What is the link between menopause and anxiety?
Anxiety is a common symptom of menopause. Hormone changes, life stresses, and sleep problems may all cause anxiety at this time.
Menopause occurs when periods have ended for 12 months. Perimenopause is the phase before the final menstrual period, during which the body undergoes many physical changes.
Many people experience anxiety or depression when perimenopause begins. However, if someone experiences frequent, severe feelings of anxiety or panic attacks, they should contact a medical professional.
This article details the link between anxiety and menopause and how a person can manage the condition.
Learn the difference between premenopause and perimenopause here.
Anxiety and menopause
A 2020 study in Brazil found that 58% of women aged 45–55 who were experiencing perimenopause had anxiety symptoms. In the same study, 62% experienced symptoms of depression.
However, a larger 2016 study in China found that the prevalence of anxiety in women 45–60 years was around 13%, and about 26% experienced depression.
The hormonal changes that happen during menopause can drive feelings of anxiety. Changes in estrogen levels, in particular, may have an impact.
Other changes related to menopause can cause anxiety. For example, 40-50% of people experience sleep disturbances or insomnia during the menopausal transition. Sleep disorders can cause anxiety, and anxiety can cause a person to sleep poorly.
Outside influence and significant life changes during the menopausal years may also cause feelings of anxiety. For example, children leaving home may cause separation anxiety. A person may also feel anxiety as menopause approaches.
Learn more about anxiety and sleep here.
It is common for people undergoing menopause to receive hormone replacement therapy (HRT) and other treatments for menopause symptoms. Treating hormone imbalances may reduce anxiety symptoms in some cases.
However, doctors may also recommend antianxiety medications and psychotherapy to directly treat anxiety. Antianxiety medications include:
- selective serotonin reuptake inhibitors (SSRIs)
- serotonin-norepinephrine reuptake inhibitors (SNRIs)
- tricyclic antidepressants (TCAs)
- monoamine oxidase inhibitors (MAOIs)
Learn more about antianxiety medications here.
SSRIs are often effective in improving anxiety symptoms. However, according to the North American Menopause Society, about half of people who use these medicines experience side effects that affect their sex lives. These side effects can include reduced libido and difficulty maintaining arousal or achieving orgasm.
Learn how to increase libido here.
Doctors believe that certain lifestyle choices, such as eating a balanced, nutritious diet, can help with menopause symptoms and reduce panic attacks. These include:
- reducing caffeine intake
- reducing alcohol intake
- having acupuncture treatment
- getting good, consistent sleep
- participating in support groups
Importantly, people should make sure that they take time out for themselves. Certain activities, such as gardening, reading, meditating, practicing mindfulness, or yoga, are all good ways to focus on oneself and create feelings of well-being and relaxation.
Learn more about ways to treat anxiety without medication.
Dealing with a panic attacks
During menopause, people may experience panic attacks. These are sudden, intense bouts of anxiety and stress.
Panic attacks typically last for 5–20 minutes, but they can also recur in a series of episodes that can last for hours.
Physical symptoms may accompany these feelings and may include:
- heart palpitations
- shortness of breath
- tingling sensations
If someone has panic attacks, a doctor can help. They may either prescribe some medication or make a referral for mental therapy.
Learn more about the differences between anxiety attacks and panic attacks here.
Medication and therapy
If a person experiences persistent or severe panic attacks, doctors may recommend medications, psychotherapies, or both.
Medications that may help reduce panic attack frequency and severity include SSRIs and antidepressant drugs.
Several forms of psychotherapy may help treat panic attacks and anxiety. These are therapies that involve talking with a licensed therapist either face to face or remotely.
Psychotherapies for panic attacks and anxiety include:
- cognitive behavioral therapy (CBT)
- exposure therapy
- eye movement desensitization and reprocessing therapy (EMDR)
- dialectal behavior therapy (DBT)
Learn more about the different types of therapy for anxiety here.
People may learn to manage panic attacks through a variety of measures.
Some lifestyle changes that may reduce panic attacks include:
- eating a nutritious, balanced diet with lots of fresh fruit and vegetables
- avoiding alcohol
- reducing consumption of caffeine
- learning self-relaxation techniques
- getting plenty of fresh air
Anxiety is common in people during menopause. Changes in hormone levels, life changes, and sleep disturbances during menopause can cause anxiety.
In addition to generalized anxiety, people may also experience sudden, intense panic attacks. People can often manage these symptoms with lifestyle changes, medications, and psychotherapy.