The Hidden Struggle: Unpacking Anxiety in Perimenopause

Perimenopause anxiety is far more common than women understand and realize as it’s a hidden struggle.

Perimenopause is the 2-12 years before menopause, one year without a period. After this, you’re considered post-menopausal. During this time, hormonal fluctuations can lead to various physical and emotional changes, including anxiety. The connection between perimenopause and anxiety is significant, and understanding the symptoms and triggers is important in feeling better.

Let’s explore the causes of perimenopause anxiety and provide effective strategies to manage symptoms and regain your peace of mind. With the right knowledge and tools, you can navigate perimenopause with confidence.

The answer to the question so many women have, why hormone imbalance causes anxiety, will be answered in this post. 

Key Takeaways:

• Perimenopause is a transitional phase before menopause that can cause hormonal fluctuations and anxiety symptoms in some women. 
• Recognizing the signs and symptoms of perimenopause anxiety is essential for seeking appropriate help and support.
• Hormonal fluctuations during perimenopause, particularly changes in estrogen and progesterone levels, contribute to the development of anxiety symptoms.
• Managing perimenopause anxiety involves a combination of lifestyle modifications, dietary adjustments, mindset changes, stress management techniques, natural remedies, and sometimes even medical interventions.
• By understanding the role of hormones, exploring treatment options, and implementing self-care practices, you can find relief and improve your overall well-being.
• I always tell my patients that understanding anxiety and why it’s there can help reduce it.  

What Is Perimenopause Anxiety?

Perimenopause anxiety refers to feelings of worry, fear, and unease that are experienced during the perimenopause stage. It can manifest as general anxiety or even panic attacks. Hormone imbalance and anxiety can go hand in hand for several women going through perimenopause. 

Recognizing the Signs and Symptoms

Recognizing the signs and symptoms of perimenopause anxiety is essential for seeking appropriate help and support. Some common signs and symptoms of anxiety include:

• Feeling constantly on edge, irritable, or frustrated (some women even experience rage)
• Experiencing racing thoughts or difficulty concentrating
• Having sleep problems, such as insomnia or restless sleep
• Feeling overwhelmed, restless, or having a sense of impending doom
• Experiencing physical symptoms like heart palpitations, dizziness, or shortness of breath. There are hundreds of physical manifestations of anxiety. 

Why does hormone imbalance cause anxiety?

Hormonal fluctuations during perimenopause, specifically changes in estrogen and progesterone levels, are believed to contribute to the development of anxiety symptoms. These hormonal changes can affect the neurotransmitters in the brain that regulate mood and emotions. Additionally, the uncertainty and challenges associated with perimenopause can also contribute to why hormone imbalance causes anxiety.

I also call this era of life, the “era of responsibility.” On top of having a rollercoaster of changing hormones all the time, most women have a lot on their plate in terms of raising families, bills, financial concerns, partnerships and marriages, aging parents, careers, and trying to balance it all. 

Women who put a lot of pressure on themselves or have certain personality characteristics such as being a perfectionist, or a people pleaser, don’t have strong boundaries, or have a history of trauma or adverse childhood experiences, tend to experience stronger anxiety even when it’s due to hormonal fluctuations.  A woman’s body has a delicate balance of both stress and sex hormones that also affect neurotransmitters. 

For this reason, a multi-faceted approach to long-term healing is necessary.

“Perimenopause is a time of significant hormonal fluctuations, and it’s no surprise that these changes can impact our mental well-being. The mind and body are intricately connected. Understanding the connection between perimenopause and anxiety is the first step towards finding effective strategies for managing and alleviating these symptoms.

