The Link Between Perimenopause and Anxiety
By: Dr. Denise Renye
A person’s health, be it mental, emotional, or physical, is a result of biological, psychological, and social factors. They are all interconnected and play a part in the full picture of a person’s well-being. I see this firsthand in my work as a sexologist and psychologist and yet, not everyone cares to examine this link. An area that is understudied, under-researched, and under-published is anything pertaining to women’s health, not to mention the utter neglect the medical community has for trans women and men. It’s criminal, frankly, but I digress.
At Whole Person Integration, we treat a lot of folks with anxiety and have noticed some trends pertaining to the body, for instance, the link between perimenopause and anxiety. Perimenopause is the period leading up to menopause when a person's ovaries gradually stop working. Ovulation may become erratic and then stop. The menstrual cycle and hormones in a person’s body change. Estrogen and progesterone fluctuate and may result in a range of physical and emotional symptoms including hot flashes, night sweats, mood swings, and anxiety.
In recent years, researchers have been exploring the potential connection between anxiety and perimenopause more deeply. As a refresher, anxiety is a common mental health condition characterized by feelings of worry, fear, and apprehension. The National Alliance on Mental Illness estimates that approximately 40 million adults in the United States have an anxiety disorder. Researchers found women are twice as likely as men to experience anxiety and hormonal fluctuations may play a role in this gender disparity.
Estrogen is known to have a mood-enhancing effect and low levels of this hormone have been linked to symptoms of depression and anxiety. Similarly, progesterone has a calming effect on the brain, and low levels of this hormone may contribute to feelings of anxiety. While more research is needed to fully understand the link between anxiety and perimenopause, there is evidence to suggest that hormonal fluctuations during this time of life may contribute to the development of anxiety in some women. For example, a 2018 study co-published in the Journal of Women's Health and Menopause found that women in perimenopause were more likely to experience symptoms of anxiety and depression than women who had not yet reached this stage of life.
However, one does not necessarily cause the other. Some women go through perimenopause without anxiety or depression. Biology is only one factor, there are others such as life stressors, economic insecurity, racism, past trauma, and many more that may also contribute to the development of anxiety in women during this time of life.
That said, anxiety, no matter when it’s experienced, can be treated. There are several strategies that women can use to manage anxiety during perimenopause. These may include relaxation techniques such as deep breathing or meditation, regular exercise, and therapy with a highly trained professional. In some cases, hormone therapy may also be prescribed to help alleviate symptoms of anxiety.
Bottom line, even if the anxiety is primarily due to biology, it’s still treatable. Women experiencing symptoms of anxiety no matter their age or stage can seek support and treatment to help them manage their symptoms and improve their overall quality of life. That’s something we care a lot about at Whole Person Integration. We believe in looking at the entire ecology of a person and supporting them in whatever ways we can, body, mind, and spirit.
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References
Hoffman, Dr. Matthew. “Estrogen and Women's Emotions.” WebMD. November 28, 2022. https://www.webmd.com/women/guide/estrogen-and-womens-emotions#:~:text=Estrogen%20acts%20everywhere%20in%20the,good%22%20chemicals%20in%20the%20brain.
Maki, Pauline; Kornstein, Dr. Susan G; Joffe, Dr. Hadine; et al. “Guidelines for the evaluation and treatment of perimenopausal depression: summary and recommendations.” Journal of Women’s Health. June 13, 2018. https://www.menopause.org/docs/default-source/default-document-library/meno-d-18-00170-final.pdf
National Alliance on Mental Illness. “Anxiety Disorders.” December 2017. https://www.nami.org/About-Mental-Illness/Mental-Health-Conditions/Anxiety-Disorders#:~:text=Anxiety%20disorders%20are%20the%20most,%25)%20have%20an%20anxiety%20disorder.
Remes, Olivia; Brayne, Carol; Van der Linde, Rianne; et al. “A systematic review of reviews on the prevalence of anxiety disorders in adult populations.” Brain and Behavior. June 5, 2016. https://onlinelibrary.wiley.com/doi/full/10.1002/brb3.497