Most everyone experiences anxiety now and again. But if you’re a woman entering into the journey of menopause, you may be surprised to find that you’re experiencing anxiety more often than you used to. Worse yet, you may experience full-on panic attacks, which can hit you with sudden, severe symptoms like chest pain, sweating, dizziness, and nausea. These experiences can make you feel like you’re going crazy—especially when you’re not facing any real danger and it seems like there’s no obvious cause. But there is a cause: The major hormonal changes that come with menopause.
How Menopausal Hormone Shifts Hijack Your Mental Health
As you enter menopause, the amount of estrogen and progesterone your body produces begins to decline. Not only does this potentially spark those infamous hot flashes and night sweats, it can also trigger anxiety. Here’s how: Some areas of your brain are packed with estrogen and progesterone receptors, meaning those regions are primed for input from those hormones. Your hippocampus, an area important for clear thinking and memory, relies on estrogen and progesterone to function properly. When supplies of those key hormones drop, you can experience brain fog, slower reaction times, even memory blips.
Your hormones also interact with several neurotransmitters, the brain chemicals that regulate your mood, including:
Volatile menopausal hormone swings can knock these neurotransmitters out of balance, bringing on anxiety and panic. For instance, progesterone promotes GABA production. When progesterone levels run low, so do GABA levels. Since GABA helps you stay calm and focused, decreased levels can spark anxiety.
Estrogen, on the other hand, is closely involved with production of serotonin, the “feel good” neurotransmitter, and dopamine, the brain chemical linked with pleasure and reward. Low levels of estrogen can lead to reduced serotonin and dopamine, which can have a negative impact on your mood.
Many clinical studies show that menopausal hormone changes can trigger anxiety and panic, even if you’ve never had to deal with them before. One study published in the journal Fertility and Sterility found that anxiety symptoms more than double during menopause. Another study—this one conducted in Australia—found that anxiety symptoms spiked even more in postmenopausal women.
Fortunately, you can take control of your mood and calm that anxiety. And you can do it regardless of where you are in your menopause journey.
4 Proven Ways to Calm Menopausal Anxiety
You can manage your menopausal anxiety safely and naturally by making four simple lifestyle changes.
What you eat can have a significant impact on your anxiety levels. Caffeine and ultra-processed foods can increase anxiety and depression. But focusing on a diet based around plenty of protein, fresh fruits, and vegetables can help to support your psychological wellbeing. Including foods rich in omega-3 fatty acids and the B vitamins play a particular role in soothing menopausal anxiety and combating frustrating brain fog. Boost your omega-3 intake with fatty fish like salmon and mackerel, flaxseeds, and walnuts. Foods high in B vitamins include leafy greens, eggs, and chickpeas.
Regular exercise can help combat menopausal mood swings and anxiety. Fun activities like dancing and hiking—just two types of weight-bearing exercise—offer benefits for both physical and mental health. And don’t forget the mind and body benefits of gardening! A 2018 study published in Complementary Therapies in Medicine found that horticultural therapy, a practice that embraces gardening to improve physical and mental health, significantly reduced anxiety and depression in middle-aged women. Whatever type of exercise you choose, make sure it’s something you enjoy so you aren’t tempted to let your workouts lapse.
3. Relaxation techniques
Routinely practicing relaxation techniques can help reduce anxiety levels and the physical signs and symptoms of anxiety. Several clinical studies show that using relaxation techniques also works to calm menopausal anxiety. One study conducted in China, which included 121 perimenopausal women, found that eight weeks of mindfulness meditation training brought on a 24 percent drop in their anxiety symptoms. Other options to induce relaxation include aromatherapy, biofeedback, deep breathing, massage, music therapy, tai chi, and yoga.
4. Stress-relieving herbs
Nature provides a bounty of balancing herbs called adaptogens. These time-tested botanicals help manage hormonal imbalances and calm the body’s stress responses. By doing that, adaptogens help reduce the symptoms of anxiety and restore crystal clear brainpower. Adaptogens shown to relieve symptoms of menopausal anxiety include:
Ashwagandha. Ayurvedic practitioners have relied on ashwagandha for centuries. The plant contains potent compounds called withanolides, which can help your body cope with menopausal stress and anxiety. Several studies show that ashwagandha reduces the stress hormone cortisol. Lowering cortisol helps decrease feelings of panic and anxiety, allowing your body and mind to calm down. A double-blind, randomized, placebo-controlled trial conducted in India found that ashwagandha lowered anxiety scores by 22 percent, compared to an 8 percent reduction in the placebo group. Patients taking ashwagandha also saw significant improvement in total sleep time and sleep quality. Other studies suggest that, in addition to soothing anxiety, ashwagandha also improves overall sexual function in women of all ages.
Andrographis. Also revered in Ayurvedic tradition, andrographis offers balance throughout the body. This herb is known for promoting energy and resilience, decreasing reactivity to stressful situations, and protecting brainpower. Laboratory research shows that andrographolide, a key compound in andrographis, possesses anti-anxiety and anti-depressant properties. In addition, andrographis has been shown to relieve fatigue—another symptom of menopause that can affect mood. Andrographis also works together with ashwagandha to reduce the anxiety and fuzzy thinking that often accompany menopause. A double-blind, randomized, placebo-controlled trial published in Pharmaceuticals (Basel) found that a combination of andrographis and ashwagandha significantly improved cognitive performance and attention while easing anxiety in older adults.
Black Cohosh. When studies began to link hormone replacement therapy (HRT) to a higher risk of breast and uterine cancers, as well as an increased risk of blood clots, menopausal women began to turn to black cohosh to relieve their symptoms. At the time, the herb’s biggest claim to fame was its ability to reduce the frequency and severity of hot flashes. But more recent studies show that black cohosh also eases the anxiety that can accompany menopause. In one analysis of four randomized clinical trials, black cohosh reduced anxiety better than a placebo. Another review of two randomized, double-blind trials reported that black cohosh was just as effective as HRT for reducing anxiety and depression in post-menopausal women, but without the pharmaceutical’s side effects. Two other open-label studies involving 86 women found that black cohosh not only decreased menopausal symptoms like hot flashes, night sweats, and insomnia, it also eased anxiety and elevated mood. But as good as black cohosh is on its own, new evidence suggests that it’s even more effective for anxiety when paired with rhodiola. Research involving 220 menopausal women that appeared in the journal Pharmaceuticals (Basel) found that those taking a combination of black cohosh and rhodiola experienced fewer menopausal symptoms and a significant improvement in their levels of stress and anxiety after just 12 weeks.
Rhodiola. With unique properties that make it especially beneficial for menopausal symptoms, rhodiola acts like a selective estrogen receptor modulator. This means it can interact with estrogen receptors in the body to help smooth out hormonal fluctuations. Rhodiola also helps relieve the symptoms of anxiety and stress. In a clinical trial published in Phytotherapy Research, participants reported significant reductions in stress, anxiety, depression, and confusion after taking rhodiola for just two weeks. As a bonus, Columbia University researchers also report that rhodiola may help prevent the cognitive, cardiovascular and bone-damaging changes that can accompany menopause.
Once you understand how shifting hormones can cause menopausal anxiety, these four strategies can help you get back to feeling more like yourself. As a bonus, these lifestyle changes also boost your overall health as you travel through menopause and beyond.