Does Menopause Cause Anxiety?

Key Takeaways:

• Hormonal changes during menopause, especially shifts in estrogen and progesterone, can affect mood and contribute to anxiety symptoms.

• Therapy, medication, lifestyle changes, and HRT can all be helpful for managing menopause anxiety.

• Seeking professional help is important if anxiety becomes overwhelming or interferes with daily life. 
  

Mood changes, hot flushes, night sweats, and emotional symptoms are to be expected with menopause, particularly during the latter part of the menopausal transition (or late perimenopause). 

But what about more significant worrying? Does menopause cause anxiety? Indeed, this can be a time of increased susceptibility to anxiety, especially among women who have a previous anxiety diagnosis.

Below, we’ll explore the relationship between menopause and anxiety, how this transitional life stage can affect your mental health, and what you can do about it.

First things first: What does menopause anxiety look like? Some of the most common symptoms include:

• Excessive worry or fear

• Nervousness and restlessness

• Difficulty concentrating

• Forgetfulness

• 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 

The natural fluctuations in hormone levels (namely, estrogen and progesterone), life stresses, and sleep problems can be the perfect storm for more noticeable anxiety during menopause. This is especially true if you’ve been diagnosed with anxiety before.

Similarly, postmenopausal women may be more prone to low mood and other symptoms of depression. While this appears to be most likely if there’s a previous struggle with depression, research shows that the midlife transition is an especially vulnerable time for it to arise.

A 2023 systematic review of 22 studies found that both anxiety and depression were common during and after menopause. And a 2025 study found that rates of anxiety disorders during perimenopause have been trending upward since 1990.

Another study says somewhere between 15 and 50 percent of perimenopausal and postmenopausal women experience emotional and psychological symptoms, often including anxiety.

A small 2020 study 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 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 are also 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 to deal 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 in menopause.

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.

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

• Eating a balanced diet

• Engaging in regular exercise

• Reducing caffeine, alcohol, and nicotine intake

• Aiming to get enough sleep at night

• Trying out mindful meditation

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

Hormone Replacement Therapy (HRT)

For many women, hormone replacement therapy (HRT) can be used to help ease common menopause symptoms. 

"Mood changes in menopause are not something you have to just accept," says Lynn Marie Morski, MD. "With the right hormone therapy plan, many patients experience meaningful relief from anxiety and depression.”

HRT works by supplementing the body with estrogen — and sometimes progesterone — to balance hormone levels that naturally decline during this time. By stabilizing hormone fluctuations, HRT may improve mood, reduce hot flashes, and lessen anxiety or irritability. 

Research supports the ability of HRT to also help improve mood and depressive symptoms among some women, but more studies are needed to determine whether the timing of its administration plays a role. 

However, HRT isn’t suitable for everyone. It’s important to discuss the benefits and rare but potential risks and side effects, such as an increased chance of blood clots, stroke, or certain cancers, with your healthcare provider before starting treatment. 

They can help you decide whether HRT, a non-hormonal treatment, or a combination of both might be best for your specific symptoms and overall health.

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.

Below, we’ve put together answers to some of the most common questions about how menopause and anxiety may be related.

Is anxiety a normal part of menopause?

It can be. Many women experience increased anxiety during perimenopause and menopause due to hormonal fluctuations, life stressors, and sleep changes, especially if they have previously struggled with it. However, ongoing or severe anxiety isn’t something you need to “just live with” — treatment options are available.

Can hormone replacement therapy (HRT) help with menopause-related anxiety?

In some cases, yes. HRT can help balance fluctuating hormone levels that may contribute to mood changes and anxiety in addition to other commonly reported menopause symptoms. It’s important to talk with your healthcare provider to determine if HRT is right for you.

How can I tell if my anxiety is from menopause or something else?

This can be tricky because menopause and anxiety disorders share similar symptoms. If your anxiety feels intense, persistent, or interferes with your daily life, it’s a good idea to speak with a healthcare professional for a proper evaluation and guidance.

What lifestyle changes can help reduce anxiety during menopause?

Regular exercise, a nutrient-dense diet, mindfulness practices, limiting caffeine and alcohol, and consistently getting enough sleep can all help manage anxiety. These habits support overall well-being regardless of life stage and may lessen the impact of hormonal changes on mood.

When should I seek professional help for menopause-related anxiety?

If your anxiety feels overwhelming, causes panic attacks, disrupts sleep, or interferes with work or relationships, reach out to a healthcare provider or mental health professional. Therapy, medication, or a combination of treatments can significantly improve your quality of life.