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How to Handle Anxiety During Perimenopause

Menopause is a time of significant transition in a woman's life. But before menopause, there is a much longer transitional period, known as "perimenopause." Menopause is not the type of condition that comes out of the blue. There is a long, slow decline in the frequency of a woman's periods in which many hormonal changes start to take place on the road to menopause. This is the "perimenopause period."

Perimenopause can be a stressful time, and one of the conditions that are most common during perimenopause is anxiety.

Stop, Don't Manage, Perimenopause Anxiety!

Perimenopause may be a time with hormonal changes beyond your control. But no matter what causes your anxiety, it can be reduced and even cured with the right anxiety treatment. Start my anxiety test to find out more about how you can prevent and control perimenopausal anxiety.

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Complex Causes of Perimenopausal Anxiety

Mood changes are listed as the number one most common problem associated with perimenopause, and anxiety is an extremely common condition. The cause of anxiety from perimenopause is not as simple as saying it is just hormonal.

There is actually a range of causes that all interact with each other that may lead to anxiety during menopause. That's why you should take my anxiety test to find out more about your anxiety. Some of the causes of perimenopause include:


Yes, while hormones are not solely to blame for anxiety during this transitional time, they certainly play a role. Hormones have a direct link to the production and management of neurotransmitters in your brain.

When these chemicals are altered during menopause, it can lead to a considerable amount of mental stress and trouble coping - emotional changes that "feel" completely normal but are nothing more than a response to inadequate regulation of these neurotransmitters. Hormones are unfairly blamed for the majority of perimenopausal anxiety, but they certainly play a role.

Body Changes

The way the body changes during menopause is not just hormones alone. Many changes take place that can change the way you feel and change the amount of stress that your body is under.

The more stress your body experiences, the more stressful thoughts you have. This mind/body connection has been substantially researched, and time and time again the results show that when your body's under stress, anxious thoughts are often the result.

Fear of the Changes

Here is where perimenopause anxiety becomes more complex because a great deal of anxiety comes not from the hormonal or body changes themselves, but just from the simple anxieties of getting older. Perimenopause and menopause are substantial life events. They cause women to reflect on their past, think about their future, and possibly even come to terms with some of their mortality.

Perimenopause occurs at a young age when women have decades upon decades of life left. But it's one of the first body changes a woman goes through that's related to getting older, and that means that it's one of the first times a woman's body prompts thinking about her past and future. That causes a great deal anxiety.

Combine those feelings with the overall fear of eventually getting anxiety, and it's easy to see why this period can be so stressful.

Hot Flashes and Symptom Stress

Some of the symptoms of perimenopause can be stressful in their own right. Hot flashes are a great example. Hot flashes can make it difficult to sleep and cause considerable stress while awake. Many women have to drastically alter their life to adjust for hot flashes, and often find that the adjustments they make are insufficient to reduce the stress that they cause.

In this sense, the hot flashes themselves start to cause to much regular distress that they cause anxiety. They may also cause a fear of hot flashes that can also contribute to further anxiety.

Anxiety Increasing Perimenopausal Symptoms

Similarly, studies have shown that menopausal symptoms (and presumably perimenopausal symptoms as well) are made worse by stress and anxiety. For many women, the problem may not be that you are suffering from perimenopause. The problem may be that you are suffering from stress, and it's causing your perimenopausal symptoms to be worse, which in turn is causing your anxiety to be worse.

Unrelated Anxiety

Finally, perimenopause tends to come at a time when other anxieties are high. Children are often reaching ages that are more difficult. Parents of adults during perimenopause may start to have greater health problems. Between the late 30's and early 50's, many women struggle with a variety of life issues, and what is sometimes blamed on perimenopause may be nothing more than life stress that happens to coincide with a very similar time.

These are all only a few of the potential issues that can create some form of anxiety. Most likely, it is an interaction of any and all of the issues above, and not quite as simple as saying "it's hormones" or "it's not."

How to Curb Perimenopausal Anxiety

Anxiety is always anxiety, no matter the cause. While some people are going to be more prone to anxiety than others due to hormonal changes, etc., anyone that suffers from anxiety can find that their anxiety can be managed if they dedicate time to effective anxiety reduction strategies.

The best thing you can do is talk to your doctor about your perimenopause. Find out how to manage it and whether or not there are any considerations you need to make to improve your physical and mental health.

Join support groups and talk with other women whenever possible. Nearly all women have or will go through perimenopause at some point in their lives, and many will have insights or thoughts on how to improve the experience.

Don't forget to stay positive. Look for activities and events that keep you focused on how great your life is and how great your life will be, not simply the fears you have about the future.

Consider kava. Kava is an herbal supplement that research found appears to benefit anxiety in perimenopausal women. Kava is one of the few herbs that has actually been researched for anxiety, and the effects tend to be strong with minimal (if any) side effects.

There were fears that kava could lead to liver issues, but most new studies show that it is likely safe in the recommended doses. Just to be safe, of course, always talk to your doctor before starting any herbal or non-herbal medicine.

And finally, take my free 7-minute anxiety test. The test will give you an opportunity to learn how to control your anxiety symptoms and what you can do to prevent your anxiety from ever affecting you the same way again.

Click here to start the test now.


Seritan, Andreea L., et al. Self-reported anxiety, depressive, and vasomotor symptoms: a study of perimenopausal women presenting to a specialized midlife assessment center. Menopause 17.2 (2010): 410.

Cagnacci, Angelo, et al. Kava-Kava administration reduces anxiety in perimenopausal women. Maturitas 44.2 (2003): 103.

Author: Micah Abraham, BSc Psychology, last updated Nov 29, 2017.

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