womenTALK: Blog

Tuesday, Aug 09th 2011

Menopause and Anxiety: What's The Connection?

authored by Sheryl Kraft

After writing about menopause and hot flashes and stress/anxiety being a possible culprit, I started wondering about the link between menopause and anxiety. How are the two linked? Are women feeling anxious about menopause? Or, is it the other way around: does menopause cause anxiety? Is it a by-product of shifting, dipping, all-over-the-chart hormones?

And how can we control our anxiety? As someone who has had her fair share of anxiety over the years (especially around menopause), I decided to ask an expert some key questions about it all. Is it a disorder, I wondered, or a normal life passage?

For some answers, I turned to psychiatrist and UCLA anxiety expert Jason Eric Schiffman, a graduate of the MD/MBA program at the University of Southern California. Dr. Schiffman is affiliated with the UCLA Anxiety Disorders Program where he has helped to develop the web-based, self-directed Cognitive Behavioral Therapy program for Anxiety Disorders found on Anxiety.org.

Q. I'm well aware that anxiety can occur at any time during a woman's life, but it does seem that panic attacks become more prevalent during times of hormonal upheavals: during adolescence, pregnancy and perimenopause and then menopause. In my experience, I've seen teens and women who never before suffered anxiety be suddenly hit with an increased incidence. Is it merely coincidence or is it indeed hormonally related?

A. Yes, there is absolutely a connection between hormonal changes and psychiatric symptoms in general, and women undergoing specific hormonal changes have increased risk for particular psychiatric disorders. With respect to anxiety, women in the perimenopausal period are more likely to experience panic attacks and other anxiety symptoms than other women of the same age who are either pre- or postmenopausal. The postpartum period is another time when women appear to be more vulnerable to psychiatric symptoms, particularly depression, which is often associated with anxiety.
 
Q. If increased anxiety is hormonally related, does that mean it will pass once a woman gets through menopause? Does the anxiety need to be treated?

A. Once menopause passes, many women find that their level of anxiety decreases. However, in addition to hormonal changes, there are often many other factors that contribute to the development of anxiety during menopause. For example, women who suffer more physical symptoms, experience negative life events or who are less functional are more likely to develop an anxiety disorder during menopause than women without these additional stressors. So, it is important not to ignore other possible causes of anxiety—just because a woman may be experiencing menopause. Treatment of anxiety is always warranted if there is significant distress or functional impairment.
 
Q. Once a woman experiences an anxiety attack does this mean she will be more likely to experience them more often?
 
A. Someone who has experienced panic attacks in the past is more likely to experience them in the future than someone who has never had one. That being said, panic attacks respond very well to a type of treatment called cognitive behavioral therapy (CBT); someone who gets into treatment may have very few or no panic attacks in the future.
 
Q. Oftentimes women may be able to feel an anxiety attack coming on. Do you have any advice as to how to recognize the start of one and how to stop it in its tracks before it progresses further?
 
A. There are very effective techniques for treating panic attacks but they need to be tailored to each individual. There are now self-help versions of CBT available online which walk someone through the creation of a personalized treatment plan. One that I have worked with that is based upon the approach we use in the UCLA Anxiety Disorders Clinic can be found at www.Anxiety.org.

Q. Anxiety can manifest itself in many forms: sleeplessness or frequent waking during the night, nervous energy, difficulty concentrating, irritability, even depression. What do you suggest for a woman who is feeling any one or a combination of these things? Are there different therapies for different types of anxiety and, if so, what are they (from a behavioral, medical and/or psychopharmacological and/or nutritional viewpoint)?

A. It is important that menopausal women identify the symptoms of anxiety they're experiencing so they find the best ways to allay them. As I mentioned, CBT is one of the most effective treatments for anxiety. There are also medications that can be prescribed by a psychiatrist. These are often used in conjunction with CBT. Practical things you can do to help reduce your anxiety include reducing or eliminating caffeine, exercising on a regular basis, eating healthy foods, getting enough sleep and setting aside time twice a day to do relaxation exercises.
 
