True or False? Anxiety Can Be One of the First Signs of Perimenopause
True.
When most women think about perimenopause, they picture hot flushes, irregular periods and night sweats. But for many women, one of the very first symptoms isn't physical at all—it's anxiety.
Many women tell me, "I've never been an anxious person before but more recently I feel overwhelmed easily and a lot of the time.."
The answer may lie in the hormonal changes that begin years before actual menopause.
During perimenopause, oestrogen doesn't simply decline—it fluctuates. These fluctuations can have a significant effect on the brain because oestrogen plays an important role in regulating neurotransmitters such as serotonin, dopamine and GABA. These chemicals influence mood, motivation, focus and your ability to feel calm. And even more important then oestrogen… is progesterone! Maybe the most significant change that starts to happen is the level of good quality progesterone you produce month to month. When progesterone is our ‘calming’ hormone, it’s easy to understand why we can start to feel more anxious, wired and not sleeping well.
As hormone levels become less predictable, many women notice they feel more emotionally reactive than they used to. Small stresses suddenly feel much bigger, they feel snappier then ever before and sleep often becomes disrupted, which only adds fuel to the fire.
The most common symptoms I see starting early on in perimenopause are:
Feeling anxious for no obvious reason
Racing thoughts at night
Waking around 3 am unable to switch your mind off
Feeling overwhelmed by everyday tasks
Increased irritability or emotional sensitivity
Panic attacks despite never having experienced them before
Of course, anxiety isn't always caused by hormones. Life in your 40s is often incredibly demanding. Many women are juggling careers, teenagers, ageing parents, financial pressures and relationship changes. These stressors are very real and are big contributors.
However, fluctuating hormones can reduce your resilience, meaning the same stress that once felt manageable now feels much harder to cope with.
This is why I always encourage women to look beyond simply treating the symptom of anxiety. Instead, I ask, "Why has your nervous system become more reactive in the first place?"
Supporting hormone balance is one piece of the puzzle, but so is optimising thyroid function, stabilising blood sugar, correcting nutrient deficiencies and supporting the nervous system.
Low iron, magnesium deficiency, poor sleep, blood sugar crashes and an underactive thyroid can all contribute to feelings of anxiety and overwhelm. This is why a personalised approach often achieves better results than focusing on hormones alone.
The good news is that many women notice significant improvements when the underlying drivers are addressed.
If you've started feeling anxious in your 40s and don't recognise yourself anymore, don't dismiss it as "just stress" or assume it's simply something you have to live with.
This is another way your body is trying to tell you something.
Understanding what's changing during perimenopause is the first step towards feeling like yourself again. With the right support, it's possible to regain calmer moods, better sleep, clearer thinking and the confidence that anxiety doesn't have to define this stage of life.
Because while anxiety may be common during perimenopause, it doesn't mean it's normal to simply suffer through it.
Natasha Gedrim (BHSc Naturopathy)
Thyroid and Hormone Naturopath
