Menopause and Anxiety: What's the Connection?

What's anxiety?

Anxiety is a common symptom of perimenopause and menopause and one of the emotional symptoms many notice. In fact, up to 37% of females ages 40-65 report they experience anxiety during the menopause transition.*

Anxiety can show up in different ways. You might feel anxious for no clear reason, worry more than usual, or get irritated easily. Your body can react too, with physical symptoms like a racing heart, tense muscles, or shortness of breath.

Irritability is a common symptom of both stress and anxiety. About 25% of females between 40 and 65 report feeling more irritable.* It’s normal, but it can still be hard to manage.

There’s a difference between anxiety linked to menopause and an actual anxiety disorder. Menopause-related anxiety is usually less intense and doesn’t last as long. Still, it can affect your daily life.

Anxiety can be difficult to quantify, and what feels like anxiety can vary from person to person. People may understand or describe anxiety differently than their doctor. This can make it hard to talk about.

If you have previously been diagnosed with an anxiety disorder, you may not notice much change during menopause. If you’ve been getting help, your coping tools, like medication and therapy, may still work for you with any new challenges.

If you have frequent or severe anxiety or panic attacks, talk to a healthcare professional.

Can menopause cause anxiety?

The link between menopause and anxiety is complex. There’s evidence that changes in hormone levels, especially estrogen, influence anxiety, but researchers are still learning how. Anxiety hasn't been studied as much as other symptoms of perimenopause, even though it can have a big impact on your mental health symptoms and quality of life.

How can anxiety affect me during menopause?

Anxiety can touch many parts of life — from how you handle stress to how well you sleep.

When you’re anxious, your mind and body are “on high alert” and are in a fight-or-flight mode. Stressful moments feel harder to manage, and it's tough to think clearly. You might feel drained and less able to solve problems effectively.

In addition, life changes during perimenopause and menopause can add to this stress and drive feelings of anxiety. You may be juggling:

• Kids leaving home or caring for young ones.
• Aging parents who need help.
• Relationship changes.
• Career shifts.
• Physical changes.

Sleep problems are also common during menopause. And anxiety is closely tied to our sleep. Poor sleep can trigger anxiety and anxiety can disrupt sleep. There’s also an association for some people with hot flashes, night sweats, and nighttime anxiety.

How can I manage anxiety during menopause?

The good news? There are ways to manage anxiety and irritability during menopause. Just knowing anxiety can be part of menopause is a helpful first step. 

If you’re using menopause hormone therapy (MHT) to help manage other menopause symptoms, you may notice that it may ease some anxiety. But it’s not often just prescribed for anxiety symptoms, as there’s been mixed results on whether it’s effective.

Not everyone experiencing anxiety during menopause needs medication. But if anxiety affects your daily life or if you have any questions or concerns, talk to a doctor. They may suggest anti-anxiety medications and/or psychotherapy to help treat anxiety.

Selective serotonin reuptake inhibitors (SSRIs) are commonly prescribed to treat anxiety and depression and can be effective for hot flashes and night sweats as well. However, these medications may have side effects like fatigue, weight gain, and reduced libido — which may make already-existing menopausal symptoms feel worse. Again, be sure to talk to your doctor about what treatments may be right for you.

Many people find that small lifestyle changes can also make a difference:

• Practice stress management techniques like meditation, deep breathing, or yoga. These techniques can help to reduce stress and anxiety and promote a sense of calm and relaxation.
• Get regular exercise. Exercise can help reduce stress and anxiety.
• Eat well-balanced meals and snacks. A healthy eating plan that focuses on fruits, vegetables, and foods that aren't heavily processed may help reduce anxiety symptoms. Eating less sugar and refined grains may also help.
• Cut down on caffeine, alcohol, and sugary foods. They can sometimes make anxiety and mood swings worse. Reducing them may help you feel calmer and more balanced.
• Prioritize sleep. Your body and mind need time to rest and recuperate.
• Take time for yourself. Find a relaxing activity that allows you to focus on yourself. You might try gardening, reading, meditation, mindfulness practices, or yoga.
• Connect with others. Reach out to trusted family and friends. If you need more support, reach out to a mental health professional.
• Give back. Take time to volunteer in your community. Focusing on and connecting with others can help you take a break from stress and anxiety.

*Data from Attitudes & Usage study conducted in August 2021 with 4,578 female participants ages 40-65. Funded by Kenvue.