More reading:
8 Ways to Deal With Hot Flashes in the Heat (Or Is-It-Hot-In-Here-or-Is-It-Just-Summer?)
Natural Approaches for Easing Anxiety
An Overview of Menopause

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Comments

Sep 19, 2014 12:Sep 12 | madelene said

anxiety during perimenopause

Hi ladies . I'm perimenopausal and I'm struggling with anxiety and fears.
I heard about stresstabs with zinc and I tried them along with magnesium(250mg) , they worked for me . I'm still having bad days but much better than before.
I walk 30 min every day , meditate and deep breathing twice a day.
Watch your diet (I read Before the change).
Keep telling yourself : the fear is not real. It works.
Believe in yourself , you're much stronger than you think.
I HOPE this post will help.
If you can help with any advice , I thank you in advance.

Jul 30, 2014 20:Jul 8 | tammi said

anxiety

FYI ladies if you have anxiety youmight want to getrid of the frebreeze or othe things that are chemical laced air fresheners. Not only air fresheners but 8 hour smelly soaps laundry soaps ect. There is a new chemical that 20 percent of people are allergic to. These chemical mess with the nerinons I the brain and hormones of your body. No lie, I suffered for years before I found out. Look under what stinks about air fresheners, or the toxic chemicals in fragrance. In the the world of science fragrance is the name of multiple chemical nota smell. Good luck and tell your friends. This does not just affect women.

Jun 10, 2014 11:Jun 11 | madelene said

flaxseed oil

I'm taking low dose birth control pills , and lately I learned that flaxseed oil reduce the estrogen dominance that cause my anxiety( I can't stop the pills now because they help me sleep) .
Does anyone use this oil along with BCP? does it help during perimenopause?
thank you ladies

May 26, 2014 10:May 10 | madelene said

Thank you LeDonna, for your

Thank you LeDonna, for your reply.. it helps a lot when you feel that you're not alone . lately I'm seeking help from God by meditation and talking to him as a powerful friend .. it helped me to go through two awful days.
I'm taking 250mg magnesium a day , I hope it would help.
ladies I'm praying for all of us every night. please let me know if you have tried anything that helped .

Aug 28, 2014 11:Aug 11 | Angie B. said

Thankfully not alone!

I've been having terrible anxiety lately and I too have been seeking God's help. I'm also going to see a herbologist to make sure I get the right supplements to help with the anxiety and menopause. I haven't asked but I really don't want to go on HRT therapy. Just knowing I'm not alone in this makes me feel better!!

May 06, 2014 16:May 4 | madelene said

anxiety during perimenopause

I'm 45 and I'm perimenopausal. My doctor put me on the contraceptive pills because I suffered from anxiety and sleepless nights.The pills helped me sleeping better and reduced my anxiety a little . I tried to cope by relaxing many times a day(yoga - breathing...)and with a great help from my husband, I survived my anxiety for 8 months ( I stopped driving and I don't stay by myself for long time) . When I started working again I had to skip my daytime relaxation and life went to the usual stressful routine..and I crashed :severe anxiety with panic attacks and scary fears..
I 'm trying Avena Sativa in the morning and can't tell yet if it will work for me. Does anyone try it before ? does it work?
Does anyone experience scary fears? Pease help

Jun 17, 2014 16:Jun 4 | Jil said

I am going through EXACTLY

I am going through EXACTLY everything that you described. Thank you for your post...I'm going to talk to my doctor about contraceptive pills now, I hadn't thought about that. I also, do very limited driving, no freeways anymore, and I don't like being alone. I always assume the worst imaginable outcome of every situation. It's horrible. Can't wait for this to pass! I feel so much better knowing that I'm not crazy or alone. Thank you so much!

May 25, 2014 10:May 10 | LeDonna said

anxiety and menopause

Madelene, I too am 45 and going through menopause. I have been suffering with massive anxiety, panic attacks and phobias for a very long time but it has gotten worse over the last 3 years. I had my hormones checked about 3 1/2 months ago and they were normal. I have actively been seeking help for the last 2 years for my massive fears.. I am hopeful that I have found the help I need at last. Keep seeking help until you find what you need. It sounds like there are so many of us in the same boat.
I can tell you the phobia or intense fear I feel is crippling. I don't like to drive outside of town and I hate staying by myself. The anxiety I can handle it's the constant rapid heart rate that bothers me the most. But just keep seeking help and remember you aren't crazy or alone.

