Table of ContentsView AllTable of ContentsSymptomsCausesRisk FactorsTreatmentPreventionWhen to See a ProviderFrequently Asked Questions
Table of ContentsView All
View All
Table of Contents
Symptoms
Causes
Risk Factors
Treatment
Prevention
When to See a Provider
Frequently Asked Questions
Menopauseoccurs when a person’smenstrual cyclehas stopped for 12 straight months, signaling the end of menstruation. The transitional period prior to menopause is referred to asperimenopause. During this time, the menstrual cycle begins to change and become irregular. Some people even experienceanxietyas a symptom, which may be due to hormonal changes.
Read on to learn more about perimenopausal anxiety and how to cope.
JGI / Jamie Grill / Getty Images
What Are the Symptoms of Perimenopause?
Many symptoms can arise during perimenopause. While not all symptoms will occur in everyone, every person that goes through perimenopause will experience some symptoms, such as:
Defining Premenopause, Perimenopause, and Menopause
Why Does Anxiety Happen During Perimenopause?
Anxiety can occur during perimenopause for a variety of reasons. Physiologically, anxiety may develop during perimenopause because of hormonal changes that occur in the body of a person with a brain sensitive to those changes.
During perimenopause, the sex hormonesestrogenandprogesteronebegin to decrease. Changes in levels of estrogen, specifically, have been closely linked to feelings of anxiety.
Along with these hormonal changes are other symptoms of perimenopause that drive anxiety. Hot flashes and a lack of proper sleep can lead to anxiety.
Anxiety during this period can also be due to midlife stressors or a fear of aging.
Why Is Anxiety Worse in the Morning?Researchers believe that anxiety is worse in the morning because of the stress hormonecortisol. Levels of cortisol tend to be highest in the first four hours after waking.
Why Is Anxiety Worse in the Morning?
Researchers believe that anxiety is worse in the morning because of the stress hormonecortisol. Levels of cortisol tend to be highest in the first four hours after waking.
Risk Factors for Perimenopausal Anxiety
According to one study, there are several risk factors associated with changes in anxiety during perimenopause. They include:
Premenopausal Anxiety and Perimenopausal AnxietyResearchers have investigated whether people with high levels of anxiety before starting perimenopause also have high levels of anxiety during the transitional period. They found that females with high perimenopausal anxiety are not at increased risk for high anxiety at specific stages of the menopausal transition, but those with low perimenopausal anxiety may be more susceptible to high anxiety during and after the menopausal transition than before.
Premenopausal Anxiety and Perimenopausal Anxiety
Researchers have investigated whether people with high levels of anxiety before starting perimenopause also have high levels of anxiety during the transitional period. They found that females with high perimenopausal anxiety are not at increased risk for high anxiety at specific stages of the menopausal transition, but those with low perimenopausal anxiety may be more susceptible to high anxiety during and after the menopausal transition than before.
Treating Perimenopausal Anxiety
There are various treatment options available for those who experience anxiety during perimenopause. They include:
What Are Mind-Body Techniques?Mind-body interventions are designed to enhance the connection between the body and the mind to improve well-being. Some examples include:MeditationBiofeedback (a learned technique to control some body functions, such as heart rate)Laughter yoga (combining laughter with yoga breathing techniques)Hypnotherapy
What Are Mind-Body Techniques?
Mind-body interventions are designed to enhance the connection between the body and the mind to improve well-being. Some examples include:MeditationBiofeedback (a learned technique to control some body functions, such as heart rate)Laughter yoga (combining laughter with yoga breathing techniques)Hypnotherapy
Mind-body interventions are designed to enhance the connection between the body and the mind to improve well-being. Some examples include:
Can You Prevent Perimenopausal Anxiety?
How Age and Other Factors Affect Perimenopause
When to See a Healthcare Provider
While not all anxiety warrants a trip to your healthcare provider’s office, you should make an appointment if you experience anxiety that interferes with your day-to-day life or if you begin havingpanic attacks.
