Cause And Effect: Menopause And Anxiety

In women’s health, menopause generally refers to the gradual decline of ovarian function that ultimately leads to the permanent cessation of menstruation. This transition is usually preceded by perimenopause, or pre-menopause, which can be accompanied by a variety of symptoms, such as increased mood changes and anxiety. Often, anxiety that accompanies menopause occurs due to hormonal changes. It can be managed through online or in-person therapy, meditation, yoga, deep breathing, and progressive muscle relaxation.

What is perimenopause?

Perimenopause is the transition that occurs before the menstrual period stops. This transitional period can last between two and 10 years and is typically marked by a fluctuation in hormones, as well as physical, emotional, and mental symptoms. The process of menopause usually begins when the ovaries stop releasing eggs and ends when your menstrual cycle ceases altogether. Any associated symptoms of perimenopause and menopause are typically caused by changes in hormone levels, especially estrogen. Low levels of estrogen can lead to physical symptoms like night sweats and hot flashes, while elevated levels may cause PMS-like symptoms.

Each person’s body is unique, so each individual may experience a different set of symptoms as they go through perimenopause. Signs and symptoms of perimenopause can include the following:

• Less frequent ovulation

• Reduction in hormone levels, such as estrogen

• Changes in period cycles, such as shorter cycles

• PMS symptoms appearing and weakening within a week before each period

• Period pains, bloating, or breast tenderness

• Headaches

• Chest pain

• Night sweats and hot flashes

• Trouble concentrating

• Brain fog

• Sleep disturbances

• Low mood, including low self-esteem

• Depressive and anxious symptoms

Keep in mind that symptoms of perimenopause can be similar to those caused by other life-threatening medical conditions like heart disease. If you are experiencing the symptoms mentioned above or any others that concern you, it’s recommended to speak with your healthcare provider to rule out any other causes. When you visit your doctor, they will most likely take your age, medical history, and family members’ medical history into account before giving you a physical exam to diagnose the cause of your symptoms. 

Why menopause can cause anxiety

While the link between anxiety and menopause has not been examined extensively, multiple research studies discuss the connection between depression and menopause. One study that analyzed the potential link between perimenopausal depression and postpartum depression found that a history of depression, no matter the timing, is associated with a “markedly higher hazard of depression during menopause.”

Nonetheless, research has revealed that one possible cause of the increased vulnerability to mental health issues like anxiety during menopause may be related to hormonal fluctuations. One hormonal change that can occur during menopause is the decrease of estrogen levels. Estrogen usually influences chemical activities in the parts of the brain responsible for mood management, including the hippocampus and the amygdala.

For example, the amygdala, an integral component in the management of mood and memory, can be especially sensitive to estrogen fluctuations. This can be explained by the high number of estrogen receptors in the amygdala. When estrogen levels are high, moods tend to be more positive, but when these levels are low, an individual may experience more negative feelings and increased anxiety. Progesterone is another hormone that can play a role in the development of anxiety. Those who have low levels of progesterone are generally more likely to experience anxiety symptoms than those with higher levels of progesterone.

As women navigate through the challenges of perimenopause and menopause, they may also find themselves balancing the responsibilities of caring for aging parents. The physical and emotional demands of menopause can intersect with the demands of caregiving, adding another layer of complexity to this phase of life.

Panic attacks and other physical symptoms

In addition to potentially causing anxiety, a decrease in estrogen and progesterone can also lead to occurrences of panic attacks, especially if you have a history of anxiety-related panic disorder.

Symptoms of a panic attack can include the following:

• Increased heart rate and/or blood pressure

• Increased breathing rate, including hyperventilation

• Dizziness

• Nausea

• Lightheadedness

• Excessive sweating

• Tingling sensations in the extremities

• Chest tightness

Frequent or persistent bouts of anxiety or panic attacks may be a sign of panic disorder. If you believe you may be living with an underlying panic or anxiety-related disorder, it can be best to make an appointment with a healthcare provider or a mental health professional. 

However, experiencing feelings of anxiety does not necessarily mean that you have a panic or anxiety disorder. Anxiety can be considered a normal part of menopause, but some circumstances may require therapeutic assistance.

Self-management strategies for anxiety

While it can be important to meet with a therapist or healthcare provider to diagnose the cause of your symptoms, there may be several strategies that can reduce stress and anxiety. For example, relaxation techniques may reduce anxiety symptoms and induce a sense of calmness. The following techniques may help you feel more relaxed, potentially leading to reduced levels of anxiety throughout the day. They can also be used when your anxiety level is high or as part of a daily routine to maintain a healthy lifestyle. 

Meditation

Meditation may be one of the most effective forms of stress reduction. The general practice can involve clearing your mind or focusing on your breath by using both physical and mental methods. You can also follow along with guided meditations. No matter which technique you choose, meditation typically brings relaxation and a notable reduction in anxiety and stress.

Yoga

Yoga is another meditative practice that can benefit your health and lower anxiety levels. Rooted in ancient Buddhist traditions, yoga often involves a combination of breathing techniques, physical postures, and meditation. 

Deep breathing

Deep breathing can be a helpful relaxation technique anytime you’re experiencing elevated stress or anxiety. It may be possible to practice deep breathing anywhere, at any time. You can also choose to take deep breaths on their own or pair them with other relaxation techniques, like meditation, aromatherapy, or listening to relaxing music. 

Progressive muscle relaxation

Progressive muscle relaxation is generally a straightforward relaxation technique that can help you manage anxiety and reduce muscle tension. The technique typically involves tensing each muscle group for a few seconds, starting with your feet, before relaxing it and moving to the next muscle group. As you work your way up your body, you may find that you become progressively more relaxed, especially if you are able to clear your mind and focus your attention on tensing and releasing each muscle group. Frequent practice of progressive muscle relaxation may lead to stress management, pain relief, and improved sleep.

Getting help for anxiety and other menopausal symptoms

Whenever change occurs in our lives, it can lead us to feel anxious and stressed. This can be especially true when the change at hand involves symptoms that can interrupt sleep, increase adverse moods, and cause undesirable physical health changes, such as sweating and hot flashes. If you are going through menopause and experiencing anxiety that negatively impacts your daily life, it may be time to reach out for professional support. 

Making appointments and meeting new people, especially healthcare providers, can be a stressful experience for many. But if you are experiencing increased anxiety, this stress may keep you from making an appointment. If this is the case for you, an online therapy platform can empower you to attend therapy from the comfort of your own home, potentially making the therapy experience much more convenient.

A 2021 study of randomized controlled trials investigated the efficacy of internet-based treatment for anxiety symptoms and found that the results generally supported the effectiveness of online cognitive behavioral therapy as a treatment. If you’re living with increased anxiety symptoms due to menopause or are having trouble managing mood disorders in general, online therapy may be a helpful tool for you.