How to deal with perimenopause anxiety
It's one of the most frequently asked questions when groups of peri- and menopausal women get together. Why is anxiety worse during these years? Where does the anxiety come from? When will perimenopause anxiety go away?
Anxiety, depression, mood swings and loss of confidence are common perimenopause symptoms and menopause symptoms, so why are so many of us unaware that our hormones are causing the challenges?
Here, Dr Clare Spencer, co-founder and clinical director of My Menopause Centre, reveals the must-knows and what can be done to manage anxiety during perimenopause.
Why does anxiety get worse in perimenopause?
Anxiety is a common yet often misunderstood menopause and perimenopause symptom. During the perimenopause, your levels of oestrogen and progesterone fluctuate erratically, with quite dramatic peaks and troughs. These fluctuations can result in changes to mood and heightened anxiety as we head towards the menopause itself, when hormone levels ultimately drop. This is not a nice, smooth transition, so it’s perhaps not surprising that fluctuations in hormone levels are going to cause fluctuations in how you feel.
What does perimenopause anxiety feel like?
Anxiety might be the only symptom of the perimenopause and menopause that you experience. Many women don’t make the connection and just think that they aren’t coping as well as they used to.
If you are experiencing anxiety, you certainly aren’t alone. Anxiety can happen to anyone – including those who’ve never experienced mental health difficulties before. You may have mild symptoms – like many of the women I speak to who say they have stopped motorway driving, or really don’t like it any more, because of anxiety. Others have more severe symptoms.
Physical symptoms of anxiety can include:
Fast heart rate
Heart palpitations
The feeling of sickness or nausea
Shaking or tremors
Sweating
Dry mouth
Chest pain
Headaches
Fast breathing
Panic attacks – these are severe attacks of anxiety, fear and panic that occur suddenly, often without warning and for no apparent reason.
It makes sense that most women don’t realise many of these symptoms are hormone-driven. Perimenopause and menopause coincide with a stress-packed time in a woman’s life. Our parents are becoming frail, our children still need a lot of our time and attention, our relationships need nurturing, and work can often be a minefield as ageism rears its ugly head. There’s a lot going on to make us feel anxious.
How do you treat anxiety in perimenopause?
The way forward is different for everyone. Treatment and management options are similar to those that can help with the symptoms of depression. If your mood changes are related to the perimenopause and menopause, evidence indicates that HRT may improve your mood and anxiety. It may be worth a try, even for a short period of time, to see if it helps. Many women find they need to look at more than one approach to manage their symptoms.
There are also holistic treatments you can try to help treat perimenopause symptoms naturally, such as decreasing your stress through meditation or relaxation techniques. Regular exercise and cutting down on alcohol will help – and are good lifestyle measures regardless. When you go through the menopause, it’s important to take very good care of yourself. Make sure you’re allowing yourself to get enough sleep and exercise, and eat a healthy, balanced diet, limiting sugar and processed foods.
A key thing that we know makes our anxiety worse is alcohol. One too many glasses of wine in the evening and we’re awake at 3am with doom-laden thoughts (and hot legs!). In the morning, we’ll feel anxious and nervous. Moderate drinking is much better for your physical and mental health.
Will perimenopause anxiety go away?
Every woman’s menopause is different, so there is no definitive answer to how long your hormonal anxiety will last. The important thing is to focus on making healthy lifestyle choices, giving yourself the time and space to notice how your mental wellbeing is faring, before seeking help if you feel you need it.
What’s important to remember is that anxiety is a normal human response to stressful situations. It starts to be an issue when it becomes hard to control your fear, making you feel stressed or overwhelmed, and getting in the way of your ability to live life as you want to.
This feature first appeared in the May 2024 issue of Red magazine.
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