When we think of menopause symptoms, issues such as hot flashes, dry skin, decreased libido and poor sleep come to mind. However, it's crucial to understand that the hormonal changes that occur during menopause (and perimenopause) can also significantly impact mood and mental health, leading to anxiety.
“In the last 10 years, we have begun to consider how hormonal changes can correlate with mood disorders,” explains Christina Maxwell, MA, LCPC, with the Anxiety Treatment Center of Greater Chicago. “It is not uncommon for women in midlife to have acute anxiety or an anxiety disorder that happens for the first time during this stage of their life. For others, anxiety and depression may have been under control for some time. Then the hormonal changes cause these issues to flare up.”
Why the Increase in Anxiety?
“I often see midlife anxiety stemming from a combination of hormonal changes and life pressures that collide during this period,” explains Dr. Himali Maniar Patel, an OB/GYN. “As levels of estrogen and progesterone start to shift with menopause, they directly impact neurotransmitters like serotonin, which plays a huge role in regulating mood. When estrogen drops, serotonin levels also tend to fall, which can lead to feelings of anxiety or even trigger panic attacks.”
Beyond the hormonal shifts, midlife often brings new or intensified stresses for women including career demands, family responsibilities, aging parents and facing their own mortality.
“Together, these changes create a ‘perfect storm’ for heightened anxiety, which is why so many women find themselves struggling with it during this stage,” says Dr. Maniar Patel.
This Anxiety Feels Different
“I'll often hear from women in my practice that they are waking up in the middle of the night in a panic,” says Maxwell. “Or, they feel overwhelmed or more emotional during their daily life, but the reaction is disproportionate to what is happening.”
The increased signs of anxiety can include:
• Irritability, feeling tense or restless
• Trouble sleeping
• Stomach issues like nausea or diarrhea
• Heart racing, trembling