During menopause, many women experience increased anxiety. Some also deal with anxiety in the years leading up to full-blown menopause, a time called perimenopause. Anxiety can arise as general nervousness or worry, specific fears, recurrent panic attacks, or intrusive thoughts and associated compulsions. Anxiety can often occur in combination with depression. Both pre-existing and newly diagnosed anxiety disorders can occur throughout all phases of menopause, including post-menopause.

While the exact connection between anxiety and menopause remains unclear, a complicated combination of factors common during this transitional time in a woman's life may contribute.

Hormonal changes: A woman's reproductive cycles can exert great influence over her emotional and mental health. The shifting levels of the hormones estrogen and progesterone play a part in the mood swings and ups and downs that accompany PMS and pregnancy. During menopause, those same hormones fluctuate and freefall, often impacting moods and possibly amplifying any anxiety symptoms a woman already feels. Some women who use hormone replacement therapy experience an increase in anxiety symptoms when they transition off the therapy.

Menopausal symptoms: The symptoms of menopause can worsen existing mood and anxiety problems. Night sweats, for instance, can wake a woman out of a sound sleep or make it difficult to get to sleep in the first place. Lack of sleep can lead to fatigue, which can in turn make a woman feel irritable and unable to concentrate.

Day-to-day stress: Menopause happens at a time in life that is often associated with greater life stress. Midlife worries and responsibilities accumulate, and chronic stress can leave a woman vulnerable to anxiety. Common midlife stresses include taking care of both children and aging parents, as well as issues in relationships (divorce, widowhood), money, and career.

Emotional stress: The way a woman feels about herself and her stage in life can factor into her overall mental health. The changes to a woman's body and appearance as she gets older and goes through menopause can worsen self-esteem that is already low. Some women experience disappointment about getting older or not being able to have children anymore.

Unhealthy lifestyle habits, like smoking and not getting enough physical activity, can also factor into a woman's vulnerability to anxiety, no matter what stage of life she is in.

Consequences of anxiety during menopause
Menopause and anxiety disorders have some similar symptoms, including racing or irregular pulse and pounding heart, sweating, skin flushing, and mood swings. Overlapping symptoms can make it harder to know what is due to an anxiety disorder and what is due to symptoms of menopause. A woman may not receive the treatment she needs if anxiety symptoms are dismissed as "all part of the process."

Anxiety can even make certain menopause symptoms worse. In one study, women with even moderate anxiety were found to be about 3 times as likely to suffer through hot flashes.

If you are a menopausal women experiencing symptoms of anxiety, you can find relief through anxiety treatment. Keep track of your symptoms and consult your doctor. Your doctor may suggest counselling, prescription medications, or a combination of the two. All have been found effective in treating anxiety symptoms. Or you may be advised to try relaxation and stress-reduction techniques to help self-manage your symptoms.