May 29, 2014 02:May 2 | lety said

menopause and anxiety

I am glad i am not alone, been suffering from this syntoms for many years, hot flushes headaches, anxiety, shaky scare of not what. dont get hungry can go two day without food, irritable to loud noises , very weak and tired want to sleep it off.
my first Dr.s keep saying i had anxiety, but i keep telling him if thats the case why do i get this only around my period cycle....i lost my good job because of this it takes over me, i call them "waves" when saddently i get all this at once the shaking, hard to swallo, hot , cold, and feel space outl like I am not there. nervous. Do you think i can work like this no way. i try to get dissability but i didnt push it cause they want a lot. even thought i have a history of Lorezapan, sanax, and all kinds i dont take them cause they dont take it away. . i wish i can find someone that can tell me ....is all gone ..do this!! I wish this has taken over my life and i want my life back. i am 60 but been going trough this for 20 yrs.
thank you

Aug 27, 2014 20:Aug 8 | said

Menopause and Anxiety

These comments could have been written by me! The first time I had an "attack" was in May. I was out of work for 2 weeks with nausea, sleeplessness, shaking, diarrhea, nervouness, irritability and buring sensation in my necky and arms. After 3 ER trips and multiple trips to the doctor I was diagnosed with General Anxiety. Everything I have read about these attacks say they usually only last 10 to 30 minutes. I am on Zoloft now but I still have an attack occaisonally but they don't last as long. When I have the first "wave", if I take a xanax it does lessen the severity. Lety you are not alone! I am 60 and thank goodness unlike you I have just started having these. Doc says its an accumulation of stress over the years. Whatever it is it is horrible! I am hoping for a miracle cure.

Jun 24, 2014 22:Jun 10 | Janet said

I totally relate

Hello Lety,I feel for you. 6 years ago I had my first serious bought of depression ..I was put on anti-depressants.Now I have weeks of debilitated anxiety and terrible depersonalization due to the anxiety. I have been going through perimenopaus for 6 years. My G,P recently put me on HRT. It seems to be helping . I have only been on them for 13 days . But will know more in a couple of weeks. meditating helps a great deal. My acupuncturist has been a great help and keeping life really simple reducing stress as much as possible.........Exercise is also key. CBt. helps greatly .I have been looking for a local support group I can meet with . I think it would help a lot to talk to other women about things and also be able to laugh about it as well. a lot of times due to my symptoms I feel so alone even when I have people around me,But I am fortunate to have an extremely supportive husband . I hope you have a few friends or family members that you can talk to .

Jun 23, 2014 08:Jun 8 | RFisher said

anxiety

Hi Lety....I saw your post and I can relate. I have had the same symptoms you described but it only lasted about 5 months. I walked it off everyday and cooking and keeping busy during the day helped. I got laid off from my job just before this all happened. The doc said it came on due to the stress of suddenly losing my job I loved so much. I was an office worker at the time. I took canal as well but the anxiety came back when the pill wore off. I was lucky it all finally subsided though after 5 months. I had no insurance at the time so seeing different doctors was out of the question. I still don't drive though (7years later). Now I am experiencing anxiety again these last few days and think it's due to menopause. It really sucks. I will have my levels checked next week. I have been on disability for 5 years now. Have you been to a gynecologist to have your hormone levels checked? I hope and pray you will find an answer. May God bless you.

May 04, 2014 11:May 11 | Cwheeler said

Menopause

Thanks to all comments....just to say ...
I am not alone with all this...please add positive comments....

May 05, 2014 12:May 12 | Sheryl said

I hope that the group support

I hope that the group support gives you hope!

May 01, 2014 17:May 5 | Carole Heath said

anxiety related to the menopause

I am 66 years old and post menopausal my doctor has told me. My menopause wasn't to bad I never took HRT as I had a breast lump which was removed but it was not cancerous glad to say. My main problem with the menopause was migraine and trouble sleeping. But recently I have been getting some anxiety shaking in my chest and stomach region and feeling anxious when left alone at home. I hope this situation passes as don't like feeling like that as it makes me quite ill. Sometimes I feel like screaming as I feel everything gets on top of me. I have started taking St John's wort a tablet once a day I am hoping this will help the symptoms. I try to keep calm but when I haven't slept most of the night it does make me very anxious.

