Menopause feels as though it brings a complicated mess of symptoms, including anxiety and hot flashes. We want to relieve as many as possible with each potential remedy we find, but sometimes, one symptom of menopause will cause another to appear.
Research shows that hot flashes and anxiety don’t just appear together during menopause. In fact, several hormonal and neurotransmitter pathways interact during menopause that also allows anxiety to cause hot flashes, a well-known symptom of menopause that can severely impact our quality of life.
Because the two symptoms are linked, we can, fortunately, relieve both at once.
How anxiety causes hot flashes
Have you ever received the well-meaning but unwelcome advice that a positive outlook may help relieve menopausal symptoms? It turns out that this isn’t a placebo effect. Anxiety causes hot flashes through your hormones.
Noradrenaline is part of the fight or flight response. It spikes during times of stress or anxiety, so we are better able to escape threats, but it worsens hot flashes too. Research demonstrates that drugs acting on the same cell receptors as noradrenaline can either increase hot flashes or delay them, depending on their specific effects.
In the real world, women with stressful lives are at a higher risk of hot flashes, particularly chronic stress such as financial difficulties.
What if you don’t just suffer from stress but instead have an anxiety or depressive disorder? Other studies have found that anxiety and depression scores are higher among menopausal women with hot flashes too.
The authors described other research with similar results, which found that increasing levels of serotonin and noradrenaline was actually linked to lower rates of hot flashes.
It doesn’t seem to make sense, but higher levels of noradrenaline will turn its production pathways down. This means keeping noradrenaline up may prevent the spikes that contribute to hot flashes by disrupting temperature control.
Can anxiety make you feel hot and sweaty at night?
The answer is no. Anxiety won’t make you have these feelings during the night.
If your levels of noradrenaline are high at night, they may lead to hot flashes and night sweats when you’re trying to sleep. However, research on the stress response shows lower body temperature when stress hormones are still high during calm periods.
In these situations, the stress response may be so burnt out from being chronically overstimulated that functions such as temperature control are not responding correctly.
Elevated levels of the stress hormone noradrenaline can affect body temperature regulation, leading to increased hot flashes and night sweats.
What causes hot flashes and anxiety during menopause?
Menopause begins when our ovarian reserves run out, as women are born with all of the eggs we will ever produce. The loss of eggs means a fall in the production of oestrogen and progesterone, the female sex hormones, and eventually issues including hot flashes and anxiety.
Which hormones can cause hot flashes?
A fall in oestrogen and progesterone causes Follicular Stimulating Hormone (FSH) and Luteinising Hormone (LH) to rise, which disrupts body temperature control during menopause. Although the main cause of hot flashes is FSH and LH spikes, other hormones such as cortisol play a role too.
Cortisol is the main stress hormone and is necessary when in balance. A healthy cortisol rhythm will peak in the morning to help us wake up and slowly taper off until night when we sleep. However, elevated cortisol may contribute to hot flashes.
As part of the fight-or-flight response, cortisol constricts the blood vessels to raise blood pressure. This keeps heat inside the body, too, so you may feel warmer or be more prone to hot flashes because the extra heat has nowhere to go.
Research also shows that cortisol rises during menopause, and higher cortisol is associated with more severe menopausal symptoms. To make things worse, this cortisol elevation was also linked to higher markers for cardiovascular disease risk and insulin resistance. This insulin resistance was an effect of menopausal weight gain, which is mostly abdominal fat.
To learn more about solutions for menopausal weight gain, read this article
The role of serotonin in preventing anxiety and hot flashes
Serotonin, an essential mood-balancing, uplifting neurotransmitter, may also play a role in body temperature regulation. For this reason, it is important for both preventing anxiety and hot flashes.
Low levels of the “happy” brain chemical lead to a rise in the stress hormone noradrenaline, which, as we know, disrupts body temperature control, causing both anxiety and hot flashes.
However, when oestrogen falls during menopause, serotonin drops too. Falling serotonin also increases noradrenaline indirectly by worsening stress and anxiety.
Serotonin levels in menopausal women are around half of that seen in younger women, so it’s not all in your head if you haven’t been feeling yourself since menopause. Not only does serotonin lift mood, but it calms the stress response too.
Can hot flashes be psychological?
No. Hot flashes may involve the physical stress response more than our psychological reactions.
Research on mindfulness practices did not show a reduction in severity of hot flashes over time. Instead, it provided stress relief and reduced how much hot flashes bothered the participating women.
The role of cortisol in the stress response links higher levels of the hormone to more severe hot flashes, while a fall in serotonin raises noradrenaline. The other negative impact of these stress hormones makes keeping them in balance, essential to your overall health.
Other menopausal symptoms linked to anxiety
Besides hot flashes, there are other menopausal symptoms linked to anxiety through the disruption of the healthy stress response. However, it’s important to have a solution-focused perspective about them, as stressing over your health can worsen any issues you may have.
Adrenaline, noradrenaline and cortisol increase heart rate and blood pressure as part of the fight-or-flight response. As a result, some of the more distressing and risky menopausal symptoms are linked to anxiety.
In one study, the rate of heart palpitations was compared to overall menopausal symptom severity, as well as overall anxiety and depression scores.
Palpitations and their severity were linked to
- higher blood pressure
- vasomotor menopause symptoms (a category that includes hot flashes)
- anxiety and depression scores
- lack of exercise and lower levels of fitness
As we covered above, higher cortisol levels also increase cardiovascular disease risk.
If you have noticed a tight feeling in your chest when you’re very stressed and anxious, you will be aware of how our emotional states affect our heart rhythm.
Research shows that chronic stress causes poor heart rate variability (HRV), a key marker of your cardiovascular system’s resilience to stress – and, therefore, your risk of heart disease later on.