Your healthcare provider will help you determine the best course oftreatmentand possibly refer you to other therapies or specialists that can aid in the management of perimenopausal anxiety.
How to Identify a Panic AttackPanic attacks come on suddenly and can cause you to feel debilitated, as if your entire life is in danger. During a panic attack you may:Feel like you can’t breatheFeel your heart poundingHave an intense fear that you are dyingIf you are experiencing your first panic attack, you can contact your healthcare provider for an evaluation to rule out medical causes of your symptoms.
How to Identify a Panic Attack
Panic attacks come on suddenly and can cause you to feel debilitated, as if your entire life is in danger. During a panic attack you may:Feel like you can’t breatheFeel your heart poundingHave an intense fear that you are dyingIf you are experiencing your first panic attack, you can contact your healthcare provider for an evaluation to rule out medical causes of your symptoms.
Panic attacks come on suddenly and can cause you to feel debilitated, as if your entire life is in danger. During a panic attack you may:
If you are experiencing your first panic attack, you can contact your healthcare provider for an evaluation to rule out medical causes of your symptoms.
Summary
Anxiety can be a symptom of perimenopause, which is the period before menopause. This could be due to hormonal changes—including declining sex hormones—that females experience during the transition, affecting the brain in those who are sensitive to these changes.
Perimenopausal anxiety can be treated with talk therapy, medication, and mind-body exercises. The anxiety likely can’t be prevented, but people can prepare themselves for the possible onset.
A Word From Verywell
Coping with anxiety is difficult, but it can be especially so if you’re also dealing with all the other unwanted symptoms of perimenopause. The best thing for you to do is prepare yourself for the possibility of increased anxiety and speak to your healthcare provider about treatment options. Try to become well-versed in relaxation and anxiety-reducing techniques so that if the anxiety strikes, you’ll be ready to cope.
Menopause starts 12 months following a person’s last menstrual period. According to the National Institute on Aging, the transitional period that signals menopause typically begins between the ages of 45 and 55.
The duration of perimenopause varies significantly from person to person. Typically, it lasts around three to four years.However, it can sometimes last longer than four years and for as little as a few months.
When a person reaches menopause, their menstrual periods stop completely. Hormones drop significantly and lead to symptoms such as hot flashes and vaginal dryness.
14 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Muslić L, Jokić-Begić N.The experience of perimenopausal distress: examining the role of anxiety and anxiety sensitivity.J Psychosom Obstet Gynaecol.2016;37(1):26-33. doi:10.3109/0167482X.2015.1127348Johns Hopkins Medicine.Perimenopause.Santoro N.Perimenopause: from research to practice.J Womens Health.2016;25(4):332-339. doi:10.1089/jwh.2015.5556Harvard Health.Perimenopause: rocky road to menopause.Borrow AP, Handa RJ.Estrogen receptors modulation of anxiety-like behavior.Vitam Horm.2017;103:27-52. doi:10.1016/bs.vh.2016.08.004Hantsoo L, Epperson CN.Anxiety disorders among women: A female lifespan approach.Focus.2017;15(2):162-172. doi:10.1176/appi.focus.20160042North American Menopause Society.Going mad in perimenopause? Signs and solutions.Powell DJ, Schlotz W.Daily life stress and the cortisol awakening response: testing the anticipation hypothesis.PLoS One.2012;7(12):e52067. doi:10.1371/journal.pone.0052067Bromberger JT, Kravitz HM, Chang Y, Randolph JF Jr, Avis NE, Gold EB, Matthews KA.Does risk for anxiety increase during the menopausal transition? Study of women’s health across the nation.Menopause.2013;20(5):488-495. doi:10.1097/GME.0b013e3182730599Leonhardt M.Low mood and depressive symptoms during perimenopause - Should General Practitioners prescribe hormone replacement therapy or antidepressants as the first-line treatment?.Post Reprod Health.2019;25(3):124-130. doi:10.1177/2053369119847867Hunter MS.Cognitive behavioral therapy for menopausal symptoms.Climacteric.2021;24(1):51-56. doi:10.1080/13697137.2020.1777965Shorey S, Ang L, Lau Y.Efficacy of mind-body therapies and exercise-based interventions on menopausal-related outcomes among Asian perimenopause women: A systematic review, meta-analysis, and synthesis without a meta-analysis.J Adv Nurs.2020;76(5):1098-1110. doi:10.1111/jan.14304Kopciuch D, Paczkowska A, Zaprutko T, Michalak M, Nowakowska E.Conventional or natural pharmacotherapy and the prevalence of anxiety and depression during menopause.Altern Ther Health Med. 2017;23(2):12-19.National Institute on Aging.What is menopause?.
