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Menopause & Anxiety: Connections, Signs, & How to Cope

Published: April 21, 2022 Updated: June 22, 2022
Published: 04/21/2022 Updated: 06/22/2022
Headshot of Iris Waichler MSW, LCSW
Written by:

Iris Waichler

MSW, LCSW
Headshot of Rajy Abulhosn, MD
Reviewed by:

Rajy Abulhosn

MD
  • What’s the Connection Between Menopause and Anxiety?Connection
  • Menopause Anxiety SymptomsSymptoms
  • When Should I Seek Help for Anxiety During Menopause?Getting Help
  • Treatments for Menopause Related AnxietyTreatments
  • Natural Remedies for Menopause AnxietyNatural Remedies
  • Final Thoughts on Dealing With Menopause and AnxietyConclusion
  • Additional ResourcesResources
Headshot of Iris Waichler MSW, LCSW
Written by:

Iris Waichler

MSW, LCSW
Headshot of Rajy Abulhosn, MD
Reviewed by:

Rajy Abulhosn

MD

Menopause, or the decline of reproductive hormones signaled by 12 months without a menstrual cycle, typically occurs for women in their 40s and 50s. Research shows that these physical and psychological changes, as well as other midlife stressors, can result in increased anxiety.1 If symptoms of anxiety are identified, they can be treated and alleviated with therapy, healthy lifestyle changes, and sometimes medication.

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What’s the Connection Between Menopause and Anxiety?

It can be hard to understand why you may be feeling differently during menopause, but it’s important to take a moment to consider all the hormonal changes and brain chemical changes happening during this time. Your hormone levels are dropping leading to lower levels of certain brain chemicals, such as serotonin. Having less serotonin circulating in your system can lead to feelings of anxiety and panic, as well as depression and unstable moods.

How Common Is It?

Anxiety with menopause is more common than you think. Many women do not enjoy talking publicly about the changes they are going through, so it can be hard to recognize how prevalent it is—one in four women going through menopause experience anxiety and panic attacks.2

Can Menopause Cause Anxiety?

The onset of menopause and its associated physiological, mood, and cognitive changes can cause symptoms of anxiety. There is actually a direct link between hot flashes and anxiety.3 Additional symptoms like loss of sleep and a reduced clarity in thinking naturally create concern, stress, and anxiety.

There is also the timing of menopause, which often coincides with important midlife transitions. It is the end of childbearing years, child rearing issues can become more prevalent as children grow older, and health issues with parents or partners can occur. Concerns about body image may also arise. Midlife is often a time to re-evaluate choices regarding career, life goals, and relationships. Any of these factors may produce feelings of stress and anxiety.

Menopause Anxiety Symptoms

Women often anticipate they will experience changes in mood when menopause occurs, but knowing the symptoms of anxiety can help you get the help you need to feel better.

Other common commonly reported symptoms that can occur with menopause and anxiety include:

  • Panic attacks
  • Heart palpitations
  • Sweating/hot flashes (also called vasomotor symptoms or VMS)
  • Shortness of breath
  • Dizziness
  • Irritability
  • Nausea
  • Shaking
  • Reduced ability to concentrate and focus
  • Chills

Does Anxiety Dissipate Post-Menopause?

Once menopause concludes, the hormonal imbalance stabilizes. Mood changes, including the anxiety that can accompany the menopausal transition, typically resolve over time. For those whose symptoms are significant enough to require treatment, medication or other interventions won’t necessarily have to continue long-term, potentially just through this time period.4

One factor that must be considered when assessing the continuation of anxiety post-menopause is a woman’s mental health history prior to the onset of menopause. Women with a pre-existing diagnosis of anxiety can be more prone to experiencing anxiety post-menopause.5

When Should I Seek Help for Anxiety During Menopause?

During menopause, experiencing anxiety is a natural reaction to the changes happening in your body. While some anxiety is normal, there are signs that you need professional help, including:

  • Difficulties with work
  • Difficulties with relationships
  • Trouble sleeping
  • Suicidal thoughts
  • Negative feelings lasting two weeks or more
  • Lack of support
  • Inability to focus or complete day to day tasks
  • Severe mood swings

Treatments for Menopause Related Anxiety

There are a number of treatment options available for women struggling with menopause anxiety, including hormone replacement therapy (HRT), medication, and therapy, along with healthy lifestyle changes like exercise and meditation. If your anxiety symptoms continue to negatively affect your quality of life, your relationships with others, or your ability to function at work or home, it is important to seek help as soon as possible.

