Can Perimenopause Spark Anxiety?

Can Perimenopause Spark Anxiety
Can Perimenopause Spark Anxiety?

As oestrogen production varies during the perimenopause, anxiety may increase. During this crucial phase, there are things you may do to calm yourself down and reduce your stress.

Before menopause, when your monthly periods stop, your body's levels of reproductive hormones fluctuate during the perimenopause.

Some women experience increased anxiety during the perimenopause. This article gives you some insight into how that anxiety may feel and what you may do to lessen it.

What does anxiety during perimenopause feel like?

Perimenopause can cause some physical problems. Some are emotional or mental. Here is a summary:

Symptoms of perimenopausal anxiety include:
  • having trouble concentrating and remembering things
  • tensing muscles throughout your body
  • feeling nervous, irritable, or restless
  • having trouble relaxing
  • worrying more than usual
  • sweating
  • having trouble falling asleep or staying asleep
For some people, perimenopausal anxiety can result in panic episodes with symptoms like fear, dizziness, chest pain, and a rapid heartbeat.

Language Matters

You'll note that we refer to "man" and "women" in this essay as two opposites. Although we are aware that this term might not accurately describe your gender experience, it is the term employed by the researchers whose work was mentioned. We make every effort to be as specific as we can when describing research subjects and clinical outcomes.

Unfortunately, participants who are transgender, nonbinary, gender nonconforming, genderqueer, agender, or genderless are not reported in the research and polls included in this article, and they may not even have participated.

Why do you have anxiety during perimenopause?

During perimenopause, a lot happens in your body, and it could also happen that a lot happens in the rest of your life. 11.4% of Chinese women between the ages of 40 and 60 who participated in one study reported experiencing anxiety during their reproductive years. The perimenopause caused that percentage to increase to 18%.

Declining Estrogen

Animal studies have demonstrated that abrupt changes in oestrogen levels alter the anatomy and function of the brain, as was highlighted in a 2022 review. These modifications may worsen anxiety symptoms and up the chance of developing anxiety and other mood disorders.

To precisely understand how perimenopausal women's anxiety might be directly impacted by a decline in oestrogen, more research is required.

Physical Symptoms

Anxiety might result from perimenopause's physical symptoms. You may begin to experience symptoms while your oestrogen levels fluctuate.
  • vaginal dryness
  • sleep disturbances
  • hot flashes and night sweats (vasomotor symptoms, or VMS)
  • weight gain
  • fluctuating periods
The symptoms' utter unpredictability contributes to some of the anxiety. It's challenging to predict when a hot flash will occur. or if having sex will be uncomfortable. Or if you'll sleep well the night before a crucial occasion. or if or when your menstruation will start again, or when it will start.

These symptoms might be significantly more distressing if you have anxiety sensitivity, a condition in which anxiety symptoms make you feel afraid. Additionally, if you belong to a marginalised group, your stress may be increased by the perimenopausal healthcare you receive.

Mid-Life Challenges

The perimenopause occurs when several other changes are taking place in a person's life. If you have kids, they can be getting close to adulthood or starting their education and careers. You could experience pressure, depression, or even grief if you want children but haven't started the process yet. If you choose not to have children, menopause may signify independence from birth control. It could also make you feel strongly about how committed you are to your choices.

There can be certain health issues you need to deal with. Your resources and financial demands may have altered, potentially as a result of a significant change in your work. Or you can be one of the increasing number of adults divorcing later in life, a practice known as "grey divorce."

Since anxiety is linked to all of these midlife experiences, it can be challenging to pinpoint the precise source of the added stress.

What is the treatment for anxiety during perimenopause?

Working with a healthcare provider and making certain self-help changes may help you cope with anxiety during perimenopause. A few remedies that could lessen anxiety symptoms are listed below:
  • Medication: Some antidepressants, such as SNRIs and SSRIs (serotonin-norepinephrine reuptake inhibitors), help lessen the anxiety symptoms brought on by perimenopause.
  • Sound sleep measures: It's crucial to safeguard your sleep throughout perimenopause. This is so because there is a reciprocal relationship between sleep and anxiety. Sleep deprivation can worsen anxiety, which in turn can worsen anxiety. Avoid coffee and alcohol later in the day or right before bed, and practise excellent sleep hygiene.
  • Hormone replacement therapy (HRT): HRT may help with VMS and sleep issues related to perimenopause, however, it is not a first-line treatment for anxiety, and these improvements may help some people with some anxiety symptoms.
  • Exercise: Whether you exercise alone or with a group, aerobic exercise (an activity that increases your heart rate), such as dancing, brisk walking, or jogging, has been demonstrated to reduce anxiety in perimenopausal people.
  • Mindfulness-based stress reduction: According to research, stress reduction approaches based on mindfulness make people feel less anxious. They might also assist with some additional hormone-related perimenopause symptoms.

How is anxiety during perimenopause diagnosed?

Although there is no single test to identify whether you are anxious during this transition, mental health professionals may use validated screening measures for anxiety, such as the GAD7, to better understand your feelings. You can answer questions from a medical practitioner regarding your symptoms when they first appeared, and what makes them better or worse.

You may have an anxiety disorder if your symptoms make it difficult for you to go about your daily activities.

What is the prognosis for perimenopausal anxiety sufferers? 

The worry that comes with the perimenopause's uncertainty will eventually subside. Each person's experience of perimenopause will be unique in terms of duration. Most people's perimenopause lasts a few months, but it can last up to 14 years, according to health professionals.

It's significant to remember that some perimenopausal women report having panic problems. It's also crucial to remember that, if addressed, sleep difficulties can cause depression and other serious long-term health issues.

Can you prevent anxiety during perimenopause?

Possibly. By talking with individuals you trust, you might be able to ease some of your worries if you're worried about how this shift will go. That could be a close friend who is going through the same thing, an elderly relative who has already gone through perimenopause, or a medical expert you can be honest with.

Some drugs might be able to lessen the uncomfortable perimenopause symptoms, sparing you the anxiety. Additionally, making a few adjustments to your sleep and exercise schedules may prevent you from having too much worry.

Even though perimenopause brings about a lot of changes, you can try to decrease the impact of worry while you go through the process.


Your body produces less oestrogen during perimenopause, which causes the cessation of periods. Anxiety may also result from it. Sleep issues, sweating, difficulty concentrating, irritability, and other symptoms can all be caused by changes in your body and brain.

You can try techniques like mindfulness, exercise, anti-depressant medication, and others if you are suffering anxiety during perimenopause, even if you can't always control how perimenopause affects your body. Reach out to people you trust, such as medical professionals who can help you identify treatments that are effective for you if anxiety is making perimenopause more difficult.


Can perimenopause cause extreme anxiety?

Anxiety can be a symptom of perimenopause

Can perimenopause trigger panic attacks?

Many people experience anxiety or depression when perimenopause begins

Is overthinking part of perimenopause?

Some women may discover that they are considerably more susceptible to this when going through perimenopause and menopause.

Can low estrogen cause anxiety?

Anxiety and other mood disorders may result from the decline in oestrogen and progesterone that happens towards the conclusion of a woman's menstrual cycle.

Is anxiety high or low estrogen?

Increases anxiety and depression risk

Is anxiety a symptom of estrogen dominance?

Hormone levels during perimenopause can fluctuate throughout the day. Hot flashes, irritability, bloating, anxiety, hair loss, and night sweats are just a few of the unpleasant symptoms of oestrogen dominance that are brought on by these changes.

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