Are you going through the perimenopause or menopause transition and wondering why am I so anxious? Perimenopause and Anxiety are definitively linked- check out this guide for more info on this link and what you can do to start feeling better!

Navigating Perimenopause and Anxiety

Perimenopause is a natural transition that women go through as they approach the menopause transition. During this phase, women may experience various physical and emotional symptoms, including anxiety. Navigating perimenopause and managing anxiety can be challenging, but there are coping strategies and tools that can help improve mental and emotional well-being. In this post, we will explore the symptoms of perimenopause and perimenopausal anxiety, the relationship between anxiety and the phases of perimenopause, and tools for managing anxiety during this stage of life.

By the end of this post you will understand the relationship between perimenopause and anxiety, as well as have more tools to help manage your symptoms of anxiety.

Key Takeaways:

• Perimenopause is a natural transition in a woman’s life, characterized by hormonal changes.
• Perimenopause can lead to symptoms of anxiety, which can impact mental and emotional well-being.
• Understanding the phases of perimenopause, including estrogen dominance, low progesterone, and low estrogen, can help in managing anxiety.
• Coping strategies such as mindfulness, stress management, cognitive behavioral therapy, and natural supplements can be beneficial in reducing anxiety symptoms during perimenopause.
• Consulting with healthcare professionals and mental health experts is important to determine the most suitable tools and treatments for managing perimenopausal anxiety.

What is Perimenopausal Anxiety?

Perimenopausal anxiety refers to feelings of anxiety or heightened levels of anxiety experienced by women during the perimenopause stage. This anxiety can be caused by hormonal fluctuations and the physical and emotional changes that occur during this time.  A woman can experience anything from mild anxiety to severe anxiety.  And if a woman has a baseline level of anxiety she may find increased anxiety during perimenopause.

Perimenopause Symptoms can include:

• Mood swings
• Mood changes
• Feelings of anxiety
• Poor Sleep
• Vaginal Dryness
• Hot Flashes (sometimes referred to as Hot Flushes) 
• Night Sweats
• Dry, itchy skin
• Hair Loss
• Many more emotional and physical changes- see my video on the 34 symptoms of perimenopause to learn more

The female hormones are in flux during perimenopause, and this cycling of hormones causes many life-disrupting symptoms. These symptoms can significantly impact a woman’s well-being and quality of life.

Perimenopausal Anxiety

Perimenopausal anxiety may manifest as severe anxiety or heightened levels of anxiety, whether it be a change in baseline or a fluctuating increase in anxiety. It can lead to emotional symptoms such as restlessness, irritability, and difficulty concentrating.

Perimenopausal anxiety can have a significant impact on a woman’s daily life and overall mental health. It is important for women to recognize these symptoms and seek appropriate support and treatment to effectively manage perimenopausal anxiety.

Managing perimenopausal anxiety is crucial for maintaining mental and emotional well-being during this transitional phase. By understanding and addressing these symptoms, women can navigate perimenopause more smoothly and improve their overall quality of life.

Anxiety and the Phases of Perimenopause

Anxiety and the phases of perimenopause are closely linked to hormonal changes and fluctuations. During the perimenopause stage, there are two main phases: estrogen dominance with declining progesterone,  and low estrogen with low progesterone.

Estrogen Dominance

Estrogen dominance refers to a period when estrogen levels are higher than progesterone levels, leading to hormonal imbalances that can contribute to symptoms such as anxiety and mood swings. Hormonal shifts during this phase can affect the mental and emotional well-being of midlife women, causing them to experience anxiety and other depressive symptoms.  Women may also feel surges of anger, irritability or even rage.  Skin may also be affected and acne and eczema can flare.

Estrogen can either stay the same or surge at times.  Progesterone is slowly declining during this phase and at times it is the gap between these two, even if the estrogen isn’t surging, that causes the estrogen dominance symptoms.  Here’s a video on the perimenopause phases that may be helpful. 

Low Estrogen Phase of Perimenopause

On the other hand, the low estrogen phase occurs when estrogen levels decrease, causing physical and emotional changes that can also impact anxiety levels. The decrease in estrogen may lead to symptoms of depression and physical symptoms such as hot flashes, sleep disturbances, and fatigue, which can further exacerbate anxiety levels in women going through the perimenopause transition.

This phase typically takes place over the last 1-2 years before your final period (the day you go one year without periods is the official day that menopause starts).

Understanding these hormonal fluctuations and their effects on mental and emotional well-being is crucial for midlife women experiencing perimenopausal anxiety. By acknowledging the impact of hormonal changes on anxiety levels, women can seek appropriate support and develop strategies to manage their physical and emotional changes effectively.

Tools for Improving Perimenopausal Anxiety

Anxiety during perimenopause can be overwhelming, but there are several effective tools and techniques that can help manage symptoms and improve overall well-being. By incorporating these strategies into your daily routine, you can regain control and find relief from anxiety.

Mindfulness and Stress Management

Mindfulness practices, such as meditation and relaxation exercises, can work wonders in reducing anxiety symptoms. Taking a few minutes each day to focus on your breath and bring awareness to the present moment can help calm racing thoughts and promote a sense of inner peace.  Deep breathing has been practiced for centuries and can help with hormonal anxiety too.  I like to teach my patients square or 4-7-8 breathing and I ask them to practice this several times throughout the day.

Additionally, incorporating stress management techniques like deep breathing exercises or engaging in stress-reducing activities such as yoga or tai chi can help regulate cortisol levels and alleviate anxiety.