Hormone Therapy for Menopause and Anxiety

This treatment option is used to help with mood instability during menopause, and alleviate menopausal symptoms that contribute to anxiety. It involves the adjustment of estrogen levels, and it can be provided by endocrinologists, obstetricians/gynecologists, internists, and family care practitioners. There are risks with hormone therapy and you should talk with your doctor about the pros and cons to determine if it is right for you.

Menopause Anxiety Medication

If anxiety is severe, a doctor may recommend an anxiety medication like a selective serotonin reuptake inhibitor (SSRI) to help stabilize mood. Examples of SSRIs include Zoloft, Paxil, or Prozac. Be sure and ask about any potential side effects.

Therapy for Anxiety

Cognitive behavioral therapy (CBT) is a short-term therapy designed to help link physical symptoms with thoughts, feelings, and behavior, allowing you to alter negative thoughts and feelings to create a positive outcome. CBT can help women in menopause feel more in control of their bodies and minds.

Finding Help For Anxiety

To cope with anxiety, start by educating yourself about how it presents with menopause, and how it can be related to the physical changes happening in your body. Talk with your OB/GYN or primary care physician (PCP) about your concerns and be honest about your symptoms and the challenges they create.

To find a therapist in your area, consider using an online therapist directory. It allows you to search for a mental health professional in your area with expertise in treating anxiety, life transitions, etc.

7 Natural Remedies for Menopause Anxiety

Women have more options than they might realize to help manage their symptoms of anxiety during menopause, including changes to diet, added physical activity, mindfulness techniques, sleep adjustments, and relying on a trusted support system. Having this knowledge at your disposal can lower anxiety levels.

Here are seven ways to alleviate anxiety symptoms:

  1. Eat healthy foods: The Center for Treatment of Anxiety and Mood disorders advises that caffeine and alcohol can worsen symptoms while complex carbohydrates act as a mild tranquilizer to steady your emotions.6
  2. Exercise: Physical activity helps you feel like you are controlling your body rather than it controlling you. Exercise acts as a natural stress reducer, and also provides a feeling of personal achievement
  3. Engage in activities that activate your mind: Memory loss and difficulty concentrating or focusing can create feelings of anxiety. Do activities to sharpen your mind like crossword and jigsaw puzzles.
  4. Practice mindfulness techniques: Yoga, meditation, deep breathing, and guided imagery are all great coping techniques. They help slow down your body, your mind, and your thinking. They also help you feel more in control of your body.
  5. Get more sleep: Interrupted sleep is not unusual during menopause. Try to get as much sleep as possible. If you have the opportunity to nap, take advantage of it. Uninterrupted sleep recharges the body and mind.
  6. Maintain social connections: Isolation can trigger depression and anxiety, so spend time with people you feel close to. It is important to have people you can candidly discuss your feelings with.
  7. Speak with others who’ve been through it: If you have friends or family that have experience with menopause and anxiety, ask how they coped. They may have helpful insights and tips.

Dealing With a Panic Attack

It’s important to give yourself some space to accept what you are going through because your body is dealing with a lot. It may not seem like it sometimes, but your symptoms of menopause are valid. If you have a panic attack, think about where it came from and how to identify triggers to learn how to redirect your thoughts. It will take time to adjust to the new body changes so being patient with yourself will be important. If you are dealing with ongoing anxiety, it’s possible you may have more panic attacks, so having a support network and treatment plan available to you will also be important.

Final Thoughts on Dealing With Menopause and Anxiety

Symptoms of anxiety in conjunction with menopause fluctuate from none to severe, and can change based on the intensity of physical factors like lack of sleep, night sweats, and hot flashes. Remember, you are not alone. If you have disruptive symptoms impairing your daily life, be assertive in terms of self-care. Educate yourself and consult with mental and medical health professionals to take back control.

Additional Resources

Education is just the first step on our path to improved mental health and emotional wellness. To help our readers take the next step in their journey, Choosing Therapy has partnered with leaders in mental health and wellness. Choosing Therapy may be compensated for referrals by the companies mentioned below.

BetterHelp (Online Therapy) – BetterHelp has over 20,000 licensed therapists who provide convenient and affordable online therapy. BetterHelp starts at $60 per week. Complete a brief questionnaire and get matched with the right therapist for you. Get Started

Online-Therapy.com – Receive help for anxiety. The Online-Therapy.com standard plan includes a weekly 45 minute video session, unlimited text messaging between sessions, and self-guided activities like journaling. Recently, they added Yoga videos. Get Started

Brightside Health (Online Psychiatry) – If you’re struggling with anxiety, finding the right medication can make a difference. Brightside Health treatment plans start at $95 per month. Following a free online evaluation and receiving a prescription, you can get FDA approved medications delivered to your door. Free Assessment

Headspace (Meditation App) – Headspace is the leading mindfulness and meditation app with over 70 million members. Headspace offers guidance and exercises for all skill levels, including beginners. Free Trial

Choosing Therapy’s Directory – Find an experienced therapist specialising in anxiety. You can search for a therapist by specialty, availability, insurance, and affordability. Therapist profiles and introductory videos provide insight into the therapist’s personality so you find the right fit. Find a therapist today.

