Column: Anxiety and the menopause

By Dani Singer, specialist menopause counsellor and psychotherapist. This excerpt has been taken from the Summer 2024 issue (101) of The Menopause Exchange newsletter.

Anxiety is a tense, diffuse, unpleasant feeling of worry and unease: an amorphous sensation of dread or impending doom, even in the absence of an obvious external trigger. Anyone can experience anxiety, but it’s often heightened for women around the time of the menopause, or just before (perimenopause). Anxiety differs from fear, which is specific, time-limited and generally has a concrete base, although sometimes fear is based on false evidence appearing real.

What are the possible causes?Fluctuations in oestrogen, progesterone and testosterone, which regulate serotonin (a natural mood-booster) and endorphins (feel-good hormones) may lead to volatile emotional responses to even the smallest things. When stressful life events are added, such as family and life changes, financial worries, difficulties at work or health conditions in ourselves or significant others, on top of ubiquitous fears about aging, the primary stress hormone cortisol can also become activated. This further contributes to racing thoughts, feelings of anxiety, irritability and worries of ‘going mad’.

The impact of symptomsPhysical symptoms of the menopause, such as hot flushes/night sweats, sleep disturbance, muscle aches and pains, pounding heart, skin irritation, headaches and brain fog, and caffeine in our system, can intensify anxious ruminations and even catastrophic worries, for example about the future. So it’s unsurprising that situations may feel overwhelming. Together, these create a potent and unpleasant cocktail, resulting in the often-expressed view of feeling ‘unlike my former self’. Our self-confidence becomes dented at what feels like a particularly vulnerable time.

Who is likely to be affected?The above concoction affects a proportion of women in or around the menopause, sometimes quite severely. Those affected in particular, but not always, may have strongphysical symptoms, have experienced multiple health conditions such as endometriosis, undergone surgery such as a hysterectomy where hormonal changes have happened abruptly, severe PMS/PMDD or other gynaecological problems, or have experienced unresolved trauma.

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The founder and director of The Menopause Exchange is Norma Goldman. Norma has a pharmacy degree and a Master’s degree in health promotion. She gives webinars to women experiencing the perimenopause and menopause and also to employees in the workplace.

The Menopause Exchange, which was established in 1999, is unbiased & independent & isn’t sponsored by any companies or organisations.