Signs and Symptoms	Potential Triggers
Feeling constantly on edge or irritable	Hormonal fluctuations
Experiencing racing thoughts or difficulty concentrating	Changes in estrogen and progesterone levels
Having sleep problems, such as insomnia or restless sleep	Uncertainty and challenges of perimenopause
Feeling overwhelmed, restless, or having a sense of impending doom	Personality characteristics
Experiencing physical symptoms like heart palpitations, dizziness, or shortness of breath	Past trauma of adverse childhood experiences

The Role of Hormones in Perimenopause-Induced Anxiety

Hormones play a significant role in perimenopause-induced anxiety. Understanding the specific hormones involved and their impact on anxiety levels is important for developing effective management strategies. Let’s explore the anxiety hormones and how hormonal fluctuations during perimenopause contribute to anxiety.

Exploring the Anxiety Hormones

Understanding what hormone imbalance causes anxiety or what hormone causes anxiety can provide an understanding of what is occurring through this perimenopause transition of life.

Several hormones are closely linked to anxiety, including cortisol, adrenaline, and progesterone. These anxiety hormones can influence mood, sleep patterns, and other physiological responses. Here’s a closer look at each hormone:

1. Cortisol: Known as the “stress hormone,” cortisol levels can rise during perimenopause, leading to increased anxiety. This is also the hormone responsible for the sleep-wake cycle (our circadian rhythm), so it’s not all bad. It should be high in the morning and decrease through the day. 
2. Adrenaline: Also known as epinephrine, adrenaline is involved in the body’s fight-or-flight response and can contribute to feelings of anxiety and tension. This is produced when our brain doesn’t feel like our world is safe for us. 
3. Progesterone: Fluctuations in progesterone levels during perimenopause can disrupt mood regulation, potentially leading to anxiety symptoms. Progesterone is our “anti-anxiety” hormone.

Understanding Hormonal Fluctuations and Anxiety Levels

During perimenopause, hormone levels can fluctuate significantly, which can impact anxiety levels. The shifts in estrogen and progesterone, in particular, can affect neurotransmitters and receptors involved in regulating mood and emotions, contributing to the development or worsening of anxiety symptoms. It’s essential to understand how these hormonal fluctuations influence anxiety levels to implement effective strategies for anxiety management.

Hormone	Effect on Anxiety
Estrogen	Fluctuations in estrogen levels can increase vulnerability to anxiety symptoms.
Progesterone	Decreases in progesterone levels can disrupt mood regulation, potentially leading to anxiety.
Cortisol	Elevated cortisol levels during perimenopause can contribute to heightened anxiety.

By recognizing the role of hormones in perimenopause-induced anxiety and understanding how hormonal fluctuations can affect anxiety levels, women can take proactive steps to manage their symptoms and improve overall well-being.

Why Does Hormone Imbalance Cause Anxiety?

Hormone imbalance, particularly a decrease in progesterone, can cause anxiety symptoms. When the body’s hormone levels are disrupted during perimenopause, it can affect the neurotransmitters and receptors, such as serotonin and GABA, involved in regulating mood and emotions. This imbalance can contribute to the development or worsening of anxiety symptoms. 

Natural Relief Tips for Perimenopause Anxiety

In the journey of perimenopause, anxiety can be a challenging symptom to manage. Fortunately, there are natural relief tips that can help alleviate perimenopause anxiety and restore a sense of calm through mindset changes, lifestyle changes, and natural remedies. 

Lifestyle Modifications for Anxiety Management

Making certain lifestyle modifications can have a profound impact on reducing anxiety symptoms during perimenopause. Here are some effective strategies to consider:

