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

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 for anxiety 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 anxiety 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.