For women approaching or in menopause, it is a time filled with changes. Lifestyle changes are frequently occurring at the same time the body is changing. These changes are unsettling enough, but then perimenopause and menopause cause changes not only in the body itself, but also in the brain.  These changes are manifested in several ways, including the increased likelihood of anxiety.  And along with anxiety comes depression for many women. Historically the medical community has focused more on the problems associated with depression in menopausal women than on anxiety. However more recent studies indicate that anxiety is even more common than depression. 

Anxiety is characterized by several symptoms, including: nervousness, restlessness and/ or being tense; a sense of impending danger, panic, or doom; increased heart rate; increased rate of breathing; and also trouble concentrating or thinking about other subjects. Everyone has experienced anxiety to some degree, but in some situations it can be debilitating.   About 23 percent of women are known to experience anxiety during perimenopause or menopause but frequent, severe feelings of anxiety or a panic attack are not normal and need to be addressed.

In addition to the abrupt changes in hormone production at the root of menopause, other factors contribute to anxiety.  Concerns about aging, life stresses, infertility, body image, and sleep problems can all be involved.  In fact even without the hormone changes occurring, any of the above factors could cause anxiety.  These life stage issues come from changes occurring in the woman’s life such as children leaving home, having to care for aging parents, or retirement looming. The fact that the hormone changes occur at the same time as other factors can serve to heighten the woman’s feelings of anxiety.  A recent study by the North American Menopause Society found that severe physical symptoms like hot flashes and night sweats were 5 times more common in women who also had anxiety. The suspicion at this point is that the higher levels of serotonin and norepinephrine caused by anxiety increase the frequency of hot flashes/night sweats.  Also there are overlapping symptoms and parallels between hot flashes and panic attacks, so women who are prone to either of these might not be able to differentiate between them.

If warranted, there are several forms of treatment for anxiety.  Especially in perimenopausal women, Hormone Replacement for women who are good candidates can be helpful in resolving anxiety in addition to other known benefits. Having the estrogen and progesterone levels in balance will reduce mood swings and irritability, which contribute to anxiety.  For mild to moderate symptoms, frequently this will fully resolve the problem.   Meditation and other stress relieving behaviors can give added relief.  In severe, debilitating situations even prescription medications specifically for anxiety can be used.  These medications range from occasional anxiety medications to routine use of an antidepressant. 

We see from all this information that if you are one of the millions of perimenopausal and menopausal women who suffer from both anxiety and the various physical symptoms of menopause that they are frequently related. And as with most conditions there are multiple levels of severity and there are treatments available to help with all of those levels.