• Regular exercise: Engaging in moderate-intensity exercise, such as brisk walking or yoga, can help reduce anxiety by boosting endorphin levels and promoting overall well-being. Pick any movement/exercise that feels good for you and do that consistently!
• Stress management techniques: Practicing relaxation techniques like deep breathing exercises, meditation, journaling, leisure walking, or mindfulness can help mitigate anxiety and promote a sense of calm.
• Sufficient sleep: Prioritizing quality sleep by adopting good sleep hygiene habits, such as maintaining a consistent sleep schedule and creating a relaxing bedtime routine, can significantly reduce anxiety.
• Changing your response to anxiety.  We get anxiety all wrong most of the time.  It feels scary, so we push it away.  We want to get rid of it in whatever way we can.  This is telling our brain that we’re in danger and the adrenaline keeps coming.  We want to change our response to anxiety by not freaking out when we’re feeling anxious.  Think about anxiety as a fire alarm in your kitchen. Anxiety is telling you to stay vigilant because something feels “off” in your environment or there’s a threat. If we respond in a way that says, “Hey, I see you, but we’re okay. We’re safe,” that helps a ton.  This is going to take some time because we’re rewiring our brains through a process called neuroplasticity. 

Dietary Adjustments to Support Hormonal Balance

Your diet plays a crucial role in maintaining hormonal balance and managing perimenopause anxiety. We want to make sure our blood sugar stays stable throughout the day.  When we are riding blood sugar highs and lows, that can both emulate the physical feelings of anxiety and also, cause a rise in cortisol.  Here are some dietary adjustments that can help:

Dietary Adjustments

• Make protein the star of the show on your plates. Eating adequate protein at each meal helps to buffer the insulin response, make us feel more full, and keep our hunger, energy, cravings, mood, and sleep in check. 
• Consume fiber at each meal.  Fiber is also equally important in our diet.  Fiber slows down the digestive process, feeds our gut bacteria, and stabilizes blood sugar among many other benefits. Try to get fiber from fruits and vegetables at as many meals as possible. Make it easy by choosing things like apples, pears, bananas, avocadoes, berries, and frozen, precut veggies and fruits. 
• Consume omega-3 fatty acids: Incorporating foods rich in omega-3 fatty acids, such as fatty fish (salmon, mackerel), chia seeds, and walnuts, can help reduce inflammation and promote brain health, potentially easing anxiety symptoms.
• Avoid caffeine: Limiting or avoiding caffeine, found in coffee, tea, and some sodas, can help prevent exacerbation of anxiety symptoms as caffeine can increase heart rate and contribute to feelings of restlessness and nervousness. 
• Limit alcohol intake: Heavy alcohol consumption can disrupt sleep patterns and contribute to anxiety. Opting for moderate or minimal alcohol intake can aid in anxiety management.

By implementing these lifestyle modifications and dietary adjustments, women can support their hormonal balance and find natural relief from perimenopause anxiety.

Lifestyle Modifications	Dietary Adjustments
Regular exercise	Consume protein, fiber, and omega-3 fatty acids at as many meals as possible.
Stress management techniques	Avoid caffeine
Sufficient sleep	Limit alcohol intake

Medical Interventions for Hormonal Imbalance

When it comes to addressing hormonal imbalance and perimenopause anxiety, medical interventions can play a crucial role in restoring balance and alleviating symptoms. Conventional medicine offers a range of hormone therapy options that are designed to address hormonal imbalances and provide relief.

Hormone Replacement Therapy

Hormone replacement therapy is a common medical intervention used to treat hormonal imbalances during perimenopause and post-menopause. It involves the use of estrogen, progesterone, testosterone therapy, or a combination of these to restore hormonal levels and alleviate anxiety symptoms.

Estrogen therapy, also known as estrogen replacement therapy, involves taking estrogen in the form of pills, patches, creams, or vaginal rings. This therapy can help relieve symptoms such as hot flashes, night sweats, and mood disturbances. Estrogen is also needed to protect our brain, heart, and bone health. 

Progesterone therapy is also helpful for women who are experiencing hot flashes, night sweats, insomnia, and anxiety or irritability. It can be administered orally, topically, or through injections.

It is important to note that hormone replacement therapy is not suitable for everyone, and the decision to undergo this treatment should be made in consultation with a healthcare professional. They will assess your health history, symptoms, and risk factors to determine if hormone therapy suits you.

