Can Menopause Cause Anxiety?

Menopause is a normal part of aging for women. Since it brings on many physical and psychological symptoms, it’s understandable to wonder if menopause can cause anxiety.

Mood changes and emotional symptoms are to be expected with menopause. But what about extreme stress or worry? Can menopause cause an anxiety disorder?

We’ll explore whether there’s a connection between menopause and anxiety and how this transitional life stage can affect your mental health.

Let’s go over the basics of menopause before getting into the relationship between menopause and anxiety. 

A woman is in menopause when they’ve gone without a menstrual period for 12 consecutive months. In the United States, the average age of menopause is 52.

Perimenopause

The period leading up to menopause is known as perimenopause (sometimes called pre-menopause or the menopausal transition). It’s when your body starts moving toward menopause but isn’t fully there yet. 

Perimenopause typically starts between the ages of 45 and 55. The median duration of this transitional period is four years. However, it can last over a decade for some.

What Triggers Menopause?

Menopause occurs due to the depletion of ovarian follicles, fluid-filled sacs in the ovaries that contain eggs, coupled with hormonal changes in the reproductive hormones estrogen and progesterone.

Women tend to notice menopausal symptoms most often during the latter part of the menopausal transition (or late perimenopause). During this time, women may experience various physical and psychological symptoms. 

Physical symptoms of menopause can include: 

• Changes in or irregular periods

• Hot flashes (or hot flushes) and night sweats, which are collectively referred to vasomotor symptoms

• Headaches

• Trouble sleeping

• Vaginal dryness

• More frequent or urgent urination

• Hair loss

• Weight gain

Many perimenopausal women also experience changes in their sex drive, difficulties with memory and concentration, and mood changes or mood swings.

Since menopause can affect mood, is there a connection between anxiety and menopause? And what about perimenopause and anxiety? Keep reading for insight.

To better understand the connection between anxiety and menopause and whether menopause can cause anxiety, it’s good to know what anxiety is.

Anxiety is a normal part of life, from worrying about money or relationship problems to stress over work. When it doesn’t go away, or when you find yourself worrying excessively about little things, you may be dealing with an anxiety disorder.

Anxiety disorders are mental health conditions that can affect how you feel, think, and behave. They can impact your quality of life and well-being and even your ability to get things done on a day-to-day basis. Symptoms of anxiety vary based on the type of anxiety disorder you have.

Some of the most common anxiety symptoms include:

• Excessive worry or fear

• Nervousness and restlessness

• Difficulty concentrating

• Trouble sleeping

• Increased heart rate or heart palpitations

• Trembling or shaking

• Sweating

• Avoiding people, objects, or situations that may cause anxiety

• Feeling of panic, danger, or impending doom

While the exact cause of anxiety isn’t entirely known, some genetic and environmental factors — such as a family history of anxiety, childhood trauma, or physical health issues — can increase your risk of developing an anxiety disorder.

Changes in hormone levels, life stresses, sleep problems, and more may cause anxiety during the menopausal transition or in the menopausal stage.

Postmenopausal women may also be more prone to experiencing low mood and other symptoms of depression, especially if they have a history of depression.

Indeed, a 2023 systematic review of 22 studies found that both anxiety and depression were common during and after menopause.

So, how common is it to experience anxiety or mood disorders like depression during perimenopause?

A 2025 study found that rates of anxiety disorders during perimenopause have been trending upward since 1990.

A 2020 study of a small sample size of Brazilian women found that 58 percent of those who experienced menopausal symptoms also had anxiety symptoms, while 62 percent experienced depressive symptoms.

But menopause and anxiety don’t always occur at the same time. A larger 2016 study in China found that only 13 percent of women ages 40 to 60 experienced anxiety, and about 26 percent experienced depressive symptoms.

Hormonal Fluctuations and Feelings of Anxiety

Changes in hormones, specifically estrogen levels, may have an impact on anxiety levels during the menopausal stage.

Research suggests that estrogen affects major neurotransmitter networks in our brain, such as those involving serotonin, dopamine, and GABA. These neurotransmitter pathways are also involved in anxiety.

Other changes, like sleep disturbances or insomnia, may contribute to anxiety during the menopausal transition as well. Indeed, research has found that insufficient sleep can contribute to anxiety or exacerbate it..

There’s also a chance of experiencing new or worsening panic disorder during the transition to menopause. Panic disorder leads to panic attacks, which are sudden and unexpected intense feelings of dread or worry, with symptoms such as sweating, trembling, shortness of breath, or heart palpitations.

Hormonal Fluctuations and Levels of Depression

There may be a connection between menopause and depression. Hormone shifts, including decreasing estrogen levels and a drop in progesterone, can also lead to a bout of depression during menopause.

These hormones also are tied to serotonin — a neurotransmitter connected to feelings of happiness. So the change in estrogen and progesterone levels may contribute to depressive symptoms.

There are a few different ways of dealing with anxiety brought on by the menopause transition. A great first step is to talk with a medical professional — like your healthcare provider — about your symptoms and how to treat them.

Options like psychotherapy, lifestyle changes, medication or a combination of all three are typical anxiety treatments during the menopausal stage.

Therapy

Even if you’re not facing menopause-related anxiety, late perimenopause is a big change for many midlife women.

Therapy — sometimes referred to as talk therapy — lets you talk about what you’re dealing with and make progress toward managing your individual anxiety symptoms and levels of depression.

A common form of therapy used to treat anxiety is cognitive behavioral therapy (CBT). You’ll work with a trained professional to identify unhelpful behaviors or patterns and learn to shift those behaviors for the better.

Other types of therapy used to treat anxiety include exposure therapy, interpersonal therapy, and supportive therapy.

If you’re looking to get started with talk therapy, find a licensed mental health professional online to discuss your symptoms and what you hope to get out of the process.

Medication

If your anxiety symptoms are severe or you’re experiencing frequent panic attacks, a healthcare provider may recommend anxiety medication.

Medications typically used for anxiety include:

• Selective serotonin reuptake inhibitors (SSRIs) like fluoxetine or escitalopram

• Serotonin-norepinephrine reuptake inhibitors (SNRIs), such as venlafaxine

• Tricyclic antidepressants (TCAs)

• Benzodiazepines

• Buspirone

• Beta-blockers like propranolol

There are benefits and adverse effects to all these options, which you can learn more about in our complete guide to medications for anxiety.

Lifestyle Changes

Implementing lifestyle changes can reduce stress levels and anxiety symptoms. Some examples of strategies to try out include:

• Eating a balanced diet

• Engaging regular exercise

• Reducing caffeine, alcohol, and nicotine intake

• Aiming to get enough sleep at night

• Trying out mindful meditation

Making good lifestyle choices can benefit your mood, quality of life, and wellness.

Some women may undergo hormone replacement therapy (HRT) and other treatments for menopause symptoms. Treating hormone imbalances may reduce anxiety symptoms in certain cases.

Whether you become more anxious after starting the menopause transition or are uneasy just thinking about the onset, there’s a notable connection between perimenopause and anxiety.

All the changes your body goes through during the menopausal transition can certainly cause anxiety and increase stress. However, while menopause and anxiety sometimes occur simultaneously, generalized anxiety disorder, panic disorders and mood disorders like major depression are more likely due to other mental health factors.

Still, if your anxiety symptoms, menopausal symptoms, or both are interfering with your daily life, you’re wise to reach out to a healthcare provider to discuss the next steps for treatment. You deserve to feel your best at every life stage.