Symptoms

Anxiety & Panic Disorder

Why you may feel more anxious, overwhelmed or on edge during perimenopause.

It’s common to notice an increase in anxiety or worry during perimenopause. Hormonal fluctuations, life changes, and physical symptoms can all combine to heighten stress and make it harder to stay calm or sleep well. Some women may also experience panic attacks or panic disorder for the first time during this stage. The good news is that perimenopausal anxiety and panic symptoms can often be managed successfully, and with the right support, many women find ways to feel calmer and more in control.

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Why Anxiety Increases Around Perimenopause

As estrogen and progesterone levels begin to fluctuate, these hormones can affect brain chemicals that influence mood and emotional regulation. At the same time, many women experience significant life pressures in their 40s and 50s, such as caring for children or aging parents, managing demanding careers, or navigating changes in relationships and health. These combined factors can amplify anxious thoughts and feelings.

Common symptoms of anxiety during perimenopause may include:

Feeling nervous, restless, or easily overwhelmed
Difficulty relaxing or quieting the mind
Trouble sleeping or staying asleep
Racing thoughts or difficulty concentrating
Tense muscles, sweating, or heart palpitations
Feeling irritable or on edge

Some women may also experience panic attacks, which can involve dizziness, a rapid heartbeat, shortness of breath, intense fear, or a feeling of losing control. When panic attacks are recurrent and cause ongoing worry or changes in behaviour, this may be panic disorder.

Contributing Factors

Hormonal changes are not the only cause of anxiety. Other factors that may contribute include:

A history of anxiety or depression
Major life transitions or relationship stress
Caring responsibilities or work-related pressure
Poor sleep and physical exhaustion
Caffeine, alcohol, or nicotine use
Lack of time for self-care and rest

Recognising these triggers can be the first step in managing anxiety more effectively.

Treatment and Support Options

Addressing both hormonal and emotional health can make a big difference. Your treatment plan might include:

Counselling or psychological therapy to develop coping strategies and reduce negative thought patterns
Mindfulness, meditation, or relaxation techniques to calm the nervous system
Regular exercise to support mood-regulating brain chemicals and improve sleep
Good sleep habits, including limiting caffeine and screen time before bed
Balanced nutrition, with steady meals and reduced sugar and alcohol intake
Hormonal or medical support, such as Menopausal Hormone Therapy (MHT) or antidepressant medication if needed
Connection and community, such as support groups or speaking with trusted friends

Read our Blog “Mental Health Issues Around Menopause”, where you can also sign up for our webinar “Mental Health & Menopause” featuring Dr Kelly Teagle & Clinical Psychologist Hilary Sargeant.

When to Seek Help

If anxiety, panic attacks or fear of another attack are affecting your work, sleep or daily life, it’s time to seek support.

It’s important to talk with your usual doctor about how you’re feeling. Together, your GP and WellFemme clinician can work collaboratively to support your overall mental and physical health during this transition.

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