Menopausal? Anxious? It’s Normal—Here’s What to Do
Ellen was getting frustrated. She had felt “off” for going on a year-and-a-half. It was hard to pinpoint her symptoms at times, but they included things like brain fog, difficulty sleeping, and changing appetite, so she figured she was going through the early symptoms of menopause. She was about the right age, after all, and understood that things were likely to get a little “wiggy” for awhile until her body’s hormones stabilized again.
She did her best to eat healthy and get enough exercise, and on most days handled her symptoms fairly well, except one: her anxiety. It seemed to creep up and take hold without warning. She would wake up in the middle of the night with her mind racing and have difficulty getting back to sleep. She called her partner several times throughout the day, just to be sure he was okay or to hear his calming voice.
One day in the middle of a traffic jam, she started sweating. Her heart raced, and for several minutes she felt she couldn’t breathe. It was a full-blown panic attack, but she couldn’t pinpoint any real reason for it. Was she going through some sort of weird nervous breakdown?
Ellen went to see her doctor, and was surprised to learn that her symptoms were normal. Her doctor confirmed she was entering menopause, and told her that unfortunately for many women, menopause and anxiety go together.
The Connection Between Menopause and Anxiety
Women who are suffering from anxiety around perimenopause or menopause can rest assured that it’s a normal symptom to have.
Scientists have found this to be true in a number of studies. You may not have heard of it before, but there’s no doubt that anxiety is often a symptom of menopause or perimenopause just as much as hot flashes and sleep disruptions. In a recent 2017 study, for example, scientists stated that not only does anxiety often plague women during this time, but that it can also seriously affect a woman’s quality of life.
In fact, anxiety is likely to make all the other symptoms you’re having worse. Researchers looked at medical data from over 3,500 women and found that severe physical symptoms were five times more likely in women with anxiety than in women without it.
They weren’t sure why this would be, but they theorized that since anxiety is associated with increased levels of messengers in the brain like serotonin and norepinephrine—and because these messengers also play a part in regulating body temperature—that suffering from anxiety could actually make things like hot flashes worse.
“This study documents the importance of screening patients for anxiety,” said Dr. JoAnn Pinkerton, the executive director of The North American Menopause Society (NAMS). “If women are having significant anxiety, they should discuss viable treatment options with their healthcare providers.”
Other studies have reported similar findings. Back in 2013, researchers found that women who didn’t have any trouble with anxiety at the beginning of the study were more likely to report high anxiety symptoms when they started going through perimenopause or menopause. This happened regardless of whether the women experienced stressful life events like financial strain or other health problems.
Other studies have gone to far as to say that panic disorder is common during perimenopause. Women may start to suffer from anxiety as they enter this phase, or if they had anxiety before, that anxiety may get worse. In one study, out of forty-five women, eight developed panic disorder with menopause, leading researchers to conclude that the disorder “may arise and worsen with menopause.”
In a larger study of over 3,300 women, panic attacks were most common when women were transitioning into menopause, and were found to be more common in women who were suffering from other physical problems as well, like migraine headaches, cardiovascular disease, and symptoms of depression.
There are many more studies showing a connection. In summary, experts have concluded that “anxiety is normal” during perimenopause, and even after menopause. The problem is that in many cases, it can stick around. The anxiety can last for years, and can severely affect your quality of life.
So what can you do about it?
How Women Can Better Manage Menopausal Anxiety
The first thing you can do is to get help. Trying to “tough it out” and get through it is a losing proposition. The anxiety will make your physical symptoms worse, and your physical symptoms are likely to make your anxiety worse. The less sleep you get the more anxious you’re going to feel, and as you feel more anxious your hot flashes and sleep disturbances are likely to get worse, too. It’s a losing battle unless you get something to break the cycle.
The good news is that addressing your physical symptoms may help your anxiety improve, too. So start by asking your doctor about options. Though many women shy away from hormone replacement therapy because of the health risks reported a few years ago, more recent studies have shown that most women don’t need to be so concerned. The risks may outweigh the benefits in your case, and hormones could help you feel a lot better.
There are other options, too. Herbs like black cohosh, St. John’s wort, and maca have the ability to help replace some of the estrogen lost during menopause, and by doing so, can help ease menopausal symptoms like hot flashes and mood swings. Other possible options include chasteberry, American ginseng, and red clover. (Always check with your doctor first before taking a new herb.)
Acupuncture and massage can also help, and regular exercise is a must. Support groups can give you the opportunity to share your feelings with other women who are going through the same thing, and mindfulness practice (meditation and related deep breathing) can create a calmer state of mind.
Next, you can focus on calming your anxiety. There are medications that can help you short-term, including anti-anxiety drugs and antidepressants, but there are also many natural options available. Calming herbal teas like chamomile, lemon balm, and passionflower can help you relax, especially before bedtime. Some herbal supplements like gotu kola, kava, valerian, and lavender may help keep you on an even keel throughout the day. Be aware that some can increase sleepiness, so give each herb a trial period so you can find the one that works best for you.
Watch your diet, too. Things like caffeine and other stimulants can make your anxiety worse. Increase your intake of calming foods with tryptophan like turkey, milk, bananas, and nuts. Then try to work in a stress-relieving activity into your day, like yoga, walking, tai chi, or even just some time at the park or in nature.
Finally, be aware of the many resources there are out there for dealing with anxiety. The Calm Clinic has great information and resources that can help you learn more about why you may be feeling anxious, and how you can address your thoughts in the heat of the moment. (Note: deep breathing always helps!)
The most important thing is to realize that this is a symptom of hormonal changes, and that your best approach is to find something to help you deal with it. Just like you may have gotten some new herbs or medications to ease your hot flashes, you should feel perfectly justified to do the same thing with your anxiety. There’s no reason to suffer through this period. With a little help, you can feel better.
Jorge L. Nunez-Pizarro, et al., “Association between anxiety and severe quality-of-life impairment in postmenopausal women: analysis of a multicenter Latin America cross-sectional study,” Menopause, 2017: https://insights.ovid.com/crossref?an=00042192-201706000-00009.
Joyce T. Bromberger, et al., “Does Risk for Anxiety Increase During the Menopausal Transition? Study of Women’s Health Across the Nation (SWAN),” Menopause, May 2013; 20(5):488-495, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3641149/.
Claudia P., et al., “Panic disorder in menopause: a case control study,” Maturitas, 2004; 48(2):147-54, http://reference.medscape.com/medline/abstract/15172089.
Smoller JW, et al., “Prevalence and correlates of panic attacks in postmenopausal women: results from an ancillary study to the Women’s Health Initiative,” Arch Intern Med., 2003; 163(17):2041-50, http://reference.medscape.com/medline/abstract/14504117.