation.This phase can last anywhere from a few months to several years, typically beginning in your 40s, although it can start earlier for some women.

During perimenopause, you might notice symptoms such as irregular periods, hot flashes, sleep disturbances, and mood swings. These are all signals from your body that it’s going through a significant hormonal overhaul. 

The fluctuations in hormone levels can affect various bodily functions, and it’s not just your physical health that’s impacted. Your mental well-being can take a hit too, with anxiety being one of the most common psychological symptoms associated with perimenopause.

Perimenopause and anxiety

The hormonal roller coaster of perimenopause doesn’t just cause physical discomfort; it can also trigger emotional turmoil. When oestrogen and progesterone levels dip, it can disrupt the balance of neurotransmitters in the brain, such as serotonin and dopamine, which regulate mood.

This disruption can lead to feelings of anxiety, even in women who have never experienced anxiety before.

Scientific studies have backed up this connection. For instance, research has shown that fluctuating levels of oestrogen can influence the brain’s response to stress, making you more susceptible to anxiety. Furthermore, perimenopausal symptoms like hot flashes and sleep disturbances can exacerbate stress, creating a feedback loop that heightens anxiety levels.

Identifying anxiety symptoms in perimenopause

Recognising anxiety symptoms during perimenopause can be tricky, as they often mimic those of general anxiety disorders. However, there are some telltale signs to watch out for. You might feel unusually nervous, irritable, or restless. 

Perhaps you’re having difficulty relaxing or find yourself worrying excessively about things that didn’t bother you before.  Physical manifestations can include a racing heart, sweating, and muscle tension.

It’s important to note that the anxiety you experience during perimenopause may differ from typical anxiety disorders in its triggers. The root cause is often the hormonal changes your body is undergoing, which means that the anxiety may ebb and flow with your hormone levels.

Managing anxiety during perimenopause

If you’re grappling with anxiety during perimenopause, there are several strategies you can adopt to manage your symptoms. Lifestyle changes can make a significant difference.

Incorporating a balanced diet rich in nutrients, regular exercise, and stress reduction techniques like meditation or deep breathing can all contribute to lowering anxiety levels.

It’s also crucial to prioritise sleep, as a lack of rest can worsen anxiety. Sometimes, these self-help measures may not be enough, and that’s okay.  It’s essential to recognise when professional help is needed.

If anxiety is interfering with your daily life, don’t hesitate to reach out to a healthcare provider.  They can guide you through this challenging time and offer support tailored to your specific needs.

Treatment options for anxiety in perimenopause

When it comes to treating anxiety that arises during perimenopause, there’s a spectrum of options available.

Hormone replacement therapy (HRT) is one avenue that can help stabilise hormone levels, potentially reducing anxiety.  HRT isn’t suitable for everyone, so it’s vital to discuss the risks and benefits with your healthcare provider.

Counselling or therapy can also be highly effective in managing perimenopausal anxiety.

Cognitive-behavioral therapy (CBT), in particular, is a form of treatment that helps you identify and change negative thought patterns and behaviours. It can provide you with coping strategies to handle anxiety more effectively.

Medications, such as antidepressants or anti-anxiety drugs, may be prescribed in some cases. These medications can help alleviate symptoms of anxiety, but they often come with side effects that you should consider and discuss with your doctor.

Remember, the best treatment plan is one that’s personalised to your needs. 

Your healthcare provider can help you weigh the options and choose the most suitable path for you.

Frequently asked questions

  • What does perimenopause anxiety feel like? Perimenopause anxiety can feel like a heightened state of nervousness, restlessness, or irritability.  You may experience difficulty relaxing, excessive worry, or find yourself unusually tense. Physical symptoms can include a racing heart, sweating, and muscle tension, which are your body’s responses to the hormonal changes during perimenopause.
  • How can I reduce my perimenopause anxiety? To reduce perimenopause anxiety, consider lifestyle changes such as regular exercise, a balanced diet, and stress-reduction techniques like meditation. Prioritising good sleep hygiene is also crucial.  If these self-help measures aren’t enough, seek professional help. Counselling, therapy, or possibly medication, under the guidance of a healthcare provider, can be beneficial.
  • What is the best medication for perimenopause anxiety? The best medication for perimenopause anxiety will vary depending on individual needs and medical history. Some may find relief with HRT, while others may benefit from antidepressants or anti-anxiety medications. Consult with your healthcare provider to determine the most appropriate medication for your specific situation.
  • How can I stop hormonal anxiety? Stopping hormonal anxiety may involve addressing the hormonal imbalances that occur during perimenopause. HRT can help stabilise hormone levels and alleviate anxiety. Additionally, lifestyle modifications, mindfulness practices, and therapy can be effective in managing hormonal anxiety.  Always discuss treatment options with your healthcare provider for personalised advice.



Ryan Snell is the co-founder of Unstoppabl, and an industry-renowned certified coach with a degree in sport and exercise science.

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