Anxiety During Perimenopause: What You Need to Know

anxiety during perimenopause

Perimenopause is a transitional phase in a woman's life that precedes menopause. It typically begins in a woman's late 30s or early 40s and lasts several years. While perimenopause is often associated with physical changes, it's essential to recognize that it can also significantly impact mental health, particularly leading to anxiety. In this article will delve into the relationship between perimenopause and stress, understanding its causes, symptoms, and practical strategies for managing anxiety during this phase.

What is Perimenopause?  

Perimenopause is the period leading up to menopause when a woman's menstrual cycles become irregular and eventually cease. During perimenopause, hormone levels, particularly oestrogen, fluctuate, leading to physical and emotional changes. While it's a natural and inevitable phase, the hormonal shifts can give rise to various symptoms, including anxiety.

Symptoms of Perimenopause  

Many symptoms can arise during perimenopause. Before discussing the link between perimenopause and anxiety, let's explore some common perimenopause symptoms associated with this phase:

  • Irregular menstrual cycles

  • Hot flashes and night sweats

  • Changes in sleep patterns

  • Mood swings and irritability

  • Fatigue

  • Changes in libido

  • Vaginal dryness

  • Changes in cognitive function ("brain fog")

  • Weight gain

anxiety during perimenopause

Irregular Menstrual Cycles: 

Perimenopause often brings about irregular periods, with cycles varying in length and flow. This unpredictability can be a significant change for many women, adding to the uncertainty of the transition.

Hot Flashes and Night Sweats: 

Hot flashes result in sudden waves of intense heat and sweating, frequently occurring during the day or interrupting sleep at night. These can lead to discomfort, sleep disturbances, and overall frustration.

Changes in Sleep Patterns: 

Perimenopause can disrupt sleep, leading to difficulties falling asleep or staying asleep. Sleep disturbances can contribute to mood changes, fatigue, and difficulties concentrating.

Mood Swings and Irritability:

Hormonal fluctuations can cause mood swings and irritability. Women may find themselves experiencing heightened emotions and reacting strongly to situations that wouldn't typically bother them.


Many women in perimenopause report feeling consistently tired, even after a full night's sleep. Fatigue can result from hormone changes, sleep disturbances, and the body's increased effort to adapt to these changes.

Changes in Libido:

Fluctuating hormone levels can impact sexual desire, leading to changes in libido. While some women experience decreased desire, others might find their libido unaffected or increased.

Vaginal Dryness:

Hormonal shifts can lead to a decrease in vaginal moisture, causing discomfort, itching, and pain during intercourse. Vaginal dryness can have both physical and emotional implications.

Changes in Cognitive Function ("Brain Fog"):

Many women experience periods of forgetfulness, difficulty concentrating, and mental fuzziness during perimenopause. This phenomenon, often referred to as "brain fog," can be frustrating but is generally temporary.

Weight Gain:

Changes in metabolism and hormonal fluctuations can lead to weight gain, particularly around the abdomen. This can be challenging for women who are accustomed to maintaining a certain body weight.

It's important to note that each woman's experience with perimenopause is unique, and while these symptoms are common, not every woman will necessarily experience all of them.

If any of these symptoms are particularly bothersome or impacting your quality of life, seeking advice from a healthcare professional can provide guidance on effective management strategies.

Why Does Perimenopause Cause Anxiety?  

The hormonal fluctuations during perimenopause can play a pivotal role in developing anxiety. Estrogens, a hormone that affects mood regulation, declines during this phase. This decrease in oestrogen can lead to imbalances in neurotransmitters, which are chemicals responsible for transmitting signals in the brain. As a result, many women experience heightened anxiety levels.

According to a Nature's Best Pharmacy article, oestrogen decline can also impact the body's stress response system, increasing susceptibility to stress and anxiety triggers. Moreover, the uncertainty and changes associated with perimenopause can contribute to psychological distress.

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Risk Factors for Perimenopausal Anxiety 

Several risk factors can contribute to the development of perimenopausal anxiety, shedding light on the complex interplay of physical, psychological, and environmental factors.

Perimenopausal Anxiety

1. Hormonal Fluctuations:

The primary trigger for perimenopausal anxiety is the fluctuation of reproductive hormones, particularly oestrogen and progesterone. These hormonal shifts can influence neurotransmitters responsible for mood regulation, potentially leading to increased anxiety.

2. Genetic Predisposition:

Genetic factors can play a role in an individual's vulnerability to anxiety disorders. A family history of anxiety or mood disorders can increase the likelihood of experiencing perimenopausal anxiety.

