Menopause Anxiety: Why Even Small Worries Feel Big—and What to Do About Them

Are racing thoughts and sudden bouts of panic becoming as regular as your menopausal hot flashes and night sweats?

Did you know that women are twice as likely to experience mood disorders associated with anxiety, and that around 4 in 10 women experience anxiety during perimenopause.^1,2 Fortunately, anxiety can be manageable with the right support. 

In this post we explore why even simple worries may feel magnified during the menopause transition and how you can manage menopause anxiety throughout this journey.

Does Menopause Cause Anxiety?

Is anxiety a symptom of menopause?

In short, maybe—menopause may contribute to anxiety. 

We’ve covered before the ways menopause may contribute to anxiety, looking at a number of potential causes at play. 

For starters, drops in estrogen, progesterone, and serotonin (your “happy hormone”) levels during the menopause transition may contribute to increased nervousness and irritability during this time.³ Simultaneously, age-related spikes in cortisol—a stress hormone—can cause or exacerbate feelings of anxiety.⁴ 

These underlying hormonal shifts—coupled with typical midlife changes in careers, relationships, health, and family dynamics—explain why, in many cases, menopause and anxiety can potentially go hand in hand.

What Menopause Anxiety Can Look Like

Are you wondering whether the new feelings you’ve been having during perimenopause or menopause could actually be anxiety? 

Even if anxiety was a stranger prior to perimenopause, there’s a risk of it occurring during and after the menopause transition – the risk is even higher among those who struggled with anxiety before this hormonal transition.⁵

Menopause Anxiety Symptoms

If you’re experiencing anxiety during menopause, you may experience some of the following symptoms: ^6,7

• Feelings of nervousness or irritability
• A sense of panic or impending danger
• Increased heart rate
• Muscle tension
• Increased breathing, sweating, or shaking
• Difficulty focusing
• Memory problems
• Trouble sleeping
• GI problems

How Long Does Menopause Anxiety Last?

Does menopause anxiety go away?

Unfortunately, there’s no way to tell how long anxiety related to menopause will last for each individual. 

Some women experience relief from the symptoms of menopause anxiety once hormone levels stabilize, around two years after their final menstrual period.⁸ For others, however, anxiety may persist. It’s important to listen to your body and seek out help if anxiety persists, worsens, or feels unmanageable.

How to Relieve Symptoms of Menopause Anxiety

In many cases, women can successfully manage feelings of anxiety with lifestyle changes and the right support system. Let’s review a few ways you can consider when looking to relieve symptoms of menopause anxiety.

Diet, Exercise Nutrition

Sometimes, the biggest impact comes from the smallest changes. Small tweaks in diet and exercise have been shown to benefit women during the menopause transition.^{9, 10} 

You can start by incorporating foods rich in lean protein, high-quality fats and omega-3 fatty acids, antioxidants, and vitamins and minerals.¹¹ For example, the Mediterranean Diet—popular for its health benefits—emphasizes lean protein, nuts and seeds, fresh fruits and vegetables – favoring olive oil and limiting salt – these are all highly recommended diet staples during menopause.¹² 

Research shows that even a moderate exercise routine can help to not only manage weight during menopause, but also reduce the risk of stress, anxiety, and depression.¹³ As menopause-related hormone changes affect sleep and mood, exercise can help to combat these issues by releasing endorphins—powerful chemicals that may help boost mental wellbeing.¹⁴

Talk Therapy

Cognitive behavioral therapy (CBT) and mindfulness-based interventions (MBI)—both kinds of talk therapy—may help women navigate mental health challenges during menopause.¹⁵ 

These types of talk therapy may encourage women to address negative thought patterns and learn coping tools when unsettling thoughts or worries arise.¹⁶ Therapy may also help to improve nighttime insomnia, a common symptom of both menopause and anxiety.¹⁷

Medication

Sometimes, lifestyle changes simply aren’t enough to conquer anxiety experienced during menopause. You may need to consider anti-anxiety medication and/or other prescription medications that are designed to help combat issues with sleep to help you function at their best.¹⁸ Common medications prescribed to treat anxiety include:¹⁹ 

• Selective serotonin reuptake inhibitors (SSRIs)
• Selective norepinephrine reuptake inhibitors (SNRIs)
• Antidepressants

Some of these medications may even offer double the benefits by treating both anxiety and vasomotor symptoms, like hot flashes and night sweats.²⁰ Prescription medications are especially recommended for women who experience nonstop worry, frequent anxiety/panic attacks, trouble sleeping, and/or symptoms that negatively impact their quality of life, careers, and relationships.²¹

Talk to Your Healthcare Provider About Menopause Anxiety

You don’t have to suffer through anxiety experienced during menopause. If you’re noticing your symptoms are interfering with everyday life, don’t hesitate to reach out for support from a friend, family member, or healthcare professional. Some symptoms—like GI problems and a rapid heartbeat—may be caused by other, underlying conditions. For this reason, it’s always best to consult your healthcare provider with any new and disruptive symptoms. 

Looking for a quick video on how moods can change during menopause? Watch the below from Bonafide Chief Medical Officer, Dr. Alyssa Dweck.

Resources

1. https://adaa.org/find-help-for/women/anxiety
2. https://www.hopkinsmedicine.org/health/wellness-and-prevention/perimenopause-and-anxiety
3. https://www.hopkinsmedicine.org/health/wellness-and-prevention/perimenopause-and-anxiety#:~:text=During%20menopause%2C%20it%20is%20normal,these%20symptoms%20before%20you%20do.
4. https://www.rupahealth.com/post/cortisol-levels-by-age-changes-impacts
5. https://pmc.ncbi.nlm.nih.gov/articles/PMC3641149/#:~:text=Given%20the%20differential%20impact%20of%20the%20menopausal,anxiety%20may%20have%20had%20relatively%20chronic%20anxiety.
6. https://health.clevelandclinic.org/is-menopause-causing-your-mood-swings-depression-or-anxiety
7. https://adaa.org/find-help-for/women/anxiety
8. https://www.hopkinsmedicine.org/health/wellness-and-prevention/perimenopause-and-anxiety
9. https://www.heartandstroke.ca/articles/menopause-wellness-how-to-balance-nutrition-exercise-and-heart-health
10. https://pubmed.ncbi.nlm.nih.gov/34126464/
11. https://www.menopausesolutions.org/post/the-power-of-exercise-and-good-nutrition-during-menopause
12. https://health.clevelandclinic.org/menopause-diet
13. https://pmc.ncbi.nlm.nih.gov/articles/PMC3296386/
14. https://www.menopausesolutions.org/post/the-power-of-exercise-and-good-nutrition-during-menopause
15. https://www.theguardian.com/society/2024/feb/28/talking-therapies-could-help-women-through-menopause-study-finds
16. https://www.hopkinsmedicine.org/health/wellness-and-prevention/perimenopause-and-anxiety
17. https://www.nia.nih.gov/health/menopause/sleep-problems-and-menopause-what-can-i-do
18. https://www.hopkinsmedicine.org/health/wellness-and-prevention/perimenopause-and-anxiety
19. https://www.webmd.com/menopause/features/anxiety-menopause
20. https://www.goodrx.com/conditions/menopause/antidepressants-for-menopause?srsltid=AfmBOopqi22fhINZEnKEZNV8YN2u2r274ODCN7iVSkb2iYNJzyTo0R-q
21. https://www.talkspace.com/blog/signs-you-might-need-anxiety-medication/