Menopause and Anxiety: What's the Connection?

By Christina Hanna, MPH, CHES • Published 7/14/2023

Medically Reviewed by Dr. Shannon Chavez, PsyD, CST

a woman standing alone outside on a porch thinking about how to cope with her menopause and anxiety

What's anxiety?

Anxiety is a common symptom of perimenopause and menopause. Up to 37% of females ages 40-65 reported that they'd experienced anxiety during the menopausal transition.* Anxiety can describe a wide variety of symptoms including suddenly feeling fearful without an identifiable trigger, excessive and uncontrollable worry and irritability, and physical symptoms like shortness of breath, racing heart, and tension.

Irritability is a common symptom of both stress and anxiety and is also normal to experience during menopause. In fact, 25% of females between 40 and 65 say they experience irritability.* It’s defined as a state of excessive, easily-provoked anger, annoyance, and impatience.

There’s a difference between anxiety connected to menopause and people who are diagnosed with an anxiety disorder. Often, the anxiety connected to menopause isn't as intense and doesn’t last as long.

Anxiety can be difficult to quantify, and what feels like anxiety can vary from person to person. In addition, the way someone might understand or describe anxiety may vary from the definition given by their doctor, so it can be difficult to communicate about it.

If you have previously been diagnosed with an anxiety disorder, you may not notice a difference during menopause. And if you’ve been seeking treatment, you may also have medication and coping skills, learned through therapy, that may help you manage any new challenges that arise.

If you experience frequent, severe feelings of anxiety or panic attacks, contact a healthcare professional.

Can menopause cause anxiety?

The relationship between menopause and anxiety is complex. There’s evidence that hormonal changes influence anxiety, but how they influence it is still being researched. There hasn’t been as much research on anxiety compared to some other menopausal symptoms, even though anxiety can have a significant effect on daily living and quality of life.

a woman experiencing anxiety at the beach practicing deep breathing as a stress management technique

How will menopause anxiety affect me?

Anxiety can affect several areas in our lives — from how we respond to stress to how we sleep.

If you’re feeling anxious, you may have a more intense response to stressful situations. When you’re already in an anxious state, your mind and body are “on alert” and are in a fight-or-flight mode. If something stressful happens, you often don’t have extra emotional capacity to manage it with a relaxed mind or the energy to effectively solve problems.

In addition, the time of life when we’re going through perimenopause and menopause is often a stressful and challenging time and that can drive feelings of anxiety. There are often a lot of life changes happening. You may have other sources of anxiety including:

  • Children leaving home.
  • Managing young children at home.
  • Taking care of older family members.
  • Changes in your relationships.
  • Career issues.

Insomnia and sleep disturbances are also a challenge during menopause. And anxiety is closely tied to our sleep. It’s very common to experience a cycle of poor sleep triggering anxiety and anxiety disrupting sleep. There’s also an association for some people with night sweats and nighttime anxiety.

a woman drinking coffee on the couch & journaling her anxiety symptoms to improve her mental health

How can I manage anxiety during menopause?

Fortunately, there are several strategies to help manage anxiety and irritability during menopause. Reading this article and learning that anxiety is a menopausal symptom is a great first step! Once you’re aware that it’s related to menopause, your reaction to certain situations may make more sense (and you can share this information with your friends).

If you’re taking menopausal hormone therapy (MHT) to help manage other menopausal symptoms, you may notice that it may also help reduce some anxiety symptoms. 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 treatment. But if the increase in anxiety is affecting your daily life or if you have any questions or concerns, talk to a doctor. They may recommend anti-anxiety medications and psychotherapy to help treat anxiety. Selective serotonin reuptake inhibitors (SSRIs) are commonly prescribed to treat anxiety and depression. They can also be helpful in managing symptoms of menopause. However, these medications may have side effects such as 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 make a difference in helping them manage their anxiety:

  • Practice stress management techniques such as meditation, deep breathing, and yoga. These techniques can help to reduce stress and anxiety and promote a sense of calm and relaxation.
  • Get regular exercise. Exercise can help to reduce stress and anxiety.
  • Eat well-balanced meals and snacks. Healthy eating plans that emphasize fruits, vegetables, and minimally processed foods and that limit sugar and refined grains may help reduce anxiety symptoms.
  • Limit your intake of caffeine, alcohol, and sugary foods, which can make anxiety and irritability worse.
  • Try your best to get as much quality sleep as possible. Your body needs 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.
  • Talk with someone. Reach out to trusted family and friends who can support you. If you need more help, don’t hesitate to reach out to a mental health professional.
  • Give back. Take time to volunteer and help 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.

Last Updated 1/23/2024

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