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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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.

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!

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


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.


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

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?

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.


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?

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.

Aug 09, 2011 14:Aug 2 | Lila said

Great article..

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

Aug 09, 2011 14:Aug 2 | Roxanne said

Interesting. I can see how

Interesting. I can see how the anxiety might ramp up like this. I wonder if that's that reason for increased grumpiness too. Or, do women just reach a certain age and simply no longer "suffer any fools"?

Aug 09, 2011 14:Aug 2 | Jane Boursaw said

I'm smack dab in the middle

I'm smack dab in the middle of the menopause age group, so reading this with interest. One thing I've learned in yoga is how our breathing is tied to anxiety. Whenever I feel anxious, I focus on breathing long, slow breaths, rather than the shallow breath that anxiety brings.

Aug 09, 2011 13:Aug 1 | NoPotCooking said

This is very helpful. Another

This is very helpful. Another factor that may link anxiety and menopause is the other physical changes that can happen at this time. There's just a lot going on.

Aug 09, 2011 12:Aug 12 | said

anxiety and panic attacts

I have been taking medication for anxiety and panic attacts, but still suffer from them on a daily bases, I have a fear of being alone and I don't do well. I don't like to go anywhere by my self. offten when i'm asleep i am woken up in such a panic and can't breath. i'm not able to sleep well at all.

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