Skip to main content

Understand this symptom

Anxiety

U

Uma Health

Medically verified5 min read

Insight

The essentials

This symptom is caused by the hormonal shifts your body is going through. Understanding what's happening helps you better cope with what you're feeling.

Possible causes

Anxiety symptoms during perimenopause and menopause can be related to fluctuating and decreasing hormones, which in turn can affect your “stress and calming system” in the brain. Think of changes in serotonin, estrogen, progesterone and GABA.

The link is complex and not the same for everyone. For many women, there's also a connection with hot flashes, although it's unclear which comes first. Good news: for some women, anxiety symptoms decrease after hormones stabilize after menopause.

What (often) helps

Start with the basics: sleep, stress reduction, regular exercise and power supply (e.g. Mediterranean and low in sugar/strong blood sugar spikes). In addition, CBT (cognitive behavioral therapy)Meditation/breathing, and spending more time outdoors can help. Supplements and medication can be helpful for some people, but the effects vary and often require guidance.

Honest and transparent

The most frequently asked questions

View all questions
Mental

The science

During the menopause transition, hormone fluctuations can affect systems that control your mood and stress response:

  • Serotonin (mood stability) can fluctuate with age and declining estrogen.
  • Estrogen is related to serotonin levels and receptors, but this relationship is complicated and still a subject of much research.
  • Progesterone is sometimes called “calming” and may possibly affect GABA, a neurotransmitter that can have a calming effect. At lower progesterone levels, this "calming" effect may diminish, causing the stress response to last longer.

There is also a striking overlap with hot flashes: research shows a link between anxiety (especially when physical anxiety symptoms are also present) and hot flashes, but the direction is not clear.


What you can do


Lifestyle

  • Power supply: Mediterranean, preferably low in sugar and "blood sugar spikes"; less alcohol (especially if your sleep suffers).
  • Movement: According to the World Health Organization, 150 minutes of moderate-intensity exercise per week is beneficial for mood and stress (e.g. brisk walking).
  • Stress reduction: meditation (apps like Headspace, Insight Timer, or Calm) or biofeedback like HeartMath.
  • Therapy: CBT can help to break worry patterns and behavior (more long-term approach).
  • Nature & social rest moments: Getting outside more often and consciously planning recovery moments can be helpful.


Medication

  • Hormonal: The data on hormone therapy and anxiety are mixed (smaller studies contradict each other or show no effect). Progesterone may be effective in early perimenopause possibly worth trying for cycle-related anxiety, and that low-dose contraception is sometimes used for PMDD or moderate PMS.
  • Non-hormonal: SSRIs and SNRIs are mentioned as first-line medications for anxiety/depression in peri- and menopause, with possible side effects such as weight gain and lower libido.


Supplements

There are supplements that have been shown in studies to potentially help with anxiety, but the effect varies from person to person, and some combinations (e.g., with antidepressants) are not safe. Therefore, it's best to consult a doctor/pharmacist, especially if you're taking medication.