Why is anxiety worse during menopause?

As women get older and wiser, they can embrace the many changes that come with menopause. During this time of change, I experienced a sudden spike in anxiety and had my first panic attack, and it took me by surprise! 

Menopause can worsen our anxiety during menopause, affecting any woman. It is not always within our control. As hormones fluctuate and our body stops menstruation, there are several reasons why we can experience the sometimes-debilitating effects of anxiety, such as

• anxious feelings
• social isolation
• mood swings
• sleep deprivation.

I discovered that hormone fluctuations or physical changes could explain why many women have anxiety during menopause. I will be looking at the different ways it can affect you, followed by some remedies and coping strategies to assist you.

The connection between menopause and anxiety

Evidence suggests that women can experience anxiety disorders during menopause due to physical changes and other hormonal fluctuations and disruptions. 

According to this study, women in the early stages of menopause (perimenopause) when Oestrogen levels drop are statistically more likely to experience anxiety disorders. The study found that women were twice as likely as men to have anxiety disorders.

According to the psychiatrist, Jason Eric Schiffman, MD, MA, MBA, anxiety expert, women can also suffer physical symptoms during this time or be experiencing adverse life events such as the loss of parents or children leaving home.

Some women report relief that they are no longer fertile, while others mourn the loss of fertility because it means an end to their childbearing years. You may also be feeling anxious about your body image due to weight gain or other physical changes. These events can be a cause of anxiety during menopause. Read:

• Can Lemon Balm Help with Anxiety?
• What Can I Do to Stop Being Anxious About Going to Work?
• Which Herbal Teas Should I Drink for Stress and Anxiety?

summary Menopause and anxiety are connected in many ways. Physical changes such as unwanted weight gain can trigger anxiety due to body image concerns. Additionally, the adverse life events we experience as we age, such as losing one's parents or children leaving home, can trigger anxiety in women.

Different types of menopausal anxiety

Because we are all so different and have individual triggers, the type of menopausal anxiety you may be experiencing can affect you in many ways.

Women with anxiety disorders tend to have a high rate of comorbidity (more than one disorder). Menopause can cause you to experience anxiety for the first time due to a combination of hormonal and physical changes.

If you read the below descriptions and decide that you don't fit into any category or have a combination of two or more, this is entirely normal. The main types of menopausal anxiety you can experience:

• Generalised Anxiety Disorder (GAD) – an anxiety disorder that can impact your everyday living. You may have symptoms of worrying constantly.

• Social Anxiety Disorder (social phobia) – a disorder that prevents you from taking part in personal and professional social events. Physical symptoms such as hyperventilation and increased heart rate can be extreme.

• Obsessive-Compulsive Disorder (OCD) can cause irrational thoughts and fears with compulsions. You may feel the need to carry out repetitive behaviours/rituals to reduce anxiety.

• Panic Disorder – a panic disorder is an extreme reaction to fear and can be debilitating. Women can experience this in conjunction with other conditions. Symptoms include hyperventilation and a highly elevated heart rate.

Summary Women going through menopause can suffer from one or more types of anxiety. The symptoms can be similar across all disorders, and it might be hard to pinpoint which condition you are experiencing.

The link between Oestrogen and anxiety during menopause

The link between Oestrogen levels and menopausal anxiety are well documented. Oestrogen levels drop from the beginning of perimenopause until you reach menopause. You reach menopause when you have not had a period for 12 months. Read:

• Signs of premature and early menopause
• How to balance Oestrogen and Progesterone during your period

This study found that Oestrogen levels influence fear, and they regulate the inhibitors that cause us to feel fear.

As shown in this additional study, researchers found that low Oestrogen levels like those experienced during menopause may be associated with an increased risk of anxiety disorders.   This research also shows that declining Oestrogen levels can influence anxiety during menopause.

summary The evidence that flagging Oestrogen levels can trigger anxiety in menopausal women is plentiful. There have been multiple studies into the links between menopause and anxiety, and scientists agree that it is a significant factor. When a woman goes through menopause, physical and emotional changes can also contribute to higher anxiety levels.