May 11, 2014 18:May 6 | Brenda Williams said

Post menopausal

Hi Carole your not on your own I am 63 at the moment I am going through a very bad time suffering bad anxiety panic attacks and scary thoughts I have suffered migraines since I was eleven and got worse through my change it was a nightmare l have a doctors appointment tomorrow fingers crossed she can help me with my anxiety she is quite useless all the best hope you fill better soon.

May 05, 2014 12:May 12 | Sheryl said

Carole, It does sound like

Carole, It does sound like you're having a tough time. I hope you get the right help that you need for your anxiety. Please make sure to find a good mental health professional that can give you some advice.

Sep 20, 2014 18:Sep 6 | Carole Heath said

menopause problems

Thanks for your comment Sheryl I have got some help from my GP and mental health professional and I am getting along much better glad to say my anxiety has improved and I am more relaxed now.

Apr 27, 2014 12:Apr 12 | Nettie said

Anxiety and Menopause

I too have been hit hard with severe anxiety attacks during menopause. I find taking deep breaths really helps and the support of other women in the same situation. Also, I had a sleep study done and found I have mild sleep apnea and will soon be wearing a mouth appliance at night which is supposed to help with the panic attacks as I will be able to breathe freely which stops the flight or fright reaction. The lack of estrogen in our bodies affects even the muscles and tissues in our throats making sleeping disorders worse. There's a 90% success rate in wearing the appliance. Anyone having problems with severe lower leg cramps at night and first thing upon awakening? Mine started 3 months ago and really add to my anxiety! I take calcium, magnesium and potassium at bedtime as well as do a routine of stretching. This helps the cramping only a little. I also have RLS and this too is out of control lately. Advice anyone?

Jun 27, 2014 00:Jun 12 | ChristineD. said

mouth piece

I was just wondering what kind of mouth piece that you wear? When I am having the anxiety it feels like im going to hyperventilate...but it never does I just breath really shallow and Id like to overcome this. I am 45 and started the anxiety around my cycle about 1.5 years ago. I hope you are doing good. Thanks C.

May 05, 2014 12:May 12 | Sheryl said

Hi, Nettie - It sounds like

Hi, Nettie - It sounds like you have been through a lot and are doing a lot to help yourself. I truly hope that you find the right relief.

Jan 20, 2014 17:Jan 5 | Patricia Nelson said

Anxiety linked to menapause

I have been suffering from severe panic attacks since starting menopause two years ago, I have stopped driving, lost my job because of anxiety. I do not have medical.

May 05, 2014 12:May 12 | Sheryl said

I am so sorry for what you

I am so sorry for what you are going through, Patricia, and hope you find help with your anxiety.

Feb 05, 2014 14:Feb 2 | anita said

Panic Attacks and Menopause

I have been taking medication for panic and anxiety since 1996. In 2007 I weened myself off the meds. Later that year I crashed. Had to go back on the meds. Been a very hard uphill climb. Now I don't drive, don't stay by myself and cant work. In '07 I was 43. Could it be menopause related? Had a hysterectomy in 99, but still have ovaries. Does anyone know how to stop this madness!!!! Feel as thou I will be this way forever.

Apr 10, 2014 18:Apr 6 | rachel said

I have been though something

I have been though something very similar. I went on SSRI's in 1998 and weaned myself off in 2012, at age 50. Was OK for a few months, and crashed. Had to go back on meds. It was a long way back for me, too. I felt that I recovered completely with the help of a good therapist. Now I am very anxious again, and am going to get my hormones tested next week. I can't blame the meds entirely, because I did have a depressive episode before I went off of them. I think that SSRI's can keep you from really bottoming out, but I would look into something called Estrogen Dominance - especially if you are overweight, it's a nasty culprit. I cope by eating VERY healthy, exercising, doing breathing exercises, and limiting alcohol. Hope that helps!

