Reviewed by: Cynthia Krause, MD
Occasional anxiety is normal at any stage of life. It’s common among women in midlife and can accompany perimenopause and menopause in some women. Prolonged anxiety during menopause, however, could be a sign of an anxiety disorder.
Anxiety is the feeling of fear, nervousness, or apprehension that arises when facing a stressful situation, like a looming deadline or a job interview. Most people experience anxiety at least once in their lives. It can arise during perimenopause and menopause for a number of reasons, including fluctuations in the levels of the hormones estrogen and progesterone and major life changes that tend to happen around midlife. Anxiety symptoms are reported more often during perimenopause compared to before its onset.
Experiencing anxiety during menopause is common. But prolonged anxiety—the kind that interferes with work, socializing, and everyday tasks—may be a sign of an anxiety disorder, such as generalized anxiety disorder, panic disorder, and social anxiety disorder. This too is not uncommon: Nearly 30 percent of adults are affected with an anxiety disorder at least once in their lives.
At any stage of life, anxiety can lead to a wide range of symptoms. In addition to nervousness and tension, it may also cause feelings of panic, terror, and dread. Physical symptoms may include a racing heart, rapid breathing, sweating, trembling, muscle weakness, and stomach issues. People with anxiety disorders often also have depression. Fortunately, anxiety disorders can be treated in a number of effective medical and non-medical interventions, including medication and psychotherapy. For people going through menopause, hormone therapy can be helpful.
During menopause, levels of the sex hormones estrogen and progesterone start to decrease. These fluctuations, though normal, are sometimes associated with the onset of anxiety. The mechanisms aren’t clearly understood yet, but some researchers think that mood disorders like anxiety and depression happen during menopause because shifts in hormone levels affect the brain’s neurotransmitters, including serotonin and norepinephrine. Others have suggested that the brains of people with serious anxiety during menopause may be more sensitive to hormonal changes during this stage of life.
Menopause also tends to coincide with big life changes, such as children reaching adulthood and leaving home, elderly parents becoming sick or passing away, career upheavals, and the realization that one can no longer have children. All of these events can be stressful, which may also contribute to feelings of anxiety. In addition, uncomfortable physical symptoms of menopause such as hot flashes can disturb sleep, which can also lead to anxiety.
Anxiety is the way the body prepares to respond to a stressful situation or threat. For a short while, the heart races, blood rushes to the brain, blood pressure spikes, and breathing becomes faster. These events are mediated by a flood of stress hormones like adrenaline (also known as epinephrine) and cortisol, which is triggered by the brain. As a result, you’re mentally and physically primed to handle the source of stress.
For people experiencing menopause, these hormonal shifts occur against the backdrop of steadily decreasing estrogen and progesterone. The role of estrogen in regulating mood is complex and not fully understood. Research has linked estrogen in the brain to increased serotonin, the production of endorphins, and the protection and growth of neurons. These effects may change as estrogen levels drop.
A psychiatrist, psychologist, licensed clinical social worker, or other mental health professional will speak to you about your experience of menopause, symptoms, family history, and medical history before coming to a diagnosis. Sometimes a physical exam or blood test is recommended to rule out any health-related causes. Your mental health professional will tell you whether what you’re experiencing is normal anxiety or an anxiety disorder.
Anxiety disorders are often treated with medication, psychotherapy (also known as “talk therapy”), or a combination of both. Some common medications include:
Psychotherapy is a common and effective treatment for anxiety disorders that’s often used along with medication.
Non-psychotherapy interventions can also be helpful in managing anxiety.
Are you experiencing other symptoms that you want to better understand? Check out our following guides:
Disclaimer: This information isn’t a substitute for professional medical advice, diagnosis, or treatment. You should never rely upon this article for specific medical advice. If you have any questions or concerns, please talk to your doctor.
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