While perimenopause often brings with it a range of physical and emotional symptoms, one of the most common and challenging is anxiety. For many women, anxiety during perimenopause can feel overwhelming and confusing, especially when it comes on suddenly or feels more intense than usual.
According to research at least 50% of women experience anxiety during perimenopause. Even if you’ve never been an anxious person, women with low levels of anxiety prior to perimenopause were more likely to have increased levels of anxiety during perimenopause. And to add insult to injury, higher levels of anxiety are associated with increased severity of hot flashes and night sweats.
Anxiety can look different in each person but some common symptoms of anxiety include:
- irritability
- nervousness or tension
- feeling fearful for no reason
- heart pounding or racing
- excessive worrying
- restlessness or feeling on edge
- difficulty concentrating or brain fog
- insomnia (difficulty falling asleep, staying asleep, or restless sleep)
As if navigating perimenopause wasn’t challenging enough, anxiety can make an already tough situation even harder. While we still don’t know why anxiety is triggered during perimenopause, there are some other factors that can exacerbate feelings of anxiety.
Some common factors include:
- undiagnosed hypothyroidism (including Hashimoto’s)
- poor adrenal function
- lack of resources or support system
- low iron, B vitamins, or vitamin D
- lack of sleep (yes, it’s a symptom of anxiety but can also cause anxiety so it can become a vicious cycle)
- poor nutrition (too much sugar, food sensitivities, or lack of nutrients)
- not enough physical movement
Understanding and eliminating these common factors is the first step in addressing anxiety naturally during perimenopause.
While it’s important to seek professional advice if anxiety becomes overwhelming, there are numerous natural approaches that can help manage symptoms and improve emotional well-being during this transition. Let’s highlight the top five most common and effective strategies that I use with patients every day.
- Passionflower (Passiflora incarnata): Passionflower is another calming herb that may help with both anxiety and insomnia. It can promote relaxation and improve the quality of sleep. It also helps relieve physical tension so it’s great for those that are “wired and tired”. It is mildly sedating, which can help alleviate intense anxiety, but needs to be used cautiously during the day but it’s also great for heart palpitations. Tea or tincture is a great way to take it, just know that it has a bitter taste.
- Limit (or eliminate) Caffeine, Sugar, and Alcohol: Caffeine, sugar, and alcohol can spike adrenaline levels and trigger anxiety. Reducing your intake of these substances can help stabilize your mood throughout the day. I’ve noticed that women seem to have a lower tolerance for these substances during perimenopause so even if it’s something you’ve been consuming since your teens or twenties, it may be worth taking a break to see if it has an impact.
- Magnesium: Magnesium has been shown to play a key role in regulating the body’s stress response, and research suggests that it may help reduce anxiety. Studies have found that magnesium deficiency is linked to higher levels of anxiety and stress, as magnesium helps regulate neurotransmitters that control mood and the body’s response to stress. Supplementing with magnesium, particularly magnesium glycinate, has been shown to have a calming effect, helping to lower cortisol levels and promote relaxation.
- Inositol: Inositol, a naturally occurring compound found in foods like beans, grains, and fruits, has gained attention for its potential to alleviate anxiety. Research suggests that inositol can positively influence serotonin and dopamine receptors in the brain, which play a key role in regulating mood and stress responses. It helps to calm the mind so can help reduce ruminating thoughts which can impact work and sleep.
- Movement: Research consistently shows that exercise is one of the most effective natural remedies for reducing anxiety. Physical activity boosts the production of endorphins, the brain’s “feel-good” chemicals, which help alleviate stress and improve mood. Studies have found that both aerobic exercises (like running, swimming, or cycling) and mind-body practices (such as yoga or tai chi) can significantly reduce anxiety symptoms by promoting relaxation, improving sleep, and enhancing overall well-being. Regular exercise also helps regulate cortisol, the body’s primary stress hormone, further reducing feelings of anxiety and tension.
Anxiety during perimenopause is a common and understandable experience, but it doesn’t have to be a permanent part of your life. By adopting natural treatments—such as herbal remedies, mindfulness practices, nutritional changes, and regular movement—you can support your mental and emotional well-being during this transitional phase. Remember, it’s always a good idea to talk to a healthcare provider about your symptoms, especially if anxiety becomes overwhelming. With the right approach, you can feel more in control and empowered as you navigate perimenopause.