Meno-anxiety: the facts

ANXIETY, DEPRESSION, MOOD SWINGS AND LOSS OF CONFIDENCE ARE COMMON PERIMENOPAUSE AND MENOPAUSE SYMPTOMS, SO WHY ARE MANY OF US UNAWARE THAT OUR HORMONES ARE CAUSING THE CHALLENGES? DR CLARE SPENCER REVEALS THE MUST-KNOWS AND WHAT CAN BE DONE

It’s one of the most frequently asked questions when groups of peri- and menopausal women get together. Why is anxiety worse during these years? Where does the anxiety come from, and will it go away? Anxiety is a common and yet often misunderstood menopause and perimenopause symptom. During the perimenopause, your levels of oestrogen and progesterone fluctuate erratically, with quite dramatic peaks and troughs. These fluctuations can result in changes to mood and heightened anxiety as we head towards the menopause itself, when hormone levels ultimately drop. This is not a nice, smooth transition, so it’s perhaps not surprising that fluctuations in hormone levels are going to cause fluctuations in you.

What does menopause anxiety feel like?

Anxiety might be the only symptom of the perimenopause and menopause that you experience. Many women don’t make the connection and just think that they aren’t coping like they used to. (Saska’s story of loss of confidence at work is all too familiar to many perimenopausal women.)

If you are experiencing anxiety, you certainly aren’t alone. Anxiety can happen to anyone – including those who’ve never experienced mental health difficulties before. You may have mild symptoms – like many of the women I speak to who say they have stopped motorway driving, or really don’t like it any more, because of anxiety. Others have more severe symptoms.

Anxiety can lead to physical symptoms, such as:

⚫ Fast heart rate

⚫ Heart palpitations

⚫ The feeling of sickness or nausea

⚫ Shaking or tremors

⚫ Sweating

⚫ Dry mouth

⚫ Chest pain

⚫ Headaches

⚫ Fast breathing

⚫ Panic attacks – these are severe attacks of anxiety, fear and panic that occur suddenly, often without warning and for no apparent reason

It’s no surprise that most women don’t realise many of these symptoms are hormone-driven. Perimenopause and menopause coincide with a stress-packed time in a woman’s life. Our parents are becoming frail, our children still need a lot of our time and attention, our relationships need nurturing, and work can often be a minefield as ageism rears its ugly head. There’s a lot going on to make us feel anxious.

How do I feel better?

The way forward is different for everyone. Treatment and management options are similar to those that can help with the symptoms of depression.

If your mood changes are related to the perimenopause and menopause, evidence indicates that HRT may improve your mood and anxiety.

It may be worth a try, even for a short period of time, to see if it helps.

Many women find they need to look at more than one approach to manage their symptoms. There are holistic things you can do, of course, such as decreasing your stress through meditation or relaxation techniques. Regular exercise and cutting down on alcohol will help – and are good lifestyle measures regardless.

When you go through the menopause, it’s important to take very good care of yourself. Make sure you’re allowing yourself to get enough sleep and exercise, and eat a healthy, balanced diet, limiting sugar and processed foods.

A key thing that we know makes our anxiety worse is alcohol. One too many glasses of wine in the evening and we’re awake at 3am with doom-laden thoughts (and hot legs!). In the morning, we’ll feel anxious and nervous. The key is moderate drinking – better for your physical and mental health.

How long will it last?

Every woman’s menopause is different, so there is no definitive answer to how long the anxiety will last. The important thing is to focus on making healthy lifestyle choices, giving yourself the time and space to notice how your mental wellbeing is faring, and seeking help if you feel you need it.

What’s important to remember is that anxiety is a normal human response to stressful situations. It starts to be an issue when it becomes hard to control your fear, making you feel stressed or overwhelmed, and getting in the way of your ability to live life as you want to.