We all associate menopause with hot flushes or dry skin but how many of us know that panic disorder and anxiety are also common symptoms? Stacey B Gramann a researcher in the United States studied 3,500 Women aged 50-79 and panic disorder was found to be the most common symptom for women in menopause. Unfortunately, it is not so widely discussed and so for many ladies is a worrying and unexpected arrival.

All menopausal symptoms are part of a life stage transition, namely a decline in our fertility. Whereas the menstrual cycle has played an important part in regulating our reproductive hormones, once this decline begins, our cycles and hormone balance fluctuate and cause an unpredictable myriad of physiological and psychological symptoms. The two star players are oestrogen and progesterone. Fluctuations in oestrogen cause bloating, sore breasts and heavy bleeding when high and hot flushes, palpitations and insomnia when low. Lack of progesterone can cause irregular periods with hormone production stopping all together after your final period. The psychological effects of these fluctuations can cause mood swings, heightened anxiety, panic attacks, irritability, anger and depression. Symptoms can pop up and disappear with no consistency. Little wonder we can feel like we are going out of our minds.

So what causes menopausal anxiety?

The biology

Just as we can experience pendulous moods during puberty or pregnancy so too can we experience emotional volatility during menopause. Our reproductive hormones really do have a big influence on both our body and behaviour and during perimenopause those hormones are changing at a rapid rate. As our ovaries cease to function and hormone levels rise and fall so we can experience feelings of stress and overwhelm. 

The main player in menopausal anxiety is the falling level of progesterone.  Known as a natural sedative, progesterone balances the effect of oestrogen and helps promote sleep and general feelings of calm. When you feel naturally calm inside your menstrual cycle it was probably down to progesterone secretion as it prepared the uterus lining at mid cycle. With less progesterone in the body anxiety issues can appear such as tension headaches, palpitations, digestive issues, sleep disruption and in some cases panic disorder.  

Fluctuations in oestrogen also cause anxiety at the onset of menopause. Oestrogen dominance is common during perimenopause when ovulation begins its decline and progesterone levels stay low.

This high level of oestrogen coupled with low levels of progesterone creates an imbalance that explains the main biological reason why you may experience anxiety and panic, often for the first time in your life.

Lifestyle medicine

When it comes to biology, implementing some lifestyle medicine can really help with feelings of anxiety throughout the entire stages of change. This might mean sacrificing some of those treats for the greater cause of calm and clarity.

• Avoid or limit stressors such as alcohol, sugar, processed food and caffeine. Try cutting down as much as possible as they are known hormone disruptors.
• Exercising a little every day is proven to reduce anxiety.
• Try to maintain a healthy weight by eating plenty of plant based foods, lean protein and wholegrains.
• Embark on a calming practise such as yoga or meditation. Practising relaxation techniques will help to increase disrupted dopamine and serotonin.
• Find a creative outlet as it is linked to lowering stress and anxiety.
• Get those endorphins pumping through laughing with friends, play and connecting with others.
• Natural supplements can really help with menopausal anxiety. It isn’t always necessary to take a prescription medication. For us the biggest supplement star for anxiety has been CBD oil. The plant cannabinoids in our CBD work with the body’s natural endocannabinoid system in balancing neurotransmitters such as serotonin that become out of kilter when oestrogen levels fluctuate.
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The fear response

In this mix we also have our response to the changes in our mind and body. Physical symptoms can be uncomfortable, scary and confusing (particularly when the brain fog descends). It is completely natural to feel fear about what is happening to you and this can kick start the fight or flight response which in turn pumps a cocktail of stress chemicals into the system such as adrenalin and cortisol. This fear response can start a cycle of worsening symptoms including anxiety disorder, panic and insomnia. 

We cannot control what is happening to us but we can control how we react to it.  There are some really crucial things you can do to limit worry and anxiety.

• Get clued up. Knowledge is power and understanding why you are feeling a certain symptom reduces the fear factor. Otherwise we can imagine the worst case scenario about every twinge.
• Join menopause groups. You may be lucky to have a local group of ladies to meet with or join one of the Facebook groups. Simply sharing symptoms and being part of a supportive environment reduces fear. Understanding you are not alone is really important.  
• Practise a mindful menopause. You can be alert to symptoms but know that they pass. Remain aware of your thoughts when discomfort arrives and consciously tell yourself that it will not be forever. Detaching from a particular emotional response whilst recognising what and why it is happening to you will prevent rising anxiety.  

Life stage

Much like puberty, menopause is a major life stage. Just as we worried about life and love in our teens so too can menopause cause us concern.  Body image, body function, old age, sexual identity and purpose can all crop up during this time causing stress and anxiety.

Whilst accepting this life stage might feel difficult the key is to be kind to yourself. Don’t beat yourself up or set impossible targets for yourself. Remain mindful of your thoughts and begin reframing anything consistently negative that pops up.

Be patient and try not to worry you will come out the other side. 

Take a look at our natural products for menopause.