Over the coming weeks, we’re going to be looking afresh at the 34 symptoms of menopause. Today, we’re zeroing in on one of the most common: anxiety. 

Menopause is a time of change. But what does that actually mean? You are considered to be menopausal once you have gone a year without having a period – but you can experience any one of the 34 symptoms of menopause in the time leading up to this (known as “perimenopause”). Some women sail through this change with few problems, while others struggle from one symptom to the next. And one of the most common psychological symptoms is anxiety 

What is anxiety? 

Anxiety can start in a subtle way. Some women might feel sad or troubled during menopause because of the changes that are happening in their body, such as loss of fertility. Others might feel relieved that they no longer have to worry about the possibility of accidental pregnancy.  

In addition, there may be other significant life changes going on during a woman’s menopausal years. Children may be leaving home, and parents or partners will age and potentially become unwell as a consequence.  

There’s a lot of change going on – which can cause a lot of anxiety. Then, when you add fluctuating hormones into the mix, anxiety can create a vicious circle that it’s easy to get caught up in. You worry about something, then you worry about the worrying, which makes you more anxious, which you then worry about (and on and on and on).  

What causes anxiety? 

There are many factors that contribute to anxiety, but mostly it’s a combination of fluctuating hormones and life-changing events. The presence of too much cortisol (one of the stress hormones) in your body can negatively influence your levels of oestrogen and progesterone, which in turn influences your moods and feelings.  

Levels of oestrogen and serotonin are also connected. Serotonin is a neurotransmitter that contributes to feelings of wellbeing and happiness. Once secreted, it is then transported back along the nerves in order to be secreted again (this process is called uptake). The length of time it remains available is pivotal for our mood. Estradiol, which is the most active form of oestrogen, promotes the actions of serotonin by increasing the time it remains available in the synapses and interstitial spaces – making you feel better for longer. That’s more or less the way antidepressants work, too.  

So, around the time of menopause, as oestrogens are depleted, thus impacting serotonin levels, women become more susceptible to mood swings and anxiety. It’s not just all the mind. 

Six tips to counteract anxiety 

Cut out caffeine 

Your hormones are already in flux, and too much cortisol (one of the stress hormones) can have a negative effect on the amount of oestrogen and progesterone in your body, as we’ve just seen. Now, we know it’s not easy to say no to the smell of good coffee, but if you have to have a cup, try to avoid it first thing in the morning, as this sudden jolt of caffeine can make your anxiety worse. Try not to use caffeine as a crutch if you are feeling anxious – go for a smoothie or a juice instead. 

Say no to alcohol 

When you’re anxious, it can be tempting to reach for a bottle of wine to take the edge off. But things will only get worse if alcohol becomes a habit – not to mention the effects of a hangover as your liver works overtime. 

Go for a walk 

Even if you don’t feel like it. Even if the thought of seeing someone along the way makes you anxious. Just go for a 10- to 15-minute walk round the block. Just this small amount of exercise can increase serotonin levels in the brain, which can drastically improve your mood. 

Get some sleep 

Menopause and lack of sleep go hand in hand. Anxiety, night sweats and generally feeling out of sorts can really take their toll on your sleep pattern. It might sound ridiculously simple, but a hot chocolate or an oat milk – or whatever milk you fancy, in fact – can help you feel sleepy. A hot bath with a cup of Epsom salts before bed will also help you relax, and the magnesium in the salts is vital for more than 300 chemical reactions in the body. Moreover, magnesium help with restless leg syndrome and muscle fatigue, that’s why can help you getting a better night sleep. 

Find the treatment that works for you 

You have to decide what’s best for you based on your body, your family history and your lifestyle. HRT may be the right thing for you – but equally, it might not. Research different treatment options and, when you visit your GP, be honest and open about your symptoms. Make sure you get the help that’s best for you. 

Don’t suffer in silence 

Talk to someone you trust about how you’re feeling, no matter how hard it might seem. Just talk. It’s true what they say: a problem shared is a problem halved. If your anxiety is taking over your life, go and see your GP, or speak to another medical professional. But do ask for help. 

Anyone can contact Samaritans FREE any time from any phone on 116 123, even a mobile without credit. This number won’t show up on your phone bill. Or you can email? or visit