Anxiety and the Menopause Transition

Many women are surprised to find themselves struggling with anxiety during peri/menopause. For some, it’s their first encounter with anxiety. For others, it’s a return of something they thought they had “worked through.” What’s most unsettling is that it often feels different this time around - sharper, more physical, less predictable.

How Hormones Affect Anxiety

The fluctuating hormones of peri/menopause have a direct effect on the nervous system and stress response:

  • Oestrogen normally boosts serotonin and dopamine (mood and motivation), and helps regulate the body’s stress system. As levels drop, the nervous system becomes more reactive and stress hormones like cortisol stay elevated for longer.
  • Progesterone has a calming, GABA-enhancing effect. When it falls away, women often feel wired, restless, or irritable.
  • The result is a more sensitive and less buffered nervous system, so everyday stressors can suddenly feel overwhelming.

This is why anxiety during peri/menopause can feel so foreign - it’s not just about life stressors, it’s about your brain chemistry changing.

What Anxiety Looks Like at This Stage

  • Sudden waves of dread or panic, sometimes without clear triggers
  • Racing thoughts and overthinking that are hard to switch off
  • Stronger physical symptoms - palpitations, dizziness, chest tightness
  • Emotional volatility - swinging quickly from calm to anxious
  • Difficulty concentrating or remembering things
  • Sleep disturbance, often waking with morning anxiety

Many women say, “I’ve had anxiety before, but this feels completely different.” That mismatch can be confusing and frightening.

What to Remeber

If anxiety is resurfacing, it doesn’t undo the work you’ve done in the past. That work gave you tools and resilience. What you’re experiencing now is hormonally driven, showing up in the context of new life pressures, and being filtered through the lens of your hard-earned midlife wisdom.