What Causes Menopause Anxiety?

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Mood swings and loss of confidence are common menopause symptoms. Dr Stephanie Goodwin, a London-based GP and menopause specialist, explains what’s behind the anxiety and what can be done.

Can menopause mood swings be blamed on hormones?

Do you remember when you were a teenager and your moods swung from euphoric to depressed and back again with regular monotony? Although we didn’t know it at the time this was the result of hormonal mayhem when our reproductive hormones swung into action.

Unfortunately far too many of us forget how our hormones affect our moods, and getting hormone levels looked at is probably the very last thing women try when trying to address a bewildering variety of anxiety symptoms that seem to come out of the blue.

When does menopause anxiety start?

Anxiety symptoms typically come on in your 40s and can include:

  • Fearfulness or even full blown panic attacks
  • Tension headaches or even migraine
  • Chest pressure or pain
  • Lack of sleep
  • Feeling nauseous
  • Feeling irritable, jumpy or shaky
  • Feeling tearful
  • Getting hot flushes
  • Upset stomach or even IBS

Do those anxiety symptoms signify menopause?

There is a clue in the time of life that these arise as you will probably be in transition towards menopause during a time called perimenopause.

Despite this, there are heart rending posts on many a chat forum where women are totally bewildered about what’s happening to them. They recount the overwhelming effect of anxiety symptoms on a previously happy life; the temporary success or failure of natural supplements; and the challenge of self-diagnosis in the absence of a sympathetic GP.

Is anxiety in menopause common?

Anxiety during perimenopause is actually a very common issue. During the perimenopause your levels of oestrogen and progesterone decline with each cycle as your body heads towards menopause. However this is not in a nice smooth transition and can occur in quite dramatic peaks and troughs. So it’s perhaps not surprising that fluctuations in hormone levels are going to cause fluctuations in you.

Can anxiety be blamed on declining oestrogen?

Scientists have discovered that oestrogen has a significant effect on the brain’s regulation of moods and emotion.

This relationship is pretty complex, it appears that a decrease in oestrogen causes a decrease in an enzyme called Monoamine oxidase (MAO) and this in turn causes damage to the neuro transmitters which offer neuro chemicals like serotonin, norepinephrine, dopamine and melatonin that affect mood, emotions and behaviour.

Any other stress side effects during menopause?

Unfortunately it may not stop there. The oestrogen/progesterone imbalance itself causes stress in the body and, if you are additionally feeling stressed about the disturbing symptoms you may now be experiencing, the likelihood is that your body is going to start producing the stress hormone cortisol.

What effect does cortisol have?

The increased production of cortisol will lead to a reduced production of progesterone. So, the more stressed an individual is, the more suppressed progesterone production becomes, and the more dominant oestrogen becomes which causes further problems.

Is depression a menopause side effect?

In about 20% of people anxiety can also cause “dysphoria”, an emotional state like a “funk” which can also manifest itself as poor concentration and even memory loss – and this is often misdiagnosed as “depression.”  At this point you are likely to be put on anti-depressants which are then of course masking one symptom instead of addressing the primary cause. So this all becomes one horrendous self-perpetuating cycle.

What can be done to reduce the stress of menopause and perimenopause?

There are holistic things you can do of course, like decreasing your stress through meditation or relaxation techniques, but in my view it is essential to address the root cause of all the problems, your hormonal imbalance.

Let’s face it when you are in the grips of this hormonal maelstrom ignorance is definitely not bliss. So take control, don’t wait out years for the symptoms of perimenopause to sort themselves out; don’t wait to seek treatment until your symptoms are so severe that you can’t function. Please talk to a menopause specialist about addressing the problem.

Read more from Dr Stephanie Goodwin and find out about her clinic, at www.drstephaniegoodwin.co.uk

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