14 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Muslić L, Jokić-Begić N.The experience of perimenopausal distress: examining the role of anxiety and anxiety sensitivity.J Psychosom Obstet Gynaecol.2016;37(1):26-33. doi:10.3109/0167482X.2015.1127348Johns Hopkins Medicine.Perimenopause.Santoro N.Perimenopause: from research to practice.J Womens Health.2016;25(4):332-339. doi:10.1089/jwh.2015.5556Harvard Health.Perimenopause: rocky road to menopause.Borrow AP, Handa RJ.Estrogen receptors modulation of anxiety-like behavior.Vitam Horm.2017;103:27-52. doi:10.1016/bs.vh.2016.08.004Hantsoo L, Epperson CN.Anxiety disorders among women: A female lifespan approach.Focus.2017;15(2):162-172. doi:10.1176/appi.focus.20160042North American Menopause Society.Going mad in perimenopause? Signs and solutions.Powell DJ, Schlotz W.Daily life stress and the cortisol awakening response: testing the anticipation hypothesis.PLoS One.2012;7(12):e52067. doi:10.1371/journal.pone.0052067Bromberger JT, Kravitz HM, Chang Y, Randolph JF Jr, Avis NE, Gold EB, Matthews KA.Does risk for anxiety increase during the menopausal transition? Study of women’s health across the nation.Menopause.2013;20(5):488-495. doi:10.1097/GME.0b013e3182730599Leonhardt M.Low mood and depressive symptoms during perimenopause - Should General Practitioners prescribe hormone replacement therapy or antidepressants as the first-line treatment?.Post Reprod Health.2019;25(3):124-130. doi:10.1177/2053369119847867Hunter MS.Cognitive behavioral therapy for menopausal symptoms.Climacteric.2021;24(1):51-56. doi:10.1080/13697137.2020.1777965Shorey S, Ang L, Lau Y.Efficacy of mind-body therapies and exercise-based interventions on menopausal-related outcomes among Asian perimenopause women: A systematic review, meta-analysis, and synthesis without a meta-analysis.J Adv Nurs.2020;76(5):1098-1110. doi:10.1111/jan.14304Kopciuch D, Paczkowska A, Zaprutko T, Michalak M, Nowakowska E.Conventional or natural pharmacotherapy and the prevalence of anxiety and depression during menopause.Altern Ther Health Med. 2017;23(2):12-19.National Institute on Aging.What is menopause?.
