Menopause comes with many changes. Many women experience disruptive symptoms like hot flashes and insomnia. Another issue that people don’t seem to talk about as much is anxiety. Anxiety during menopause may be due to several factors, including hormone fluctuations during and after menopause. Because hormones can have such an impact on mood and anxiety, hormone replacement therapy (HRT) may help alleviate your symptoms. Let’s talk about menopause, anxiety, and HRT.
Before we get into HRT for menopausal anxiety, let’s go over what HRT is and why you may need it during menopause. Hormone replacement therapy refers to medications that supplement your natural hormone levels. During menopause, women may have a regimen of estrogen and progesterone to help even out hormone levels. Many women also take testosterone replacement therapy.
The goal for HRT is to alleviate menopause symptoms, which are typically brought on by low and imbalanced hormone levels. During menopause, our bodies start to produce significantly less estrogen, progesterone, and testosterone. Levels may fluctuate leading up to our last period, sometimes being higher or lower than normal. After we reach our last period and enter post-menopause, our ovaries produce much less of the sex hormones estrogen and progesterone.
These hormone changes can cause many symptoms, some of which you’re probably familiar with. They include symptoms like:
Low hormone levels after menopause can also increase the risk for many health conditions, such as osteoporosis and heart disease.
Our providers may prescribe HRT to help relieve your symptoms during menopause, particularly if you experience hot flashes, as hormone therapy is one of the most effective treatments for menopausal hot flashes, also known as vasomotor symptoms. However, HRT may also help with many other symptoms, such as mood changes, including depressive and anxiety symptoms.
Many women say they feel more anxious during menopause. In fact, an estimated 23% of women experience anxiety symptoms during menopause. Therefore, it’s no surprise you might be wondering if menopause can cause anxiety or whether there is a connection. Anxiety is a pretty complex condition, so there may be many factors at play. However, hormone and life changes may contribute to feeling anxious during menopause.
Some symptoms of anxiety include:
Every woman is different, but generally if you have past history of anxiety symptoms, your risk for experiencing anxiety-like symptoms in menopause may be higher. However, there does appear to be a connection between menopause and anxiety, as some studies show that menopausal women are more likely to experience anxiety symptoms and panic attacks compared to pre- or post-menopausal women of the same age.
Some factors that may explain the increased rates of anxiety during menopause include hormone levels and life changes that are common during this time.
One reason you may experience anxiety during menopause is due to changing hormone levels. As we mentioned, hormones during menopause typically start to fluctuate, change, and decrease. Low estrogen levels during this time are likely responsible for many menopause symptoms, like hot flashes and mood changes. Many believe estrogen also plays a role in anxiety during menopause. Many women notice their anxiety symptoms get better after beginning HRT with estrogen for their menopause symptoms. In fact, one 2009 study in Gender Medicine journal looked at the relationship between estrogen and behavior linked with anxiety and depression. The researchers found that higher scores for anxiety and depression were associated with lower estrogen levels. Therefore, low estrogen and hormone imbalances during menopause may contribute to anxiety during this stage of life.
However, there may be other factors at play if you’re feeling anxious during menopause. The average age of menopause in the U.S. is 51, which is also an age where many of us experience other life changes as well.
For instance, many women become empty nesters at this time, which can change many family and relationship dynamics. You might be caring for aging parents and dealing with the stressors that come along with it. This is often also a time of high stress in many people’s careers. Some also go through a period where they are re-discovering themselves and may struggle with insecurity. Therefore, many life changes that often happen during the time of menopause can also contribute to mood changes and feelings of anxiety.
Since menopausal anxiety may have a hormonal component to it, you might wonder whether HRT can help relieve anxiety symptoms during menopause. Some studies do suggest that estrogen may have some anti-anxiety properties. Of course, you should talk to our providers to find personalized treatment options based on your specific circumstances. However, research from Harvard and Emory University suggests estrogen may play a big role in anxiety.
According to The Harvard Gazette, recent research shows that estrogen levels may affect how susceptible some women are to anxiety. The article explains that depression and anxiety disorders are about twice as common in women than in men, with times of higher anxiety often linking up with hormone changes, such as puberty, certain periods of the menstrual cycle, pregnancy, and during menopause.
Both studies looked at fear response in relation to estrogen. They found that estrogen may have a calming effect on the fear response, including for women suffering from post-traumatic stress disorder (PTSD). Therefore, there is some evidence that increasing estrogen may reduce anxiety-like symptoms. Researchers are still studying the effects of HRT on anxiety in menopausal women, but many women notice improvements in their mood symptoms after beginning an HRT regimen.
Estrogen is a sex hormone, so you might be wondering what it has to do with anxiety and why hormone imbalance treatment may help with anxiety symptoms. Scientists are still studying the connection. However, it may be due to estrogen receptors in the brain that can increase the risk for anxiety. For instance, estrogen receptors may affect the hypothalamic-pituitary-adrenal axis, which is basically the relationship between the hypothalamus, pituitary gland, and adrenal gland. The key detail to note here is that this axis has a large impact on your body’s response to stress. Some researchers also believe estrogen receptors in the brain can impact serotonin levels, which may also explain the link between estrogen and anxiety.
If you’re experiencing menopause symptoms, visit our providers at HerKare for help. We are a women’s health clinic dedicated to empowering women through quality health care. Our team takes a holistic approach to health care and provides treatment solutions personalized to you. If you’re experiencing symptoms of a hormone imbalance, our team may prescribe bioidentical hormone therapy to help alleviate your symptoms. Make an appointment at one of our convenient locations today!