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What is the Connection Between Menopause and Anxiety?

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  • Written By: Tricia Ellis-Christensen
  • Edited By: O. Wallace
  • Last Modified Date: 22 September 2016
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There are many connections between menopause and anxiety. Doctors are quick to point out the lack of a direct causal relationship. This is due to the many reasons why women may experience inordinate anxiety during perimenopause and menopause, and these plausible occurrences make it difficult to assert menopause is the only cause of mood distortions during this time of life. As hard as it is to prove causality, it is difficult to disprove it. It’s also evident that anxiety can exacerbate other menopause symptoms, which may then contribute to higher anxiety.

The evidence suggesting that menopause, alone, results in anxiety comes from different sources. Some studies have evaluated anxiety levels in women with surgically induced menopause, who tend to be much younger and at different stages of life than the average woman who enters this time when periods cease naturally. Increased anxiety levels in women with surgically induced menopause suggests cessation of female hormones alone reduces competent stress-handling, resulting in more perceived anxiety. These studies are small, and surgically induced menopause is much more abrupt than the gradual changes in natural menopause, so research can’t clearly establish sole causality between menopause and anxiety.

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It’s known that fluctuations in female hormones in the perimenopausal and menopausal state have some effect on mood-stabilizing neurotransmitters like serotonin. Anxiety and depression are strongly related and both are expressions of inadequate serotonin amounts. Most women experience these emotional states during menopause to some degree and many women benefit from antidepressants during this time to address mood distortions.

One fact that argues against a direct connection between menopause and anxiety is that hormone replacement therapy isn’t necessarily adequate to treat strong depression or anxiety. If fluctuating hormones were the only relationship between menopause and anxiety, it could be reasonably posited that regulation of these hormones would fix the problem, but it doesn’t. This suggests other potential issues that muddy the waters in establishing a clear connection.

What many researchers in this area have suggested is that there are numerous reasons for anxiety at the time of life menopause is usually experienced. These include changes to life as children grow or leave home, changes in physical appearance, insomnia due to menopause, potential decline in sexual interest, worries about aging, concerns about swift mood changes, greater prevalence of disease, and other factors. Any of these circumstances may create more stress that can compound with menopausal symptoms to produce higher anxiety levels.

There are also cyclical relationships between menopause and anxiety. Anxiety can result in insomnia, which may cause reduced ability to handle stress and result in greater predilection to panic. It also appears that higher levels of anxiety predict higher number of hot flashes, which may produce more insomnia and greater stress levels or instability during the day. It’s evident that the connections between menopause and anxiety are complex. A holistic approach to treatment that emphasizes medication, therapy, and stress reduction techniques is likely to be most effective in addressing all possible causes.

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