Is Your Anxiety Worse With Menopause?

There are many common symptoms associated with both peri-menopause (the start of the hormonal changes) and actual menopause including hot flashes, night sweats, vaginal dryness, weight gain, increased joint pain, irregular cycles, heavier periods, hair loss, and insomnia.  In discussions with their friends, female family members and health care provider, most women have a general understanding of ‘what’s to come’ when it relates to the big hormonal transition however symptoms such as increased, worsening or new anxiety might be a surprise.  Many women have experienced at least some form of anxiety in their lifetime and find it concerning when those nervous, overwhelm, worry or fretting feelings really ramp up in their forties and fifties. 

Research (and anecdotally in my practice) shows that women who are prone to anxiety before menopause are much more likely to have higher levels as they go through it.  In fact, it is reported that 51% of women between 40-55 years old experience mood swings or anxious type feelings more regularly than when they were in their twenties and thirties.  While there is little research on the subject of “why,” and the reasons are conflicting, there are a few consistent theories that may apply.

As women approach menopause, the need to become pregnant becomes less therefore ovulation becomes less frequent.  Without ovulation a woman does not make (much) progesterone and progesterone is the more calming, soothing, anti-PMS hormone for women.  This leaves estrogen to become more dominant which can cause increased symptoms of PMS, irritation, anger and overwhelm.

This hormonal transition of menopause is often occurring at the same time that life is stressful – Murphy’s law?  Women are juggling family, work, financial, relationship, and world responsibilities while trying to eat healthy, exercise, stay sane and navigate menopause.  This causes a lot of internal stress on the body, particularly the adrenal glands, which leads to feelings of anxiety, irritability, overwhelm and panic. 

Women going through peri-menopause and menopause often experience long periods of insomnia or waking up regularly between 2am-5am.  This leads to more fatigue and less patience causing those low-level feelings of anxiety to worsen.  Everybody feels better after a good night’s sleep as it is restorative to the body.

So, what can be done?  First, recognize that it is a normal (but not fun or fair) part of going through menopause.  Talk to your female family members about their experience and then consult with your health care provider about options (even if temporary) to help you get on the other side of all the transition.  Find coping skills to first recognize what is going on and then how to act/react with yourself and those around you.  Put yourself in time out and take 5-10 minutes for yourself (or more) and just breathe deeply, go for a walk, sit in the sun, read, exercise or close your eyes.  Focus on setting boundaries and saying “no” to things that create more stress and chaos in your life and remember that it is okay to do so.  Lastly, hope that your menopause is short and sweet!

 

References:

1.       Bromberger, J., Kravitz, H., Chang, Y., Randolph, J., Avis, N., Gold, E., and Matthews, K.  Does Risk for Anxiety Increase During the Menopausal Transition?  Study of Women’s Health Across the Nation.  Web.  2 June, 2013.

http://www.medscape.com/viewarticle/803506

2.       The Merck Manual.  Menopause.  Web.  2 June, 2013.

http://www.merckmanuals.com/home/womens_health_issues/menopause/menopause.html?qt=progesterone&alt=sh

3.       Kumari, v., Konstantinou, J., Papadopolous, A., Aasen, I., Poon, L., Halari, R., and Cleare, A.  Evidence for a Role of Progesterone in Menstrual Cycle-Related Variability in Prepulse Inhibition in Healthy Young Women.  Web.  2 June, 2013.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3055354/

5 Facts About the Hormone Testosterone for Women

When women think of the word testosterone they often think of MEN.  To sum it up, testosterone is what makes a man a man (so-to-speak) while estrogen and progesterone are often more associated with women.  However, testosterone is just as important to women but not in the same high level amounts.  These are five things about testosterone that may have you asking your health care provider for a test.

1)      Testosterone is made from cholesterol (its backbone) and another hormone known as DHEA.  DHEA is made in the adrenal glands and can help with stress, increased energy and low mood.  The more well known DHEA is DHEA-S, which is the one to test for.  Supplementing with DHEA should be done in the morning however; women should use lower doses than men.  The side effects can include increased anger, irritation, acne and inappropriate hair growth often on the face, nipples and chest.

2)      Testosterone helps significantly with energy, motivation, sense of well-being and sex drive in women.  When testing for this hormone, the total and free levels should be evaluated as the ‘free’ is active.  Testosterone has similar side effects to elevated DHEA and should be used with caution only under your health care provider’s direction.

3)      Keep in mind, testosterone is not a ‘magic pill’ for sex drive.  Many women have normal levels of testosterone and still find themselves lacking in desire.  A lot more goes into the libido for women than it does in men.  As women get older, their hormone levels overall change but so do their energy levels, sleep habits and stress which all interfere with their sex drive.

4)      Testosterone is made in both the ovaries and adrenal glands. Women who had their ovaries surgically removed may notice a significant decline in testosterone in the body.

5)      The birth control pill, if used correctly, protects against unwanted pregnancy but can also lower sex drive by lowering testosterone.  The pill increases a hormone known as sex hormone binding globulin that binds up excess free testosterone and gets rid of it from your body.  With less testosterone floating around, the desire for sex is less.

 

Just as a man might need testosterone replacement, so might a women but with significantly lower doses.  Consider asking your health care provider about testosterone and DHEA-S testing if hormone changes, fatigue, mood issues, and lower sex drive are occurring on a regular basis.  Your hormones may truly be out of balance.

References:

1.       Androgen Replacement Therapy in Women.  Web.  2 December, 2012.

http://www.medscape.com/viewarticle/773774_1

2.       Birth Control Pill Could Cause Long-Term Problems With Testosterone, New Research Indicates.  Web.  2 December, 2012.

http://www.medicalnewstoday.com/releases/35663.php