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Muslić L, Jokić-Begić N.The experience of perimenopausal distress: examining the role of anxiety and anxiety sensitivity.J Psychosom Obstet Gynaecol.2016;37(1):26-33. doi:10.3109/0167482X.2015.1127348Johns Hopkins Medicine.Perimenopause.Santoro N.Perimenopause: from research to practice.J Womens Health.2016;25(4):332-339. doi:10.1089/jwh.2015.5556Harvard Health.Perimenopause: rocky road to menopause.Borrow AP, Handa RJ.Estrogen receptors modulation of anxiety-like behavior.Vitam Horm.2017;103:27-52. doi:10.1016/bs.vh.2016.08.004Hantsoo L, Epperson CN.Anxiety disorders among women: A female lifespan approach.Focus.2017;15(2):162-172. doi:10.1176/appi.focus.20160042North American Menopause Society.Going mad in perimenopause? Signs and solutions.Powell DJ, Schlotz W.Daily life stress and the cortisol awakening response: testing the anticipation hypothesis.PLoS One.2012;7(12):e52067. doi:10.1371/journal.pone.0052067Bromberger JT, Kravitz HM, Chang Y, Randolph JF Jr, Avis NE, Gold EB, Matthews KA.Does risk for anxiety increase during the menopausal transition? Study of women’s health across the nation.Menopause.2013;20(5):488-495. doi:10.1097/GME.0b013e3182730599Leonhardt M.Low mood and depressive symptoms during perimenopause - Should General Practitioners prescribe hormone replacement therapy or antidepressants as the first-line treatment?.Post Reprod Health.2019;25(3):124-130. doi:10.1177/2053369119847867Hunter MS.Cognitive behavioral therapy for menopausal symptoms.Climacteric.2021;24(1):51-56. doi:10.1080/13697137.2020.1777965Shorey S, Ang L, Lau Y.Efficacy of mind-body therapies and exercise-based interventions on menopausal-related outcomes among Asian perimenopause women: A systematic review, meta-analysis, and synthesis without a meta-analysis.J Adv Nurs.2020;76(5):1098-1110. doi:10.1111/jan.14304Kopciuch D, Paczkowska A, Zaprutko T, Michalak M, Nowakowska E.Conventional or natural pharmacotherapy and the prevalence of anxiety and depression during menopause.Altern Ther Health Med. 2017;23(2):12-19.National Institute on Aging.What is menopause?.
Muslić L, Jokić-Begić N.The experience of perimenopausal distress: examining the role of anxiety and anxiety sensitivity.J Psychosom Obstet Gynaecol.2016;37(1):26-33. doi:10.3109/0167482X.2015.1127348
Johns Hopkins Medicine.Perimenopause.
Santoro N.Perimenopause: from research to practice.J Womens Health.2016;25(4):332-339. doi:10.1089/jwh.2015.5556
Harvard Health.Perimenopause: rocky road to menopause.
Borrow AP, Handa RJ.Estrogen receptors modulation of anxiety-like behavior.Vitam Horm.2017;103:27-52. doi:10.1016/bs.vh.2016.08.004
Hantsoo L, Epperson CN.Anxiety disorders among women: A female lifespan approach.Focus.2017;15(2):162-172. doi:10.1176/appi.focus.20160042
North American Menopause Society.Going mad in perimenopause? Signs and solutions.
Powell DJ, Schlotz W.Daily life stress and the cortisol awakening response: testing the anticipation hypothesis.PLoS One.2012;7(12):e52067. doi:10.1371/journal.pone.0052067
Bromberger JT, Kravitz HM, Chang Y, Randolph JF Jr, Avis NE, Gold EB, Matthews KA.Does risk for anxiety increase during the menopausal transition? Study of women’s health across the nation.Menopause.2013;20(5):488-495. doi:10.1097/GME.0b013e3182730599
Leonhardt M.Low mood and depressive symptoms during perimenopause - Should General Practitioners prescribe hormone replacement therapy or antidepressants as the first-line treatment?.Post Reprod Health.2019;25(3):124-130. doi:10.1177/2053369119847867
Hunter MS.Cognitive behavioral therapy for menopausal symptoms.Climacteric.2021;24(1):51-56. doi:10.1080/13697137.2020.1777965
Shorey S, Ang L, Lau Y.Efficacy of mind-body therapies and exercise-based interventions on menopausal-related outcomes among Asian perimenopause women: A systematic review, meta-analysis, and synthesis without a meta-analysis.J Adv Nurs.2020;76(5):1098-1110. doi:10.1111/jan.14304
Kopciuch D, Paczkowska A, Zaprutko T, Michalak M, Nowakowska E.Conventional or natural pharmacotherapy and the prevalence of anxiety and depression during menopause.Altern Ther Health Med. 2017;23(2):12-19.
National Institute on Aging.What is menopause?.
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