How to cope with perimenopause anxiety
11 June 2024
By Dr Sophie Shotter

Perimenopause, the transitional phase leading up to menopause, is a significant period in a woman’s life, marked by a series of hormonal changes. These changes can manifest in various physical and emotional symptoms, with anxiety being one of the most profound and often overlooked aspects.
Why does anxiety occur in perimenopause?
As oestrogen levels fluctuate during perimenopause, many women experience a rise in anxiety. Oestrogen plays a crucial role in regulating mood, and its decline can lead to heightened feelings of anxiety, panic attacks, and a general sense of unease. This anxiety is not merely a psychological phenomenon but is deeply rooted in the biological shifts happening within the body.
One of the most challenging aspects of perimenopause-related anxiety is its unpredictability. Women may find themselves suddenly overwhelmed by intense feelings of fear or panic, often without a clear trigger. This unpredictability can make everyday tasks feel daunting and can significantly impact one’s quality of life. Simple activities, such as going to work, socialising with friends, or even running errands, can become sources of stress.
Moreover, perimenopause anxiety is often accompanied by other symptoms such as insomnia, fatigue, and mood swings, which can exacerbate feelings of anxiety. Lack of sleep, in particular, can create a vicious cycle where anxiety leads to poor sleep, and poor sleep, in turn, increases anxiety. This interplay of symptoms can make it difficult for women to identify the root cause of their distress, leading to feelings of frustration and helplessness.
Despite the prevalence of these symptoms, perimenopause anxiety remains under-discussed and under-diagnosed. Many women do not realise that their anxiety could be linked to hormonal changes and may attribute it to external stressors or personal weakness. This lack of awareness can prevent women from seeking the help they need and deserve.
What are the signs that you’re dealing with anxiety?
Anxiety can manifest in various ways, both physically and mentally. Common signs of anxiety include persistent feelings of worry or dread that are difficult to control. Physically, individuals may experience symptoms such as a racing heart, rapid breathing, sweating, trembling, and fatigue. They might also encounter sleep disturbances, such as difficulty falling asleep or staying asleep. Mentally, anxiety can lead to restlessness, difficulty concentrating, and an overwhelming sense of impending doom or fear. These symptoms can interfere with daily activities, making it challenging to perform routine tasks or interact with others. Recognising these signs is crucial for seeking appropriate help and managing anxiety effectively.
How do you treat anxiety in perimenopause?
It is essential for women experiencing perimenopause to recognise the connection between hormonal changes and anxiety. Acknowledging this link can be the first step towards seeking appropriate treatment and support. Treatments can include hormone replacement therapy which aims to balance hormone levels, as well as lifestyle changes such as regular exercise, a healthy diet, and mindfulness practices. Additionally, talking to a healthcare professional who is knowledgeable about perimenopause can provide invaluable guidance and reassurance.
Support from family and friends also plays a crucial role in managing perimenopause anxiety. Open communication about what you’re experiencing can help loved ones understand and provide the necessary support. Furthermore, connecting with other women going through similar experiences can be incredibly comforting and empowering.
Perimenopause is a natural phase of life, and while it brings its challenges, it also offers an opportunity for women to prioritise their health and wellbeing. By increasing awareness and understanding of perimenopause anxiety, women can better navigate this transition and find effective ways to manage their symptoms.