Alternative Therapies for Perimenopause Anxiety

In addition to hormone replacement therapy, alternative therapies can provide holistic relief for perimenopause anxiety. These therapies focus on addressing the underlying causes of hormonal imbalance and anxiety, promoting overall well-being.

Acupuncture

Originating from traditional Chinese medicine, acupuncture involves the insertion of thin needles into specific points on the body to restore balance and alleviate various symptoms, including anxiety. It is believed to stimulate the body’s natural healing mechanisms and improve energy flow. Acupuncture is really helpful in calming down the nervous system which is a primary driver of anxiety, irritability, rage, and panic attacks. 

Herbal Remedies

Certain herbs, such as black cohosh, evening primrose oil, lemon balm, lavender, maca root, vitex/chaste tree berry, chamomile, and so many more have been used for centuries to relieve menopausal symptoms, including anxiety. These herbal remedies can potentially help rebalance hormone levels and reduce anxiety. However, it is important to consult with a qualified herbalist or healthcare professional before starting any herbal regimen. Not all of these herbs are suitable for all women. It’s important to look at your symptoms and the phase you’re currently in in perimenopause. 

Supplements

Supplements such as GABA, l-theanine, magnesium, NAC and so many others have been used for decades now to help with perimenopausal anxiety.  L-tyrosine, l-tryptophan, and 5-HTP can also be helpful for anxiety and mood disturbances as they are precursors to dopamine and serotonin.  It’s important to note these are contraindicated in women who are taking SSRIs and SNRIs as they have a similar effect. 

Mindfulness-Based Practices

Mind-body techniques like yoga, meditation, and deep breathing exercises can help reduce stress and anxiety during perimenopause. These practices promote relaxation, improve emotional well-being, and support overall hormonal balance.

Psychotherapy, EMDR, and cognitive behavioral therapy

I am a huge fan of getting a mental health provider on your team because as I mentioned, there can be more to anxiety and mood issues than simply hormonal imbalances.  A lot of women who struggle with increased anxiety in perimenopause tend to be perfectionists and put a lot of pressure on themselves, type A or people-pleasers.  A therapist or counselor can help unpack these characteristics and give you better coping mechanisms for the full plate in your life. 

Exploring alternative therapies alongside conventional medicine provides women with a comprehensive approach to managing perimenopause anxiety. It’s important to remember that what works for one person may not work for another, so finding the right combination of therapies that works best for you is essential.

I created a free, on-demand training – Achieve Better Moods, Sleep, Energy and Periods in Perimenopause. In this 1-hour training, you’ll uncover the hidden truths behind hormonal imbalances and learn proven strategies to regain control of your health and well-being. CLICK HERE to access it!

Managing Perimenopause Dizziness and Anxiety

Perimenopause can be a challenging time for women, as it is often accompanied by symptoms such as dizziness and anxiety. These two symptoms can often go hand in hand, exacerbating each other and making it difficult for women to find relief. However, with a multi-faceted approach that addresses both the hormonal changes and provides strategies for symptom management, it is possible to effectively manage perimenopause dizziness and anxiety.

Dizziness during perimenopause is typically caused by hormonal fluctuations and changes in blood pressure. This can lead to feelings of lightheadedness, unsteadiness, or a spinning sensation. These sensations can trigger anxiety and make it difficult for women to go about their daily activities with confidence.

Perimenopause Dizziness

To manage perimenopause dizziness and anxiety, it is important to address the underlying hormonal changes. This can be done through hormone replacement therapy, which can help restore hormone levels and alleviate symptoms. It is important to consult with a healthcare professional to determine the best course of treatment for your individual needs.

One of the reasons for dizziness that occurs from anxiety is that when your brain thinks you’re in danger and the stress response starts up, all sorts of things begin to happen in your body that can cause symptoms. You can experience a rush of blood away from your brain to areas needed to keep you safe such as your muscles and heart. This rush of blood away from your head can cause dizziness. 

