Can Menopause Cause Anxiety?

If menopause is on the horizon (or perhaps has already started), you’re probably thinking about potential symptoms. And if you’re like many women, you might be wondering about the connection between menopause and 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.

We’ll go over the basics of menopause before getting into the relationship between menopause and anxiety.

Menopause occurs 12 months after a woman’s last menstrual period. This change typically happens between the ages of 45 and 55, though it can be earlier or later.

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.

Perimenopausal women can be in this state for anywhere between seven to 14 years before menopause officially begins.

What Triggers Menopause?

Menopause occurs because the ovaries stop producing estrogen and progesterone, causing overall levels of both reproductive hormones to drop. Women tend to notice menopausal symptoms most often during the menopausal transition (or late perimenopause).

During late perimenopause, women may experience physical and psychological symptoms. 

Physical symptoms of menopause can include:

• Hot flashes

• Night sweats

• Hair loss

• Tender breasts

• Dry skin or eyes

• Headaches

• Joint or muscle pain

• Vaginal dryness

• Weight gain

• Changes in or irregular periods

• Tingling hands, feet, arms or legs

Many perimenopausal women also experience changes in their sex drive, as well as 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, you may be dealing with an anxiety disorder.

Anxiety disorders are mental health conditions that can affect how you feel, think and behave and impact your quality of life. Symptoms of anxiety vary based on the type of anxiety disorder you have.

But some of the most common anxiety symptoms include:

• Difficulty concentrating on anything other than current worries or concerns

• Fatigue

• Nervousness and restlessness

• Trouble sleeping

• Increased heart rate

• Shortness of breath

• Sweating

• Tingling or numbness

• Avoiding people, objects or situations that may cause anxiety

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 symptoms of depression, especially if they have a history of depression.

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

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. 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, such as estrogen levels, may have an impact on anxiety levels during the menopausal stage.

Other changes, like sleep disturbances or insomnia, may cause anxiety during the menopausal transition as well.

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

The similarity in symptoms can make distinguishing a panic attack from menopause difficult. However, shortness of breath doesn’t occur with menopause or late perimenopause.

Hormonal Fluctuations and Levels of Depression

There can also 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 therapy, 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 (like fluoxetine or escitalopram)

• Serotonin-norepinephrine reuptake inhibitors (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 like mindful meditation, regular exercise and reducing caffeine intake can reduce stress levels and menopausal anxiety symptoms. Making good lifestyle choices can also benefit your overall mood and quality of life.

Some women may undergo hormone replacement therapy 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.