How to reduce anxiety during perimenopause, menopause and midlife

The perimenopause and menopause can have a significant impact on our mental health. Anxiety, or a sense of impending doom, is one of the most commonly reported symptoms by women in our community. But why does this happen and what can we do to help ourselves?

Katie speaks with award-winning Menopause Specialist and Founder of Vital Wellness Clinic, Dr Wendy Molefi to find out more about treatment options, both medical and holistic.

Listen to the full conversation in The Latte Lounge podcast episode above.

What is anxiety and why does it affect us in perimenopause, menopause and midlife?

Anxiety is a state of hypervigilance. Your body is producing adrenaline and cortisol which prepare us for a fight or flight response to a situation and these hormones are churning around in preparation for that response, whichever is needed.

Symptoms can include feeling on edge, uneasy, irritable and restless and you may feel sick or have a dry mouth or unsettled tummy that you can’t explain.

Anxiety has a spectrum. You can feel anything from slightly uneasy to being totally overwhelmed or having a full blown panic attack.

Most of us will experience this at some time in our lives but in the context of menopause, it can creep up on us or suddenly come out of nowhere without an obvious cause.

Your sleep can also be affected by a busy mind so for those of us already struggling with poor-quality sleep due to hormone imbalances, anxiety may be an additional contributing factor. 

Often, just as we enter perimenopause or menopause, we are taking on new responsibilities in caring for our parents and all at a time when the children are leaving the nest and we may also be reinventing our careers and starting a new phase in our lives.

There is a lot going on in midlife so it is little wonder that anxiety can take hold. 

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Why are some people more affected by anxiety than others?

We are all different and our genetics do play a role.

The hormonal fluctuations which occur during perimenopause can trigger mood changes and anxiety and genetics certainly determine our response to the decline in oestrogen.

Those who struggle at this time may have also done so postnatally or during menstruation. 

Past medical history or underlying mental health issues can also mean a predisposition but lifestyle factors such as work stresses, loneliness, or even adjusting to that empty nest for example can also contribute. 

There are cultural differences in terms of how we deal with anxiety.

It can be embarrassing for example for women in communities who don’t even have a word for the menopause, let alone discuss it openly to talk about the impact on their mental health.

This leads to a vicious circle where these women suffer in silence without the support that they need.  


How and when would you recommend women go about getting the correct diagnosis for anxiety?

In terms of whether it’s related to menopause or not, women know themselves.

If it's occurring around a certain age and you know you’re not yourself, see your GP in the first instance.

It’s important that medical professionals listen to how you are feeling, when it started and what else is happening in order to be able to unpack it and be sure that you’re not missing anything else that could be an issue.

There are some really good sources of information such as the BMS if you want to read around the subject.

You can also print our symptom checker here to determine whether there are any other indications that you are perimenopausal or menopausal and it will help your GP to make a more informed diagnosis if you take that information with you.

Don’t avoid seeking help, women often don’t like to admit that they’re not coping as well as they have in the past or aren’t feeling themselves when they’ve always been able to juggle and need to be able to in a work environment.

It can feel threatening when you suddenly can't remember where you left your keys or you have brain fog or haven’t slept well because of hot flushes ahead of an important presentation but like any other menopause symptoms, you needn’t just put up with it. The support is out there.

What do you recommend from a lifestyle approach?

See food as medicine and make a conscious effort to eat things that will boost your wellbeing in general. Diet is important so talk to a nutritional advisor if you need advice to start you on the right path.

Exercise is also important. It boosts endorphins, clears your mind and improves sleep quality which in itself is nourishing. It doesn’t have to be strenuous, a half an hour brisk walk or some yoga is sufficient.

Reduce your alcohol intake, it’s easy to reach for and seems as though it has a calming effect but it can actually exacerbate anxiety. 

Take a proactive approach with your mental health. Talking therapies like CBT have been shown to be incredibly beneficial in helping you to develop coping strategies. 

Try some mindfulness practices such as meditation. If this isn’t something you've tried before, there are apps which you can download to provide some structure and help you to get started.

Calm or Insight Timer have meditations you can dip in and out of and use at different times of the day. 

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Woman gestures as she talks about something with the members of a support group.

What about medical treatments?

If you’ve made lifestyle changes and they’re not resolving your anxiety, there are medical options.

Caution is advised with over-the-counter choices but HRT is generally very safe, despite the worries people have and it is definitely worth exploring if it means balancing a tiny risk with the benefits it provides.

Like any medical intervention, it isn’t for everybody and, as always, we would urge you to seek individual advice from your healthcare provider and make an informed decision.

And finally

With any aspect of midlife and menopause, remember these 3 important steps:

Firstly, awareness. Being aware of what is happening in your body is empowering.

Secondly, acceptance. This will happen to every woman, make room in your life for the transition with all of the physical and psychological manifestations it has.

Lastly, be accountable for your own health and wellbeing, self care is fundamental.

Don’t put yourself at the bottom of the priority list because if you are well and you are happy then everybody else benefits.

Discover more: Listen to more of The Latte Lounge podcast episodes - and don't forget to subscribe / follow to be notified of future episodes!

How to reduce anxiety during perimenopause, menopause and midlife with Dr Wendy Molefi

In this episode, Katie speaks to Dr Wendy Molefi about why women can suffer from anxiety during the perimenopause and menopause years and they discuss what we can do both holistically and/or medically to improve these concerns. Dr. Molefi is an award winning menopause specialist and founder of the Vital Wellness clinic.

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