Anxiety and the menopause - increasing awareness

If there were headlines attached to the menopause, then they would almost certainly start with hot flushes, perhaps with ‘brain fog’ getting a mention, and maybe aching joints. Anxiety is rarely up there with the top symptoms, yet for a lot of women, it’s one of the worst aspects of the perimenopause and menopause.

Anxiety and the menopause

It’s perhaps a bit of a double whammy. We find it hard to talk about mental health and probably even harder to talk about menopause. Put the two things together and you can almost hear the tumbleweed blowing, but by acknowledging that anxiety is a major problem for a lot of women at this stage in their life and by talking more about the biological reasons behind it, we can perhaps reduce the stigma and increase awareness.

Anxiety of any kind can be helped by lessening the pressure to be perfect. If you suffer from social anxiety, then it can often be useful to give yourself ‘permission’ to be less than perfect in a social situation. You don’t have to be the life and soul of the party, you can be just ‘OK’ or ‘good enough’. By taking away some of the pressure, you can often reduce anxious feelings.

In the same way, the realisation that there are strong biological reasons why you are likely to feel anxious during perimenopause can also help reduce these feelings. It can help to know that although unwelcome, anxiety is an understandable, even normal response to what’s happening in your body. It’s not just in your head, and you are not to ‘blame’ in any way.

There are two major changes happening in women’s bodies during this time. One is the lowering of oestrogen levels. The well-known effects of this are changes to the menstrual cycle, hot flushes and changes to skin and hair, but lack of oestrogen can also restrict blood flow to the brain, as oestrogen deprivation causes blood vessels to constrict. This can then affect emotional balance which can contribute to higher levels of anxiety.

Secondly, during perimenopause, women also see a dramatic reduction in progesterone, which is sometimes described as a woman’s ‘calming hormone.’ Lack of progesterone has been implicated in mood swings and insomnia. So, it isn’t surprising that given this hormonal turbulence, anxiety levels can increase.

And, as it usually hits in the late 40s and in the 50s, the perimenopause can often coincide with other major, life stressors, such as children leaving home, career pressures and responsibilities around caring for elderly relatives.

What can help?

• If you start to feel anxious and don’t understand what’s happening, accepting that there’s a clear biological reason can reduce the pressure.
• Be kind to yourself, don’t get angry about for ‘not being able to cope.’ After all, you don’t tell yourself off for having hot flushes.
• Watch out for critical language addressed to yourself. You’re not to blame, you’re coping with biological turbulence.
• Become more aware of negative thought patterns which can accompany anxiety at any stage in your life. Challenge these patterns. Are you catastrophising or seeing everything through a rigid mental filter?
• Use recognised relaxation techniques. Breathing, mindfulness and progressive muscle relaxation exercises can all help.
• Talk about it and seek professional help, if this feels like the right thing to do.
• Remember, finally, that this is a stage in life and, in most cases, just as many of the other symptoms of the perimenopause will be temporary, then so will anxiety.