Jul 02, 2014 07:Jul 7 | melissa stoey said

I just started reading all

I just started reading all the comments and your is the first to mention estrogen dominance. It seems like a lot of doctors leap to giving women birth control pills or HRT assuming a woman is short of estrogen. These meds can have terrible side effects when the issues could actually be a lack of progesterone (the calming hormone) which in turn, causes estrogen dominance. It makes sense that if you're short on the calming hormone and it's not balancing out the estrogen in your body, you could possibly suffer from nervousness and anxiety. I have used a topical progesterone cream that I found quite helpful and almost predictably when I stop using it for an extensive period of time, I have more trouble with anxiety. However, in my 30's I had fertility problems so my progesterone levels were tested with a endometrial biopsy which showed that my luteal phase was short, caused by not having enough progesterone, so I know that I'm already deficient. I would suggest that all women consider their progesterone levels and not just their levels of estrogen.

May 05, 2014 12:May 12 | Sheryl said

Thanks for sharing your

Thanks for sharing your story, Rachel. I do hope you continue to find relief.

Jun 05, 2013 11:Jun 11 | Kraig said

Thank you for the good writeup.

I really like what you guys tend to be up too. Such clever work and reporting! Keep up the awesome works guys I’ve included you guys to our blogroll.

May 13, 2013 10:May 10 | Susan Hines said

anxiety

My husband doesn't understand why I am anxious. I am actually very happy in my life. We currently have enough money so we aren't too stressed with that. My children are grown and successful. But I do stress over things. I guess from what he's saying Imust be driving him nuts. I can't help it. I don't know what to do. I don't mean to be anxious. I've actually been this way forever. but normally I'm very happy go lucky. Am I not entitled to be a bit anxious about things?

Dec 22, 2012 07:Dec 7 | ranjana said

how to prevent panic attacks

Very interesting artical about
how to prevent panic attacks ,Thank u so much really amazing.

www.stressanddepressionfacts.com

Dec 20, 2012 08:Dec 8 | kelly said

Dec 11, 2012 15:Dec 3 | jbk said

menopause and anxiety

I have been struggling with severe anxiety attacks for the past two years. It is no small coincidence that it started when menopause started with me like a freight train hitting a barn!What bothers me is that my doctor tries to help by prescribing this med and that but she has not gone through menopause so I feel she is stabbing in the dark. I'm going to see an ob/gyn soon and I hope to God that he will start to put me on the right path so I don't have to feel everyday my world is coming to an end.

Nov 26, 2012 01:Nov 1 | said

Panic away

To the last commenter, and others...I had my first panic attack several months ago, my doctor told me no way it was hormone-related. I just turned forty, so it's very likely perimenopause! I found a very useful program called Panic Away that has changed how I look at anxiety, and how I resolve the accompanying feelings. I am a skeptic, so it was difficult for me to purchase the program, but it was cheaper than ONE session of CBT, so I figured I would try it. So glad I did. You can do a trial for a month for $5.00. Good luck! It is so unnerving to go through anxiety, but you aren't alone...the fear is REAL to you, but how you approach it can change your life!

Nov 19, 2012 08:Nov 8 | remedy for menopause said

remedy for menopause

This is interesting. I have been looking forward to reading this kind of article and also other remedy for menopause. In fact, I really needed it. Thanks for this post.

Sep 09, 2012 03:Sep 3 | Margaret Ferrante, MD said

September is Menopause Awareness Month

Just stopping by in the name of Women's Health. Thank you for all you do, and please note that September is Menopause Awareness Month!

Dr Margaret Ferrante
www.girlpowerinamm.blogspot.com

Aug 15, 2012 18:Aug 6 | Naomi said

Thank you so much for this

Thank you so much for this post. I have always been really laid back until now - my perimenopause, when I seem to have a regular feeling of anxiety surrounding me. At first I thought it was my imagination, then I thought 'come on girl - snap out of it' and now I know (due to your post) that it is hormonal. Thank heavens for that! and thank you - it's nice to know I am quite normal after all!!!

Aug 18, 2011 12:Aug 12 | Susan said

It's really comforting to

It's really comforting to know there are things women can do to deal with and even lessen bouts of anxiety. Several of my friends have found help at the Women to Women clinic (www.womentowomen.com) - not just for anxiety, but for lots of menopause related health issues.

