Anxiety and Panic–An Early Sign of "Peri-Menopause?"

by Shelley Binkley on January 13, 2009

Silver gaze

This post is an excerpt from “Get A Grip On Your Hormones!” To pre-order the book, to be published in October,  2009, click here.

You pull up to the grocery store, locate a parking space, but just as you  put your car in “Park” and shut off the ignition, you’re overcome with a wave of heat. You develop a lump in your throat, your heart begins to race and you can’t seem to open the door to exit your car. Your lungs feel crushed and you wonder if you’re going to die, right there in the grocery store parking lot. Are you having a heart attack. Should you go to the emergency room?

Well, you may be having a heart attack, but if you’re a woman in her mid thirties-to-late-forties, you’re more likely having anxiety.

Hormonal Transitions Can Span Four (or more) Years

The hormonal transition to menopause begins, on average, four years before you actually stop menstruating. One of the first signs of these hormone transitions can be anxiety and panic attacks. The average age a woman ceases menstruating is 52 but some women experience the worst of their symptoms between ages 35 to  45.

Erratic Fluctuations in Hormone Levels During Transition

During the “pre-menopausal transition” your levels of estrogen and progesterone (the ovarian hormones) decline with each cycle. But they don’t decline in a nice, smooth, orderly fashion. Instead, it’s a herky-jerky ride down the hill. You can actually have dramatic hormone surges (very high levels of estrogen) while your ovaries are transitioning to menopause–think of these as “sun flares”. They are extremely high levels of hormones followed by “crashes”. It’s the crashes that can precipitate anxiety and panic attacks.

Hormones and Their Pre-Molecules Can Relieve Anxiety

Ovarian hormones and their precursors (estrogen, progesterone, and their building-block molecules) are natural “anxiolytics”. This means they naturally interact with the “anxiety-control” receptors in your brain (gaba-receptors) to keep your mood even, cope with stress, and prevent panic. Fluctuations of one molecule in particular, allopregnenalone, have been found to be crucial in triggering peri-menopausal mood swings, anxiety, and premenstrual syndrome.

External Factors (”Life”) Can Exacerbate Symptoms of Hormone Change

Anxiety in the peri-menopausal transition is often confounded by job factors and family changes. You may find you’re having more conflicts with your boss or employees–perhaps you are older or a different gender than them and this creates tension. Children may be growing up and leaving (or not) home. Your relationship with your spouse may be changing as your sexual and other interests evolve.

Sometimes anxiety causes “dysphoria”, an emotional state like a “funk”–this can be mis-diagnosed as “depression”.

You Can Manage Anxiety

So what can you do about peri-menopausal anxiety? First, talk to your health care provider because sometimes anxiety is severe enough it needs to be treated. There are many good treatments for anxiety. Untreated anxiety can lead to heart disease, depression, and a host of other health problems. So anxiety needs to be identified and taken seriously by both you and your health care provider.

Medications and Nutrition Support

Although hormonal changes can precipitate anxiety, hormones may or may not be the best thing to treat your anxiety, depending on the character and timing of your symptoms. There are cognitive (mental) techniques for managing anxiety as well as medications such as benzodiazepines and anti-depressants that work well for anxiety. Exercise, Vitamin D, and a B-Complex (plus a multi-vitamin) can support your body physically and mentally as you’re going “through the change”. Many women’s anxiety responds well to the cognitive techniques and paying attention to physical and mental health.

Peri-Menopause–More Than A Flash

So while hot flashesDetailed Total Eclipse have received a lot of “press” as the harbingers of “menopause”, many women experience anxiety long before hot flashes set in. This anxiety can be the first sign of peri-menopausal hormone transitions.

So while hot flashes have received a lot of “press” as the harbingers of “menopause”, many women experience anxiety long before hot flashes set in. This anxiety can be the first sign of peri-menopausal hormone transitions.

This post is an excerpt from “Get A Grip On Your Hormones!” To pre-order the book, to be published in May 2009, click here.

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{ 8 comments… read them below or add one }

1 SeaSpray March 25, 2009 at 6:49 pm

Hi..I enjoyed the post. I am 53 and actually STILL peri-menopausal. I am much later than my friends. The cotton pony may skip a few visits… and even though shorter..sometimes…she’s still riding into town. ;)

Is that alright? (I do have my yearly gyn exams and did in October.. but didn’t think to ask about being this long in peri-menopause)I’m glad because I figure I am still getting benefits of hormones. I don’t get hot flashes..thank GOD! I did have 5 since I was 44 with 2 bad ones out of five… and last one…which was on vacation summer 05 -that memorable. :)

Anxiety? ha..I can relate to that. :)

2 Shelley Binkley March 26, 2009 at 7:26 am

Hi SeaSpray, Thank you for your comment.
53 is on the longer side for the appearance of the cotton pony, but not all that unusual.
The average age for cessation of menses is 52–this means about half of women are older than 52 when the cotton pony stops visiting.
Other symptoms, e.g. anxiety, insomnia can begin long before and persist long after the cotton pony is gone.
Shelley

3 SeaSpray March 26, 2009 at 4:28 pm

Thanks Shelly – I will be 54 in June.

I do hope I sail through without the hideous hot flashes some of my friends have. As I stated … mine have been minimal. But I will say… I used to sleep so well and easily and now I am lucky if I get 5 hrs uninterrupted. And I sleep restlessly. Thinking of getting melatonin. :)

4 Michele July 28, 2009 at 8:21 pm

Hi, I’m 47 (will be 48 in Nov) and for the first time I’m experiencing anxiety (started 2 months ago). I had a period in Aug 08 and 1 in Dec 08 and then nothing. My GYN put me on HRT three and a half weeks ago, but I’m still experiencing the anxiety. I’d trade the anxiety for hot flashes any day. Frankly, the anxiety scares the crud out of me. I get 2 semi good days (where I almost feel normal), 2 days of anxiety, a day and a half of anger and the other day and half are a grab bag. I’ve had a lot of job stress, family medical issues, refinance house all at the same time. Any advise? Thanks, Michele

5 Shelley Binkley September 16, 2009 at 9:29 am

have you looked at the posts on anxiety on this site?

6 Jes September 30, 2009 at 6:25 pm

Hi, I’ve never written anything on a website before never really even surfed the web but my first panic attack in May of this year changed that. I’m 38, always been even-keelled but now I feel like I’m going crazy and always on edge that some weird symptom is going to flare up. My symptoms include tingling in my scalp which progresses to just feeling flushed and hot on my face, palpitations…like my heart skipped a beat, and psychological/emotional fluctuations…I find these extremely disturbing. I might be driving along just fine and then suddenly I’m in a deep, almost angry, depression and it might last 30 minutes or 4 hours. I’ve had my FSH and estradiol levels checked. FSH slightly elevated, estradiol normal. My doctor tells me this means I am in early perimenopause and that it may last up to 10 years! Are there any supportive therapies I can look into? Thank You, Jes

7 Ashley October 11, 2009 at 6:48 am

Hello,
Im 56 years old and just starting peri menopausal I believe?
My question to you is it normal to have severe anxiety and then left with pain in neck back arms and also sever heart palapitations and then diminishes into the next episode

8 Shelley Binkley October 11, 2009 at 4:50 pm

That could just be anxiety or it could be something more serious such as cardiac problems. I’d recommend seeing your doctor.

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