Other reasons why you can feel anxious during menopause

If you feel like you can never get comfortable at night, and it affects your sleep, you could be experiencing one of many physical symptoms of menopause.

While hormonal fluctuations and the lower Oestrogen levels that women experience during menopause are significant contributors to anxiety levels, evidence suggests that this is not the only factor. Additional symptoms of menopause could be to blame.

We have already touched on additional reasons such as physical or emotional changes; you may be experiencing that can cause you to suffer from anxiety during menopause. We will now look at some of these in detail.

Lack of sleep during menopause can make anxiety worse

Insomnia is an unfortunate side effect of beginning your journey into menopause and out the other side. Many women report sleep disorders during the change, the most common being lack of sleep or the inability to sleep for long periods. Read:

• How can I Solve My Sleeping Problem Naturally?
• Valerian Root: My Best Natural Supplement for Anxiety
• The best sleep teas in Australia and New Zealand

Women should aim for seven or eight hours of good quality sleep a day as recommended by the Australian Government website Health Direct.

Not getting enough sleep can make anyone grumpy and tired. Inadequate sleep can also lead to poor work performance and an increased risk of injury.

Lack of sleep can also cause the following health problems:

• weakened immune system
• poor heart health
• weight gain

A history of postpartum depression can cause you to experience anxiety during menopause.

If you experienced postpartum depression following your child's birth, you might be more likely to suffer from anxiety or depression during menopause.

This study found that women with a history of postpartum depression were more likely to develop the same symptoms during perimenopause.

Perimenopause can endure up to ten years, and it is the time when your body is approaching the end of childbearing. Most women enter menopause in their 50's.

Problems with memory and concentration may cause anxiety

Nobody likes to forget things. If you find yourself in mid-conversation at a cocktail party and you can't remember someone's name, don't worry. You are not alone! It's not just menopausal women who have memory problems or issues concentrating.

Brain fog is experienced by up to 60% of menopausal women. Sleep deprivation is one of the causes of memory loss and the prevalence of hot flushes. One study found that women who experience an excess of hot flushes also complained of brain fog.

This article published in The Conversation in December 2021 looks at women's concerns that brain fog could lead to dementia. Thankfully there have been no links made between the two. You can be assured that even if your brain feels foggy right now, it should eventually clear.

The physical symptoms of menopause can make you anxious

Along with the internal feelings that accompany your menopause, several physical symptoms could be messing with your head.

Here are some physical signs you could be experiencing while going through menopause.

• Irregular periods – while you may have had regular periods most of your life, perimenopause will mess with your calendar, and you could miss periods altogether or bleed when you don't usually bleed.
• Hot flushes – Any woman who has been through menopause will tell you that hot flushes are uncomfortable and inconvenient.  They come on without warning and can leave you covered in sweat even when it’s wintertime! Read this article for further information about hot flushes – Anxiety can cause hot flashes during menopause.

• Bladder problems – Do you find yourself unable to get to the loo in time? Or you may feel like you need to pee constantly. With hormone changes comes less elasticity in your pelvic floor and the lining of your urethra begins to thin. Stress incontinence and increased peeing are possibilities at this time.
• Decreased fertility – As your body prepares for menopause, you will not be releasing as many eggs as before. If you are trying to get pregnant around this time, you may be up against the march of time. Women going through perimenopause can still get pregnant, but they may need some assistance, and it can take longer. Read: How can a woman increase her fertility naturally?
• Vaginal dryness – Having a dry vagina can affect your sex life. But it does not have to be the end of sex. There are many creams and treatments available to help.
• Thinning bones – Bone density can significantly drop following menopause if you have low density before you start menopause. See the Australian Government website Health Direct for information about how you can maintain good bone density.
• High cholesterol – a rise in the cholesterol levels of menopausal women is prevalent. Oestrogen helps regulate cholesterol, so a drop in Oestrogen means a spike in your cholesterol.
• Weight gain – Women cite this as the most common and frustrating complaint of menopause. We lose muscle tone, and our metabolism slows down, causing the kilos to creep up. Read these articles on menopausal belly fat – How to get rid of menopause belly naturally How to lose weight and belly fat by drinking hibiscus tea

The physical signs of menopause can cause undue anxiety for women going through menopause. While it might feel overwhelming, you can rest assured that you may not experience all the physical symptoms listed above. If you are concerned about any sign of menopause, you can seek reassurance from your medical professional.