Aug 15, 2011 10:Aug 10 | sarah henry said

I detected one piece of

I detected one piece of potential good news post-menopause in this story: The possibility that anxiety may subside. Amen to that sistah.

Aug 15, 2011 10:Aug 10 | Mila said

Nutrient depletion?

I recently heard that nutrient depletion from medications may be the cause of a lot of symptoms related to menopause, anxiety, depression, etc. It's a big topic now because there's quite a bit of research that shows the connection between medications, nutrient-depletion and symptoms. It's definitely something to look into. One helpful resource is Mytavin, which is a calculator that shows how you might be depleting your body. It's free and I just typed in my symptoms and it populated the research and results that showed I was depleting zinc. Interesting right?

Jul 02, 2014 08:Jul 8 | melissa stoey said

Serotonin is made in the gut

Serotonin is made in the gut so it makes sense that a healthy diet and healthy gut bacteria is critical toward the creation of this important chemical. I take a probiotic every day but if you have a really healthy diet (which most of us don't!) full of vegetables, you may not need it. But I think it's safe to say that most Americans are nutrient deficient.

Aug 11, 2011 07:Aug 7 | Living Large said

This is good information.

This is good information. I've been in peri-menopause for sometime and more recently have had more symptoms associated with huge hormonal changes at certain times of the month. A friend recently told me, "That sounds like a panic attack." I will have to check into this when I see my doctor next month.

Aug 11, 2011 03:Aug 3 | Jennifer Margulis said

NOT. Looking. Forward. To.

NOT. Looking. Forward. To. This. Particular. Menopause. Problem.

Sigh...

Aug 10, 2011 15:Aug 3 | Melanie said

Good to know this sort of

Good to know this sort of thing can be a hormonal issue, I suppose, but it seems like EVERYTHING we hear/read about menopause is completely negative. Isn't there something good about it we could hear about for once?

Aug 10, 2011 11:Aug 11 | Kristen said

I just read an article

I just read an article yesterday about certain mental ailments--including anxiety--being linked to medical problems. The article pointed out thyroid conditions as an often undiagnosed problem linked to anxiety and depression. Any thoughts on that?

Jul 02, 2014 08:Jul 8 | melissa stoey said

That is true. I'm not a nurse

That is true. I'm not a nurse or doctor but I am well researched in these issues since I'm a long time sufferer. I would suggest that one of the first things you do if you suffer from anxiety is have your thyroid checked. Not just a TSH test but a Free T3 and Free T4 test. Thyroid issues, especially hyperthyroid can cause anxiety and many Americans have un- diagnosed thyroid issues. The bad news is however, that normal lab numbers does not necessarily mean that you aren't suffering from thyroid related issues. You can have symptoms but your numbers look fine. One of the best things you can do is focus on a healthy lifestyle - eating a diet full of a variety of nutrient dense foods especially vegetables, practice stress reduction techniques such as meditation, yoga and exercise and try to get a good night's sleep. I have trouble with anxiety and I have two nodules on my thyroid however, my thyroid numbers always show up in the normal range. So, the getting a diagnoses of thyroid issues is a tricky thing.

Aug 09, 2011 18:Aug 6 | Alisa Bowman said

I kind of think it's like PMS

I kind of think it's like PMS on steroids. Oh, wait, it actually is in a way.... Or off steroids as the case may be.

Aug 09, 2011 17:Aug 5 | Christinegl said

Thanks for this timely

Thanks for this timely article - my friend's daughter is suffering panic attacks daily. She's an adolescent. I hadn't realized it can be hormonally triggered. I'll let her know.

Aug 09, 2011 16:Aug 4 | Alexandra said

I had never heard of CBT.

I had never heard of CBT. Will check into it. Thanks.

Jul 02, 2014 08:Jul 8 | melissa stoey said

It's just talk therapy. I've

It's just talk therapy. I've been doing it for 4 years now and I say all of the time that it saved my life. My therapist has taught me how to think differently.

Aug 09, 2011 14:Aug 2 | Lila said

Great article..

Thanks for such a helpful explanation of what I've been feeling!

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