Choosing Therapy partners with leading mental health companies and is compensated for referrals by BetterHelp, Online-Therapy.com, Brightside, and Headspace

For Further Reading

  • 12 Best Self-Help Books for Women
  • Mental Health America
  • National Alliance on Mental Health
  • MentalHealth.gov
6 sources

Choosing Therapy strives to provide our readers with mental health content that is accurate and actionable. We have high standards for what can be cited within our articles. Acceptable sources include government agencies, universities and colleges, scholarly journals, industry and professional associations, and other high-integrity sources of mental health journalism. Learn more by reviewing our full editorial policy.

  • Going Mad in Perimenopause? Signs and Solutions. (2021) North American Menopause Society. Retrieved from https://www.menopause.org/for-women/menopauseflashes/menopause-symptoms-and-treatments/going-mad-in-perimenopause-signs-and-solutions

  • Rössler, W., Ajdacic‐Gross, V., Riecher‐Rössler, A., Angst, J., & Hengartner, M. P. (2016). Does menopausal transition really influence mental health? Findings from the prospective long‐term Z urich study. World Psychiatry, 15(2), 146-154.

  • Liisa Hantsoo, Ph.D and C. Neill Epperson, M.D. (2017) Anxiety Disorders Among Women: A Female Lifespan Approach. Focus American Psychiatric Publication. Spring 2017; 15 (2): 162-172. doi:10.1176/appi.focus.20160042. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5613977/

  • Harvard Health Publishing. (2020) Menopause and Mental Health. Harvard Women’s Health Watch. Retrieved from https://www.health.harvard.edu/womens-health/menopause-and-mental-health

  • Joyce T. Bromberger, Ph.D, Howard M. Kravitz, D.O., Yuefang Chang, Ph.D, John. F. Randolph Jr., M.D., Nancy E. Avis, Ph.D, Ellen B. Gold, Ph.D, Karen A. Matthews, Ph.D.
    (2013) Does Risk for Anxiety Increase During the Menopausal Transition? Study of Women’s Health Across the Nation (SWAN). Menopause 2013 May; 20(5):488-495. doi:10.1097/GME.0b013e3182730599. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3641149/

  • Center for Treatment of Anxiety and Mood Disorders. Menopausal Anxiety. Retrieved from https://centerforanxietydisorders.com/treatment-programs/menopause-anxiety/

update history

We regularly update the articles on ChoosingTherapy.com to ensure we continue to reflect scientific consensus on the topics we cover, to incorporate new research into our articles, and to better answer our audience’s questions. When our content undergoes a significant revision, we summarize the changes that were made and the date on which they occurred. We also record the authors and medical reviewers who contributed to previous versions of the article. Read more about our editorial policies here.

  • Originally Published: March 12, 2021
    Original Author: Iris Waichler, MSW, LCSW
    Original Reviewer: Rajy Abulhosn, MD

  • Updated: April 21, 2022
    Author: No Change
    Reviewer: No Change
    Primary Changes: Updated for readability and clarity. Reviewed and added relevant resources. Added “What’s the Connection Between Menopause and Anxiety?”, “How Common Is It?”, “When Should I Seek Help for Anxiety During Menopause?”, and “Dealing With a Panic Attack”. New material written by Silvi Saxena, MBA, MSW, LSW, CCTP, OSW-C and reviewed by Dena Westphalen, PharmD.

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Headshot of Iris Waichler MSW, LCSW
Written by:

Iris Waichler

MSW, LCSW
Headshot of Rajy Abulhosn, MD
Reviewed by:

Rajy Abulhosn

MD
  • What’s the Connection Between Menopause and Anxiety?Connection
  • Menopause Anxiety SymptomsSymptoms
  • When Should I Seek Help for Anxiety During Menopause?Getting Help
  • Treatments for Menopause Related AnxietyTreatments
  • Natural Remedies for Menopause AnxietyNatural Remedies
  • Final Thoughts on Dealing With Menopause and AnxietyConclusion
  • Additional ResourcesResources
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