3. Past Mental Health History:

Women with a history of anxiety disorders, depression, or other mental health conditions may be at a higher risk of developing anxiety during perimenopause due to their predisposition to mood-related challenges.

4. Age and Hormone Changes:

The age at which a woman enters perimenopause can impact the intensity of hormonal fluctuations and subsequent anxiety. An earlier onset of perimenopause may lead to more prolonged hormonal changes and an extended period of vulnerability.

5. Stressful Life Events:

Life events such as divorce, loss of a loved one, job changes, or financial difficulties can coincide with perimenopause and contribute to heightened stress levels. These stressors can exacerbate anxiety symptoms.

6. Hormone Sensitivity:

Some individuals are more sensitive to hormonal changes, experiencing more pronounced emotional responses. This heightened sensitivity can make women more susceptible to anxiety during perimenopause.

7. Perimenopausal Symptoms:

Physical symptoms such as hot flashes, night sweats, sleep disturbances, and mood swings are common during perimenopause. The collective impact of these symptoms can contribute to increased stress and anxiety levels.

8. Body Image Concerns:

Changes in body composition and appearance can lead to negative body image and reduced self-esteem. Women who struggle with body image issues may be more prone to developing anxiety during this phase.

9. Lack of Social Support:

Limited social support networks and a lack of outlets to express emotions can lead to feelings of isolation, loneliness, and anxiety during perimenopause.

10. Cultural and Societal Factors:

Societal attitudes toward aging, menopause, and women's roles can influence self-perception and contribute to feelings of anxiety about entering this new phase of life.

11. Trauma History:

Women with a history of past trauma, such as childhood abuse or other traumatic experiences, may find that the hormonal changes of perimenopause trigger unresolved emotional issues and exacerbate anxiety symptoms.

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How to Manage Anxiety During Perimenopause  

Managing anxiety during perimenopause and treatment for perimenopause involves a combination of lifestyle changes, self-care practices, and, in some cases, professional intervention.

 Here are some effective strategies to consider: 

  1. Healthy Lifestyle: Adopting a balanced diet, engaging in regular physical activity, and getting enough sleep can contribute to overall mental well-being.

  1. Stress Reduction: Incorporate stress-reduction techniques into your routine, such as meditation, deep breathing exercises, and yoga. These practices can help regulate the body's stress response.

  1. Counselling and Therapy: Speaking to a mental health professional, such as a therapist or counsellor, can provide a safe space to discuss anxiety and develop coping strategies.

  1. Social Support: Stay connected with friends and family, and consider joining support groups for women experiencing perimenopause. Sharing experiences can be comforting and reduce feelings of isolation.

  1. Mindfulness and Relaxation: Mindfulness and relaxation techniques can help you stay grounded and manage anxiety-provoking thoughts.

  1. Medication: In cases where anxiety significantly impacts daily life, consulting a healthcare provider about medication options, such as antidepressants or anti-anxiety medications, can be beneficial.

When to Seek Help for Perimenopause-Related Anxiety  

While some level of anxiety is average during perimenopause, it's important to recognize when it becomes overwhelming and interferes with daily functioning. Consider seeking professional help if:

  • Anxiety significantly affects your quality of life.

  • You experience panic attacks or severe physical symptoms of anxiety.

  • You have a history of anxiety or mood disorders.

  • Self-help strategies are not providing relief.

 Is There any Cure For Perimenopause ?

There is no cure for perimenopause, but there are treatments that can help relieve the symptoms. The products on the Mother Cuppa Tea are not intended to cure perimenopause, but they may help to relieve some of the symptoms.

The best product for perimenopause relief will vary depending on the individual's symptoms and preferences. However, some of the products on the Mother Cuppa Tea website that may be helpful include:

Wellness Tea is a blend of herbs is specifically designed to help with the symptoms of menopause, including hot flashes, night sweats, mood swings, and fatigue. It contains ashwagandha, chamomile, lavender, lemon balm, and rose petals.


Perimenopause is a natural phase every woman experiences, but its impact on mental health, particularly anxiety, should not be underestimated. Understanding the relationship between hormonal fluctuations and anxiety can empower women to manage their mental well-being effectively.

By adopting healthy lifestyle practices, treatments for perimenopause, seeking professional support, and practising self-care, women can navigate the challenges of perimenopause with greater resilience and maintain a positive outlook on their journey towards menopause. Remember, you don't have to go through it alone – resources and strategies are available to help you manage anxiety during this transformative phase.

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