Your diet can make your menopausal anxiety worse (or better)

There is a saying that "you are what you eat".

If you regularly put fresh, healthy foods into your body when going through menopause, it will thank you by making you feel on top of the world. Conversely, if you load up with fast food and sugary snacks, you may find that your anxiety levels can be worse.

When you are going through menopause, eating a healthy diet could help decrease feelings of anxiety by also solving some of the physical symptoms such as high cholesterol or bone density loss. A good diet will also help to balance your slow metabolism.

Let's look at what is good to eat and what we should avoid during menopause to lessen anxiety.

What to eat to reduce anxiety during menopause

As with most diets and food programs, common sense will tell you what to eat to maintain a healthy body and mind. It is not always easy to stay good all the time! We all slip up, and that's ok. We are human, after all.

The Health Direct website recommends a balanced diet from the five main food groups to maintain a healthy body. Food choices during menopause are essential to avoid unwanted weight gain and other related health concerns.

Here is a list of foods that can help reduce anxiety and maintain a healthy body.

• Nuts such as Brazil nuts are high in selenium and vitamin E, which can be beneficial in treating anxiety.
• Dairy products – Milk yoghurt (non-dairy alternatives high in calcium) to help with building bone density
• Fatty fish – salmon and fish rich in Omega 3
• Eggs – contain amino acids that can create serotonin
• Bananas or pumpkin seeds – high in potassium and zinc for brain nerve function
• Dark Chocolate – you didn't think it would be all healthy stuff, did you? Dark chocolate low in sugar is high in flavonoids and magnesium for brain wellbeing.

To find out more information on what to do for a slow metabolism, read this article – Metabolism changes during menopause can cause you to gain weight.

Foods to avoid if you have menopausal anxiety

Sometimes, it's easy to grab a takeaway or skip meals when you are busy at work. Take away is fine if it is only now and then. Some foods are best to avoid if you suffer from anxiety during menopause.

We know that sugar is unhealthy, and we should avoid it as much as possible. This 2015 study showed that excess sugar consumption amongst menopausal women could be a risk factor for depression and associated anxiety.

Foods to avoid:

• Sugary foods and drinks – carbonated sweet sodas, fruit juice, any food high in sugar
• Alcohol – Alcohol is a depressant and can make anxiety or depression worse.
• Trans fats – deep-fried food such as chips, chicken and fish can make you put on weight and prevent blood flow to the brain.
• High salt – salty snacks such as peanuts and crisps. Try no or low salt versions of your favourite snack.
• Caffeine – If you are a coffee-lover like me, limit yourself to one cup a day (try some natural teas instead!)
• Fermented food – while fermented foods such as sauerkraut are great for your gut health, they could increase anxiety due to the production of histamines.

summary A healthy and balanced diet is sometimes vital to improving how you feel both physically and mentally. If it is healthy and fresh, you can eat most food without having any negative impact, such as weight gain or high cholesterol. Some foods high in fats and sugars are best to avoid when you have anxiety during menopause.

The best teas to relieve menopausal anxiety

If you want to reduce your caffeine intake, you might want to try some teas that taste delicious and help reduce and relieve anxiety during menopause.

If it’s a good night sleep you are looking for, or you need some soothing fragrant beverages to help you relax, herbal teas such as the ones listed below could treat your menopause anxiety naturally. You can consume teas such as valerian root, chamomile, lavender and ashwagandha in place of your usual caffeinated brew.

We will now overview the top five teas for treating anxiety during menopause.

Valerian tea can reduce menopausal anxiety and help you sleep

Valerian Root Tea is a tea with sedative properties that has been used for thousands of years to aid sleeping. If you have insomnia associated with menopausal symptoms, valerian could help you get a good night sleep.

