Is perimenopause behind my anxiety?

Q:

Ever since I turned 45, I’ve had increasing bouts of severe anxiety, especially in the evening. I’m already taking prescription progesterone for other menopausal symptoms and thought it would tame anxiety as well, but it hasn’t. Can you suggest a natural remedy that will help?

A:

You’re not alone. One study found that up to 51% of women ages 40 to 55 feel some degree of anxiety during the menopause transition. Your brain needs progesterone to regulate mood, but some women taking progesterone say they experience anxiety as a side effect. And while researchers aren’t exactly sure why, they blame the wildly variable swings in the body’s hormone production. I actually find that, for my patients, estrogen is better at easing menopausal symptoms, including anxiety, so you may want to discuss this option with your doctor.

But there are also natural remedies that can help ease your anxiety. First, studies have found regular walks to be one of the most effective ways to ease anxiety symptoms because they raise levels of feel-good endorphins. Try a walking app (like 99 Walks) for motivation and inspiration. You can also take a look at your diet: If you consume caffeine, do your best to cut back to one cup of coffee or tea a day since caffeine acts as a central nervous system stimulant and can worsen anxiety symptoms. Also, a diet high in sugar can affect your mood, so I suggest reducing your sugar intake to avoid insulin spikes and drops.

Supplements can help too. Since most women over 45 are deficient in magnesium—a factor that’s been linked with anxiety—I suggest supplementing with 250 mg. of magnesium citrate a day. Tip: Take it at bedtime— it calms the central nervous system and relaxes muscles to promote sleep.