Perimenopause Anxiety: How to Navigate the Transition

Anxiety and Perimenopause

May 20, 2022

Hi, I’m Angela
I'm a functional medicine practitioner & hormone expert working primarily with women in their 40's and 50's to create lasting health.
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The time around menopause can be a challenge for many women. Along with the physical symptoms like hot flashes and night sweats, many women also experience anxiety and other mood changes. If you’re dealing with anxiety during perimenopause, here are some tips to help you navigate the transition.

Perimenopause Anxiety

Many women feel anxious as they get older. This can sometimes cause physical anxiety, like when a woman feels shaky, her heart races, she feels jittery, and has a hard time focusing. Sometimes this makes it hard to get through everyday life at work. Some women may not be able to maintain healthy relationships with close loved ones like family because they are always angry or easily upset.

A lot of this has to do with this anxiety. Many women report that they feel their anxiety getting worse at certain points in their cycle. Often, it’s in that back half of the cycle, in other words, the week or two before getting the period for those who are still having regular ones. Some women report it continues even up to the first couple of days of their cycle.

There’s no doubt that this does partially have to do with hormones shifting, fluctuating, and changing as women get into the forties and beyond. But it’s not the only thing that’s probably disrupting and causing this anxiety.

There are two things we need to talk about. They both influence each other. We can take steps to help improve our mood balance, both now and in the long term, no matter what our hormone levels are like, as we transition towards menopause. As we know, the hormones are getting lower as women get into that transitional time.

From the hormonal perspective

As women get into their forties and move towards their fifties, the female sex hormones: both estrogen and progesterone go down. Progesterone lowers more quickly than estrogen. This is partly the reason why women start to get more anxious. When progesterone levels are at a healthy level, and they’re more balanced with estrogen, women will tend to feel more calm and balanced with their moods. 

This fluctuation and imbalance as the progesterone lower faster than the estrogen, can trigger some anxiety for women. For some women, this can become quite severe. One of the reasons that can happen most typically is when we went are under a lot of stress. This could be emotional stress, physical stress, or could just be a “busy-ness” stress.

I find some women are kind of in a go-go-go pace of lifestyle even when they’re in their forties. They’re always working and being busy with their family, friends, and social activities. Most of them always plan multiple things on the go.

This can put the body under stress too. It can often cause an elevation in our primary hormone that helps us cope with the stress: cortisol. What can happen over time is, if we keep asking our body to operate under high levels of stress, we’ll have to keep producing more cortisol. Basically, to keep up with a lot of stress, more often than not,  the body can’t keep up.

A survival mechanism

The human body is quite clever. What it will start to do over time is to start utilizing some of our other hormones to help us produce cortisol. It sees this as a survival mechanism. Frequently, it will steal progesterone as one of the primary hormones to make cortisol. And since progesterone’s already lowering during the transition in menopause, this hastens the acceleration of the hormone levels dropping. 

Progesterone can lower too much and too quickly. In turn, this can make women feel more anxious, especially in the first half of their cycle. We want to put in mind how we can get a handle on our stress. We want to slow down a little bit, make sure we have some strategies in place for buffering that stress. 

We need you to exercise, do meditation, and have a wind-down technique so you can relax. These things will help your body not be in overdrive all the time.

Imbalances in gut health

Another aspect to this, which I feel is very commonly overlooked is, that anxiety can also be triggered, not just by the hormones, but also by imbalances in our gut health. Over our lifetime, we will have an accumulation of toxins and a buildup of things that have just come through our bodies over a lifetime. A lot of this depends on diet and lifestyle preferences. One thing to note is, that this is natural, thus, it happens to everyone. 

If you eat foods that might cause inflammation, like sugary sweet foods, foods with too many carbohydrates, or high protein diets with lots of red meat, your gut might be inflamed. This is especially true if you have been eating this way for a long time.

If we have too much inflammation in the gut, the neurotransmitters produced there is pretty much affected. These chemical signals are messengers that help us to maintain a calm, balanced mood. They help us prevent anxiety from happening. Serotonin is the primary neurotransmitter we are talking about. But it also has to be balanced with dopamine, norepinephrine and epinephrine.

There are ways to check for this. Particular lab tests can be done. There’s a urine testing as well that we can do to check on these neurotransmitter levels and see if they’re out of balance. Quite commonly, it can almost be what I would call “a perfect storm”. There are imbalances in the gut health, there are also imbalances in the sex hormones and the cortisol levels all at once.

This can cause a lot of this anxiety to develop. We need to start to understand through proper lab testing, where the root of the problem is. Then we can start to understand what to do about it. We will try and see if: 

  1. Is your anxiety more related to your hormones and your stress levels
  2. Is your gut health in too bad of a shape? Or
  3. Is it more related to gut health over time? And this precipitated the hormone imbalance starting in the first place. 
  4. is it a combination of the two? 

Sometimes, it requires that you work with a practitioner to help you understand this. 

There are some of the steps you could take even before you work with a practitioner.

Regarding gut health, there are some things you can do right away. 

One of them is to make sure that you are drinking enough water daily. This help to flush out toxins. We become a little less efficient with this process over time as we age, it’s just part of the aging process. This, though, becomes more important as we get into our forties and beyond.

Another thing is to make sure that you are eating a well-balanced diet. There should be lots of vegetables and enough fiber coming in. It is better to do away from those sweet sugary carbohydrate-type foods.

When you’re more mindful of this, it will help keep the balance with inflammation in your body. This allows your body to produce those neurotransmitters in a more balanced way

If anxiety is bothering you a lot, and it’s hard to control it, even if you try some of these tips, then I suggest you talk to me. We can talk about your health history and find out the cause of your anxiety.

As necessary, we can do the proper lab testing, and then we can start to put a plan in place to help you start supporting your body. This way, you can get it back into balance both now and in the long term. I understand that if you are suffering from anxiety, it’s probably not just you, that it’s affecting, it’s probably affecting others around you. This could be impacting your work and relationships, and your ability to get things done and be efficient. It can have quite a negative spin-off in several categories of your life once the anxiety is starting to get the better of you.

We know that you want to address it. Also, when we know that the root cause is related to gut health and imbalances, especially high inflammation, you could be at risk for other conditions developing as well. Cardiovascular conditions can develop when we have inflammation that’s too high for long periods, especially for women as they approach menopause and beyond.

There is the possibility that a woman could be more prone to developing autoimmune conditions if the inflammation is too high. Depending on genetics and lifestyle susceptibility, she could also be at higher risk for female cancers. We just want to make sure that we’re not just thinking about the current symptoms, but also about how can we get your health back on track both now and for the long term.

Although anxiety is a common experience for women during the perimenopausal transition, it doesn’t have to be debilitating. There are many things you can do to help address your anxiety in the long term. We hope the tips we shared will help make this process a little bit easier for you. If you’d like more personalized support, please don’t hesitate to reach out to us for a free discovery call. During our chat, we can discuss your unique situation and create a plan tailored specifically for you. Thank you again for reading our blog post!

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DISCLAIMER:  The information in this email is not intended nor implied to be a substitute for professional medical advice, diagnosis or treatment. All content is for general informational purposes only and does not replace a consultation with your own doctor/health professional 

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