We recommend that you drink no more than three cups throughout the day. If insomnia is an issue for you, try drinking a cup of valerian root teas 30 minutes before bed. This study shows how valerian is a safe treatment for anxiety and insomnia.

Chamomile tea can calm your anxiety during menopause

Chamomile tea is another well-known tea for soothing anxiety and treating insomnia. It has long been utilised as a complementary and alternative medicine (CAM) for treating psychiatric disorders. Scientists who conducted this study found that chamomile has a modest effect on treating generalised anxiety.

Chamomile can be served hot or cooled, and you should not exceed three cups per day. Try organic stevia leaf powder if you wish to add some natural sweeteners.

Lavender tea is a soothing balm if you feel anxious when going through menopause

Lavender tea is not only a fragrant brew made from calming purple flowers. It is also an excellent treatment for anxiety and depression and helps with insomnia. Lavender has the active ingredients of antioxidants and anti-inflammatories, which can improve mood and reduce the signs of anxiety.

This study shows how lavender is an accessible and inexpensive complementary treatment for anxiety and depression.

Lavender tea can be served hot or cooled. Do not exceed three cups a day and drink before bed to treat insomnia.

Ashwagandha Tea can help you cope with anxious feelings during menopause

Ashwagandha tea has properties to treat stress, anxiety, and depression. It is also known as a class of plant called adaptogens which can be consumed in a tea, a tincture or a powder form. The powder can be sprinkled on food or whipped up into your favourite latte.

Ashwagandha also has the added benefits of treating some of the other symptoms of menopause that cause anxiety, such as:

• Lowering blood sugar and fat
• Increasing muscle strength
• Sharpening your memory
• Improving women’s sexual function
• Improving heart health

This study found that participants who regularly took ashwagandha before bed had reduced cortisol levels when tested the following morning. Cortisol is also known as the stress hormone.

Read:

• How to balance hormones naturally during menopause
• Ashwagandha: A Natural Remedy for Female Hormones

Stress Relief Tea Anong is a helpful treatment when you experience menopause anxiety.

What if you could have some of the delicious teas we have already discussed in one blend? Well, you can. Stress Relief Tea Anong is a blend of chamomile, ashwagandha and valerian with the added deliciousness of fennel seeds, cinnamon quills, and ginkgo leaf.

This tea can reduce anxiety and help you gain a good night's sleep. You can consume it before bed, and it is recommended that you don’t exceed three cups per day.

summary Natural herbal teas such as valerian, chamomile, lavender and ashwagandha can help you relax and get a good night's sleep. The additional properties of these teas far outperform their function of a relaxant.

Can a psychiatrist help with anxiety during menopause?

Of course! A psychiatrist or therapist can help you with any perimenopausal or menopausal mental health concerns you don't feel able to handle.

Anxiety sufferers respond positively when treated by a psychiatrist or therapist who deals with cognitive behavioural treatment (CBT). Panic attacks which are an extreme reaction to fear or anxiety, can be reduced by using the self-care strategies utilised by CBT practitioners.

This article shows how CBT is an effective and efficient treatment for all types of anxiety disorders. Cognitive behavioural therapy is a short-term treatment that focuses on people’s thoughts, beliefs and attitudes and feelings and behaviours.

Some of the ways cognitive behavioural therapy can help you:

• Identify problems
• See things from another perspective
• Identify irrational thoughts
• Face your fears instead of avoidance
• Stop judging yourself and others
• Develop a positive way of thinking or viewing situations
• Stop fearing the worst

Will my anxiety go away once menopause is over? Once menopause is over, many women find that their menopausal anxiety decreases. If your anxiety is purely hormone-based, this might be the case; however, if you have other issues in your life that are causing anxiety, you may still need to find ways to cope with continuing anxiety.

Conclusion

As you can see, anxiety during menopause can be a complex condition to deal with. There are many reasons we may be feeling anxious, not all of them hormonal. The reason I experienced panic attacks will not be the same reason you do.

The critical thing to remember is that you are not alone, as menopausal anxiety and depression are very real. Each day can be a struggle for some women, but if you use some of the self-care suggestions in this article, hopefully, you can see the light at the end. Remember always to love yourself first!