Managing Anxiety in Perimenopause
Perimenopause is a season of transition—one that often brings about changes in mood, sleep, energy, and, for many, an increase in anxiety. If you’re in this stage of life and noticing a rise in worry, irritability, or even full-blown panic, you’re not imagining it. Hormonal shifts, life stressors, and biological changes can all contribute to heightened anxiety during perimenopause. The good news? You don’t have to just ride the wave. There are practical, evidence-based ways to manage and ease anxiety so that you feel more balanced and in control.
Why Anxiety Increases During Perimenopause
Perimenopause, the years leading up to menopause, is marked by fluctuations in estrogen and progesterone. These hormones play a critical role in regulating mood and stress responses. When their levels start to shift unpredictably, it can lead to increased feelings of anxiety, mood swings, and even depression.
Beyond hormones, perimenopause often coincides with other mid-life stressors: career transitions, aging parents, children leaving home, or changes in relationships. All of this can create the perfect storm for heightened anxiety.
How to Manage Anxiety During Perimenopause
Regulate Blood Sugar & Nutrition
What you eat directly impacts your mood and anxiety levels. Blood sugar spikes and crashes can exacerbate feelings of stress and worry. Prioritize protein, healthy fats, and complex carbohydrates to keep energy and mood steady. Also, magnesium-rich foods (like leafy greens, nuts, and seeds) can be helpful in calming the nervous system.
Prioritize Sleep
Sleep disturbances are incredibly common in perimenopause, and poor sleep can make anxiety worse. Establish a nighttime routine that supports rest: limit screens before bed, create a calming environment, and consider relaxation techniques like progressive muscle relaxation or deep breathing.
Move Your Body (But in a Way That Feels Good)
Exercise is a natural anxiety reliever, but perimenopause is a time to be mindful of what kind of movement feels best. High-intensity workouts may spike cortisol, which can increase anxiety for some. Try gentle strength training, yoga, walking, or dance—whatever makes your body feel good.
Practice Mindfulness & Breathwork
Mindfulness techniques, meditation, and breathwork can help regulate the nervous system and reduce anxiety symptoms. Box breathing (inhaling for four counts, holding for four, exhaling for four, and holding again) is a simple, effective way to calm the body and mind.
Consider Therapy
If anxiety is significantly impacting your daily life, therapy can be a game-changer. Psychodynamic therapy can help you explore unconscious patterns and past experiences that may be contributing to anxiety, while EMDR (Eye Movement Desensitization and Reprocessing) can address deeper emotional triggers.
Talk to Your Doctor About Hormonal Support
For some women, hormone replacement therapy (HRT) or other medical interventions can help stabilize mood and ease anxiety. It’s worth having a conversation with your healthcare provider about what options might be right for you.
How I Can Help
As a therapist specializing in anxiety, trauma, and life transitions, I understand the complexities of perimenopause and how it impacts mental health. Through psychodynamic therapy and EMDR, I help clients explore the deeper roots of their anxiety, process unresolved emotions, and develop coping strategies tailored to their unique needs. If you’re struggling, know that you don’t have to navigate this alone. Reach out, and we can work together to help you feel more grounded and in control.
Final Thoughts
Perimenopause is a transition, but it doesn’t have to be a time of suffering. By supporting your body, mind, and nervous system, you can navigate this phase with more ease and less anxiety. If you’re struggling, know that you’re not alone—and help is available.
If anxiety feels overwhelming, reach out to schedule a free 20 minute intro call to see how I can help. You deserve support and strategies to feel like yourself again.
