Mention the word menopause and most people think of hot flushes, mood swings, and maybe fatigue, but less familiar is the onset of anxiety which around half of us will experience during this time.

Anxiety is one of the most underestimated symptoms of the menopause and it can take many women by surprise, it often creeps up during the early years of the perimenopause. The hormonal fluctuations that take place during this phase leave many women suddenly experiencing a loss of confidence or a sense of anxiety, even when this has never previously been an issue.

Anxiety is a general feeling of unease that can cause you to feel worried or fearful, and the symptoms can range from mild to severe.

What Are The Causes Of Anxiety In Menopause?

Progesterone Deficiency:

Fluctuations in hormone levels can lead to periods of progesterone deficiency. Tests have shown that progesterone has a calming effect on the body, and so having too little of this hormone can make a woman more vulnerable to developing anxiety disorders.

Other Menopause Symptoms:

Other symptoms of menopause e.g. hot flushes, sleep problems, and vaginal dryness have an effect on overall wellbeing and can be the source of a low mood and anxiety. Symptoms like night sweats that disrupt sleep or waking up exhausted, which in turn makes it much harder to keep calm and think clearly during a busy and stressful day.

Negative Outlook:

Feeling negative about menopause and getting older can take its toll on a woman’s mental wellbeing. Likewise, fears for the future can induce stress and lead to anxious feelings.

How Can We Treat Anxiety?

Women seeking anxiety treatment can choose from among three main approaches: (1) Lifestyle changes, (2) Alternative medicine, and (3) Medications.

1. Lifestyle Changes

The first level of treatment consists of making healthier lifestyle adjustments, which can bring tremendous benefits in treating anxiety.

Nutritious Diet

Eating a balanced diet not only affects our physical health, but also our emotional wellbeing. To improve energy levels, boost mood, promote hormonal balance, and treat anxiety, our daily food intake should consist of lean proteins, healthy fats and complex carbohydrates, rich in essential vitamins and minerals, including the following:

• Phytoestrogens exert weak oestrogenic effects in the body, which can help reduce anxiety, depression, and other menopause symptoms by promoting hormonal balance – e.g. soya, oats, flaxseed, sesame seeds, broccoli.
• Magnesium helps regulate the function of neurotransmitters, like serotonin, which controls mood. Its deficiency has been shown to increase the risk of developing anxiety-related behaviours and depression. Found in nuts, seeds, spinach, avocado, leafy greens.
• Zinc is a nutrient needed for proper brain function, including stress management and mood regulation. Its low levels have been linked to anxiety as well as other mental health disorders, like depression. Found in eggs, oysters, asparagus, cashew nuts and pumpkin seeds.
• Omega-3 fatty acids have shown to help regulate mood-controlling neurotransmitters, reduce inflammation, and ease anxiety symptoms. Found in salmon, walnuts, flaxseed and olive oil.

Regular Exercise

The effects of regular physical activity on mental health are bountiful. It not only helps release stress and promote relaxation, but also improves mood and overall outlook on life. In fact, exercise has been shown as effective as antidepressant medication for treating mild to moderate anxiety and depression.

2. Alternative Medicine

Alternative approaches to how to treat anxiety encompass a wide variety of options, of which the most popular ones are herbal supplements. They are not only the easiest regimens to follow, but some of the most effective ones since supplements address the underlying root of menopause anxiety, hormonal imbalance.

Combining lifestyle adjustments with herbal supplements is often the most holistic and lasting approach to restoring hormonal balance and treating anxiety during menopause. However, women with severe anxiety may need a more conventional treatment, including medications and therapy.

3. Medications & Psychotherapy For Anxiety

There are two types of conventional anxiety treatments available to help women with severe anxiety. 

Psychotherapy

Psychotherapeutic options for generalised anxiety disorder treatment can be highly beneficial, although they do require a significant time commitment. They are usually recommended before prescription medications and come in two main types:

• Neuro-Linguistic Programming (NLP) and Cognitive Behavioural therapy (CBT) is the most common and effective anxiety therapy. It aims to break negative thought cycles and replace them with more constructive ones.
• Applied relaxation therapy consists of learning – under the guidance of a licensed therapist – various coping techniques to relax one’s muscles during anxiety attacks and lessen the symptoms

Medications

Please discuss with a medical professional before proceeding with any treatment.

Anxiolytics, or anti-anxiety medications, are usually prescribed when psychotherapy has not brought the desired results. They can also be used in conjunction with psychotherapy. However, we must remember that the majority of medications work by alleviating anxiety symptoms, not treating the underlying cause.

• Antidepressants, most commonly selective serotonin reuptake inhibitors (SSRIs), work by modifying brain chemicals to ease anxiety. They are generally the first option prescribed for anxiety treatment.
• Sedatives, or benzodiazepines, might be used short-term in the case of severe anxiety attacks to promote relaxation and relieve physical anxiety symptoms, like muscle tension.
• Hormone-replacement therapy – containing oestrogen, progesterone, or their combination – used to be the go-to treatment for women with anxiety and other menopausal symptoms. However, because of the side effects and health risks linked to its use, treatments with HRT are evaluated on an individual basis and generally reserved for severe symptoms.

The three levels of anxiety disorder treatment discussed above are not mutually exclusive. Women may find that some approaches might be more beneficial at various stages of the menopausal transition than others. Nevertheless, many opt to combine lifestyle changes with herbal supplements for optimal, risk-free results the natural way.

On top of a healthy diet and exercise, some lifestyle tips aimed at relaxing the mind and generating good, positive feelings. Some of the best recommendations for anxiety treatment are as follows:

• Deep slow breaths can strengthen the mind and help it manage thoughts and tasks at hand in a more controlled, productive way.
• Maintaining a healthy sleep schedule is an essential part of treating anxiety, especially since both disorders are known to co-exist. Studies have shown that most adults need seven to nine hours of sleep every night.
• Brewing herbal infusions of relaxation-inducing herbs, like valerian or chamomile, can help quiet the mind and decrease anxiety attacks during menopause.
• Engaging in a hobby, such as photography or dancing, can help distract the mind from anxious thoughts, promote relaxation, and increase overall emotional wellbeing.
• Controlling addictions to substances, like nicotine and caffeine, that are known to worsen anxiety symptoms is key for lasting results.
• Mindfulness can be highly beneficial for anyone with anxiety. Try downloading a mindfulness app and give it a go.
• Regular exercise can help to relieve mild anxiety, so make sure you schedule it into your week and especially spending time in nature can help reduce stress and anxiety.
• Booking a Menopause Spa Day at SenSpa can help you relax, re-connect with yourself and alleviate any tensions with the menopause massage. The Menopause Boutique has partnered with SenSpa to create the 'Moments for Me' Menopause Spa Day.

With all the internal and external changes occurring to menopausal women, it is no surprise that anxiety and depression are common symptoms. Implementing simple lifestyle changes, however, means that the distressing psychological and physical symptoms should decrease, leading to a better sense of overall wellbeing.

Lynda Allison – Nutritional Therapist

The Menopause Boutique

Vanda Varga NLP & Hypnotherapy Master Practitioner