You might also experience a rush of blood TO your brain if your brain thinks you need to think more clearly to be safe. This, too, can cause dizziness or lightheadedness. Some of my patients (and myself) describe this feeling as feeling like you’re on a boat or unsteady. 

In addition to hormonal management, several lifestyle adjustments can help reduce perimenopause dizziness, and anxiety. These

Lifestyle Adjustments to Address Perimenopause Dizziness

• Staying hydrated: Dehydration can exacerbate dizziness, so it is important to drink plenty of water throughout the day.
• Getting regular exercise: Exercise can help improve circulation and reduce dizziness. Low-impact activities such as walking or yoga can be particularly beneficial.
• Eating a balanced diet: A diet rich in nutrients can help support hormone balance and reduce symptoms of dizziness and anxiety. Focus on consuming a variety of fruits, vegetables, lean proteins, and whole grains.
• Avoiding triggers: Certain foods or substances, such as caffeine and alcohol, can worsen symptoms of dizziness and anxiety. Pay attention to how your body reacts to these substances and make adjustments as necessary. When our nervous system (stress response) is increased, our body isn’t going to handle substances as well either. 
• Learning how to breathe properly: When we’re in danger, we’re breathing shallowly and fast. This is giving your body the directions that we’re in danger.   Try to start breathing deeply and slowly.  Watch your stomach rise and fall.  We want to take full breaths. 

By incorporating these strategies into your daily routine, you can effectively manage perimenopause dizziness, and anxiety. It is important to remember that every woman’s experience with perimenopause is unique, so finding what works best for you may take some time and experimentation. Remember that freaking out never helped anyone get better, so give yourself messages of safety vs. danger when you’re feeling symptomatic. 

Conclusion

Anxiety hormone imbalance during perimenopause is a common experience for many women going through this transitional phase. However, there are various relief tips and strategies available to manage the symptoms and regain a sense of peace of mind. By understanding the role of hormones, exploring natural and medical interventions, and implementing lifestyle modifications, women can find effective ways to alleviate perimenopause anxiety and improve their overall well-being. 

If you’re struggling with hormonal imbalances, go watch my free training to learn exactly why so many women are struggling, what your doctor is missing, and most importantly, what to do about your perimenopausal symptoms! 

FAQ’s

How do I get rid of hormonal anxiety?

Managing hormonal anxiety often involves a combination of strategies, including lifestyle modifications, natural remedies, and potential medical interventions. It’s best to consult with a healthcare professional who specializes in hormone health for personalized advice and treatment options. There is so much that can be done to help with both anxiety and hormonal imbalances. There is hope! 

What hormone causes anxiety?

Several hormones can contribute to anxiety, including cortisol, adrenaline, estrogen, and progesterone. Imbalances in these hormones can disrupt mood regulation and contribute to the development or worsening of anxiety symptoms.

Which hormone deficiency is responsible for anxiety?

While there is no specific hormone deficiency solely responsible for anxiety, imbalances in estrogen, progesterone, and cortisol can all impact anxiety levels. Identifying the specific hormonal imbalances through thorough testing can help guide appropriate treatment approaches. When looking at hormone testing, make sure to work with someone knowledgeable about hormonal testing because there are specific times of a menstrual cycle to do testing.  Also, with cortisol testing, it’s important to look at it at several points in the day because it fluctuates all day as part of the sleep-wake cycle. 

What hormone causes anxiety?

Several hormones can cause anxiety including cortisol, adrenaline, estrogen, and progesterone.  In their ways, they all can be responsible for anxiety.  With that said, there are reasons each one of these hormones is imbalanced, and lifestyle changes, natural remedies, changes in nutrition, exercise, and hormone replacement therapy can help treat perimenopausal anxiety.  A healthcare provider needs to get a full history of the symptoms and potentially some lab testing done to make the best treatment plan. 

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