Cognitive Behavioral Therapy

Cognitive Behavioral Therapy (CBT) is a powerful form of therapy that can help identify and reframe negative thought patterns and behaviors associated with anxiety. By working with a mental health professional, you can learn effective coping strategies to manage anxiety triggers, challenge irrational beliefs, and develop healthy coping mechanisms. CBT equips you with the tools to rewire your thinking patterns, empowering you to navigate perimenopausal anxiety more effectively.

Essential Oils

Using essential oils like lavender and chamomile can provide a natural and soothing way to ease anxiety symptoms. These oils have calming properties that promote relaxation, reduce stress levels, and improve sleep quality. Incorporating them into your daily routine by diffusing them, adding them to a warm bath, or applying them topically can provide a gentle and pleasant sensory experience that helps alleviate anxiety.

Check out our blog on essential oils for perimenopause symptoms to learn more!

Natural Supplements that Help Anxiety

There are natural supplements that have been found to be beneficial in reducing anxiety symptoms.

Omega-3 fatty acids, found in fish oil or flaxseed oil, can help support brain health and reduce inflammation, which may improve mood and alleviate anxiety.  You may need higher doses to help with anxiety.  You can work with your provider to find a safe dose for you, but we generally use between 1 and 3 grams per day of an EPA/DHA blend.  Be sure to read the bottle to ensure that the type you choose provides 1-3 grams in 1-3 gel caps or liquid servings.  You don’t want to take a handful of large fish oil capsules or multiple gulps of fish oil to get these benefits!

Ashwagandha, an adaptogenic herb, has been used for centuries to reduce stress levels and promote a sense of calmness. You will find this in many hormone blends and for good reason- it really works well for female hormone balance! Remember though, before adding any supplements to your routine, it’s essential to consult with a healthcare professional to ensure they are safe and suitable for you.

Hormone blends of herbs and nutrients can be very helpful during perimenopause and the synergy when using a blend can sometimes be even more beneficial than using a single herb or nutrient.  We use fem-guard balance by Designs for Health quite frequently in our practice due to its helpful blend of vitex, dim, black cohosh, calcium d glucarate, brocolli seed extract, b vitamins, magnesium, and calcium.   This blend helps in balancing estrogen, boosting progesterone, detoxing excess estrogen, and giving vitamins and minerals that can help with hormone balance.

Follow this link for a discount on this item from Fullscript!

I also love to recommend l-theanine for anxiety related to perimenopause.  It’s very safe and is one of the main beneficiary agents found in green tea. It is an amino acid and it supports relaxation and an improved response to stress.

Bioidentical Hormone Replacement

For those experiencing severe anxiety due to hormonal imbalances, bioidentical hormone replacement therapy (BHRT) may be an option. BHRT involves using hormones that are chemically identical to the ones our bodies naturally produce. By rebalancing hormone levels, BHRT can help alleviate anxiety, stabilize mood, and improve overall mental health. It’s important to consult with a healthcare professional specialized in hormonal health to determine if BHRT is the right choice for you.

Remember, everyone’s journey through perimenopause is unique, and what works for one person may not work for another. It’s important to listen to your body, prioritize self-care, and seek guidance from healthcare professionals and mental health experts who can provide personalized recommendations tailored to your specific needs. With the right tools and support, you can effectively manage perimenopausal anxiety and maintain your well-being.

Physical Activity and Healthy Lifestyle Changes

A Hormone Supportive Diet

Having a balanced diet, rich in omega 3 fatty acids, fiber, protein, and antioxidants, and low in sugar and alcohol, can make a work of difference in both low mood and anxiety in perimenopausal women.

Aim for 30-35 grams of fiber per day, 0.5 grams of protein for every pound of body weight (generally, this may need to be adjusted in weights over 200#), and less than 20 grams of added sugar per day (the less the better).  To get healthy antioxidants aim for 7 to 9 servings of brightly colored fruits and veggies per day!

Exercise

Exercise can be a game-changer when it comes to managing anxiety.   Getting 30 minutes of exercise daily can drastically reduce anxiety levels.  Be sure you choose a supportive type of exercise that doesn’t surge and crash your cortisol.

Beneficial types of exercise for anxiety:

• Yoga
• Pilates
• Walking
• Hiking
• Cycling
• Gentle weight training

Even if you can’t do it daily fitting in some movement 2-3 times per week this will help!

Perimenopause can be a roller coaster of emotions and physical symptoms, and understanding the relationship between perimenopause and anxiety is important to take the steps you need to feel better!

This blog was all about the relationship between perimenopause and anxiety!

FAQ

What are the symptoms of perimenopause?

Common symptoms of perimenopause include mood swings, changes in mood, and feelings of anxiety. Other physical symptoms may include hot flashes, night sweats, irregular periods, and changes in libido.

What is perimenopausal anxiety?

Perimenopausal anxiety refers to feelings of anxiety or heightened levels of anxiety experienced by women during the perimenopause stage. It can be caused by hormonal fluctuations and the physical and emotional changes that occur during this time.

How can I manage perimenopausal anxiety?

There are various tools and techniques that can help improve perimenopausal anxiety. Mindfulness and stress management practices, such as meditation and relaxation exercises, can be beneficial. Cognitive behavioral therapy (CBT) can help identify and change negative thought patterns and behaviors. Essential oils, natural supplements, and bioidentical hormone replacement therapy (BHRT) may also provide relief. It is important to consult with healthcare professionals and mental health experts to determine the most suitable tools and treatments.

How are anxiety and the phases of perimenopause related?

Anxiety and the phases of perimenopause are closely linked to hormonal changes and fluctuations. Estrogen dominance, when estrogen levels are higher than progesterone levels, can contribute to symptoms such as anxiety and mood swings. The low estrogen phase, when estrogen levels decrease, can also impact anxiety levels and lead to physical and emotional changes.