The cardiovascular symptoms and potential complications of menopause are linked to anxiety too. Cortisol and other stress hormones are likely responsible as their cardiovascular effects form part of the fight-or-flight response.
Herbal remedies to relieve anxiety and hot flashes during menopause
If you have another condition that makes increasing your oestrogen levels unsafe, you don’t have to only rely on hormone replacement therapy (HRT) or bioidentical versions of it. There are other ways to relieve anxiety and hot flashes during menopause, such as using herbal remedies.
Some clinical trials show that herbal remedies can restore your levels of serotonin and relieve both anxiety and hot flashes during menopause as a result. Others point to the benefits of reducing inflammation and modulating hormone pathways by acting on the receptors or providing weaker versions of oestrogen.
Many herbal remedies can also lift serotonin, with fewer (if any) side effects:
- St John’s Wort is perhaps the most well-known herbal remedy for boosting serotonin. This ability has meant that researchers have described it as similar to some antidepressant medication in efficacy for mild to moderate depression. However, St John’s Wort is incompatible with a number of pharmaceutical drugs.
- Ginkgo biloba is a popular herbal tea for boosting cognition, as it can increase blood flow to the brain alongside antioxidant capacity. Some clinical trials show that ginkgo is able to relieve anxiety through mechanisms such as enhancing serotonin levels.
- Turmeric, more specifically its active phytochemical curcumin, can raise serotonin and relieve anxiety, possibly even when it has an additional cause such as heavy metal toxicity.
Some more herbal remedies that can help to relieve hot flashes work on the hormonal pathways, and even by reducing inflammation and oxidative stress:
- Ashwagandha is a popular herbal remedy for fatigue. In menopausal women, it can partially restore oestrogen while reducing FSH and LH. Click here to learn more about Ashwagandha for female hormones.
- Flaxseed is an omega-3 fatty acid-rich food that you can use in many keto and low-carb recipes. The seeds are rich in lignans, which can be converted into weak oestrogens. Research shows they can moderately but significantly reduce symptoms such as hot flashes while improving oestrogen levels in the blood.
- Maritime pine bark extract is a potent, protective antioxidant valued in some antiaging circles for its ability to prevent tissue damage. This property may extend to menopause, with a standardised extract found to relieve hot flashes and other symptoms.
- Maca root is a popular ingredient in superfood smoothies, as it is claimed to enhance energy, overall vitality and hormone production. A number of small studies show that maca could reduce the severity of hot flashes, possibly by enhancing or behaving like oestrogen.
A number of herbal remedies can relieve hot flashes and sometimes anxiety too. They work by enhancing serotonin, reducing inflammation and moderating hormone pathways.
Other ways to relieve anxiety during menopause (and hot flashes too)
The reduction in anxiety lowers cortisol and overall dampens the fight-or-flight response; therefore, it can relieve hot flashes. Besides herbal remedies, lifestyle interventions can also ease anxiety and hot flushes during menopause.
Regular exercise and certain types of meditation may relieve anxiety during menopause, calming hot flashes as a result. These often work by calming the fight-or-flight response, lowering cortisol and other stress hormones in the process.
Regular exercise for anxiety relief
Walking regularly is one example of lifestyle remedies that can relieve menopausal symptoms such as anxiety and insomnia.
A study of over 100 women compared increasing their step count by just 500 more per day to no change and still found great benefit. The women walking more had anxiety and insomnia scores of just 4.2-3, while the control group saw worsened scores, increasing from 5.4 at eight weeks to 7.2 at 12 weeks.
Meditation to relieve stress
Additionally, some types of meditation may improve heart rate variability and relieve stress, which may help to prevent some cardiovascular complications of menopause.
They include loving-kindness meditation, a practice that involves sending love and compassion out to a random person. You don’t have to know or even like them, which some people find difficult.
Research shows the benefits of swapping anger for compassion, even if it may seem difficult. Compassion is linked with higher levels of protective antibodies that guard our digestive systems and lungs from damage. On the other hand, anger negatively affects heart rate and heart rate variability.
Both exercise, meditation and other lifestyle changes can help too if you are anxious about going to work.
The importance of gut health on relieving anxiety
Addressing food intolerances that you may have had for years could also help relieve anxiety.
These potentially harmful foods, including gluten and cow’s milk, can increase inflammation in the digestive tract. Intestinal inflammation then leads to disruption of neurotransmitter production, both directly in the gut and by dysregulating the immune system.
Some gut bacteria help us out by producing neurotransmitters, including serotonin and the calming GABA, which relieves anxiety too.
Besides eliminating problem foods, increasing your intake of vegetables and whole grains can feed these friendly species with their fibre content.
The best foods to support friendly bacteria include:
- Wheat bran (unless you are intolerant).
Fermented foods may be helpful too because they not only feed the bacteria you already have but provide anti-inflammatory, neurotransmitter-producing species directly.
Relieving anxiety during menopause involves many of the same lifestyle remedies as you would see in any other holistic protocol. Regular exercise, meditation and improving gut health can all restore healthy neurotransmitter production, along with regulating heart rate and inflammation.
Even though hot flashes and anxiety during menopause are common, you don’t have to suffer from them with no relief.
We know that stress hormones and reduced neurotransmitter production play a role in the appearance and severity of hot flashes, so you can even find relief if you aren’t able to take oestrogen replacement.
Increased stress hormones dysregulate body temperature directly and indirectly though raised blood pressure and blood vessel constriction. Neurotransmitter deficiencies worsen our mood and ability to handle stress, increasing levels of these hormones even more.
Herbal remedies such as ginkgo, maritime pine bark and St John’s Wort can help restore healthy levels of neurotransmitters and calm cell-damaging inflammation. These, along with stress-relieving lifestyle changes such as meditation and exercise, can help you feel more like your true self again.