Anxiety is a psychological state characterized by excessive and persistent worry. Anxiety disorders are twice as common in women and can be caused by decreased estrogen levels during menopause. Symptoms of anxiety include nervousness, difficulty concentrating, and physical symptoms like heart palpitations. Treatments include stress management techniques, diet changes like increased carbohydrates, herbal supplements, and medications like SSRIs or HRT.

1. Menopause
and Anxiety

2. Index
Page
About Anxiety 2
Generalized Anxiety Disorder (GAD) 2
Panic Disorder (PD) 3
Social Phobia /
Social Anxiety Disorder (SAD) 3
Post Traumatic Stress Disorder (PTSD) 3
Obsessive Compulsive Disorder (OCD) 3
Symptoms of Anxiety 4
Causes of Anxiety 6
Anxiety Treatments 7
Diet Change 8
Alternative Medicine 9
Medications 10
References 11

3. Menopause and Anxiety
About Anxiety
Anxiety is a psychological state characterized
by excessive and persistent worry, tension and
nervousness. There are several types of
anxiety disorders, classified on the basis of
symptoms, causes and other central features.
Anxiety disorders are twice more common in
women than men, affect more than 40 million
Americans.
Generalized Anxiety Disorder (GAD) is
characterized by a persistent state of
exaggerated worry and fear (at least six
months), often when there is little or nothing
to provoke it.

4. Menopause and Anxiety
Panic Disorder (PD) is characterized by recurring
acute episodes of sudden terror and
overwhelming dread, which produce a variety of
emotional and physical symptoms.
Social Phobia / Social Anxiety Disorder (SAD)
involves excessive worry and self-consciousness
about everyday social situations.
Post Traumatic Stress Disorder (PTSD), unrelated
to hormonal changes in menopause, is an anxiety
disorder triggered by a traumatic life event.
Obsessive Compulsive Disorder (OCD), also
infrequently associated with menopause, involves
irrational preoccupations. Specific phobias,
including agoraphobia, are unwarranted and
extreme fears of particular stimuli.

5. Menopause and Anxiety
Symptoms of Anxiety
People who experience anxiety often can't
seem to shake their concerns and worries
about everyday events, even though they may
know that their anxiety is out of proportion to
the triggering situation. Psychological
symptoms of anxiety can also include
nervousness, difficulty concentrating, trouble
relaxing, tension, hypervigilance, restlessness
and irritability.
Anxiety can put someone on edge, making it
feel as if disaster is always just around the
corner. Just getting through the day can feel
overwhelming and even unbearable. At night
it can wake someone from sleep or make
falling asleep extremely difficult.

6. Menopause and Anxiety
Moderate to severe levels of anxiety can put a
significant strain on our personal and
professional relationships, not to mention
how it makes us feel about ourselves.
Anxiety produces more than just psychological
symptoms. People who suffer from anxiety
typically experience a host of physical
symptoms, including heart palpitations,
fatigue, muscle aches, digestive problems,
excessive sweating, frequent urination,
shortness of breath and more. These
symptoms may be especially intense for
people who experience panic attacks, or
sudden and acute episodes of overwhelming
fear and panic.

7. Menopause and Anxiety
Causes of Anxiety
For women in their 40s and 50s who are going
through menopause, one of the most
common causes of anxiety is decreased
estrogen levels. Estrogen declines during
perimenopause, or the time before
menopause, as the body prepares to cease
egg development and menstruation.
Scientists have discovered that estrogen has a
significant effect on the brain's regulation of
moods and emotion.
While this relationship appears complex,
experts do know that changes in estrogen
levels have a direct effect on the
neurochemicals serotonin, norepinephrine,
dopamine and melatonin. Since all of these
chemicals play an integral role in emotion and
mood regulation, disruptions caused by
estrogen fluctuations can lead to anxiety
during menopause.

8. Menopause and Anxiety
Anxiety Treatments
Stress management and relaxation techniques
are extremely valuable to women
experiencing anxiety. While many people are
unfamiliar with the tremendous benefits of
relaxation techniques such as yoga,
meditation, breathing techniques and
visualization, more and more people are
discovering just how effective they are in
helping a person cope with anxiety, not to
mention the stresses and strains of daily life in
general.

9. Menopause and Anxiety
Diet Change
This can also change the way you feel. Some
basic guidelines:
• Stay well hydrated
• Increase carbohydrates, which increase
serotonin levels in the brain to calm you
down
• Eat smaller, more frequent meals to avoid
low blood sugar
• Increase intake of tryptophan, found in milk,
bananas, soy, nuts, peanut butter and oats
• Reduce intake of caffeine, which can
increase nervousness and the jitter

10. Menopause and Anxiety
Alternative Medicine
There are two types of herbs that can be used
for treating mood swings: phytoestrogenic
and hormone-regulating herbal supplements.
Phytoestrogenic herbs (e.g. black cohosh)
contain estrogenic components produced by
plants. These herbs, at first, do treat the
hormonal imbalance by introducing these
plant-based estrogens into the body.
However, as a result of adding outside
hormones, a woman's body may become less
capable of producing estrogen on its own.
This causes a further decrease of the body's
own hormone levels.

11. Menopause and Anxiety
Hormone-regulating herbal supplements,
such as Macafem, don't contain any estrogen.
These herbs stimulate a woman's hormone
production by nourishing the pituitary and
endocrine glands, causing them to more
efficiently produce natural hormones. This
ultimately results in balancing not only
estrogen, but also progesterone.
Medications
Drug interventions at the third level involve
the highest risk and often the highest costs.
• Selective serotonin reuptake inhibitors
(SSRIs)
• Anti-anxiety medications (called anxiolytics)
• Mild sedatives
• Hormone replacement therapy (HRT)

12. Menopause and Anxiety
References
• “Anxiety Disorder”. National Institute of
Mental Health. www.nimh.nih.gov
• “Generalized Anxiety Disorder”.
MedicineNet.com
• Dr. Pick, Marcelle. “Anxiety in Women-
Causes, symptoms, and natural relief”.
www.womentowomen.com