Why Your Hormones Might Be Making You Feel on Edge
If you’ve been feeling more anxious than usual, struggling with racing thoughts, or even experiencing full-blown panic attacks, you’re not alone. Many women find that, seemingly out of nowhere, their anxiety ramps up in their 40s—sometimes even earlier. The culprit? It could well be Perimenopause.
While we often associate the menopause transition with hot flushes and night sweats, the hormonal rollercoaster of perimenopause can trigger a whole host of unexpected symptoms—including anxiety. In fact, I would say this, along with sleep disturbance (getting to sleep ok then waking in the early hours) are the most common symptoms of the early perimenopause I see almost daily. Let’s break down what’s happening in your body and why it can feel like your nervous system has gone haywire.
The Science: What’s Actually Happening?
Perimenopause is the transitional phase leading up to menopause, often lasting anywhere from a few months to over a decade. During this time, your oestrogen and progesterone levels fluctuate unpredictably, and it’s this hormonal instability that can wreak havoc on your mood. Sorry ladies, but it’s a bit like being a teenager again or experiencing permanent PMS!
- Oestrogen & Serotonin: Oestrogen plays a key role in regulating serotonin, one of the brain’s “feel-good” neurotransmitters. As oestrogen levels drop, so does serotonin, potentially leading to increased anxiety, low mood, and even depression.
- Progesterone & Calmness: Progesterone has a naturally calming effect on the brain. In perimenopause, progesterone levels decline earlier and more dramatically than oestrogen (as progestogen highs are driven by good quality egg release during ovulation), meaning less of this soothing hormone is around to keep stress in check.
- Cortisol & Stress: With oestrogen and progesterone no longer counterbalancing stress hormones like cortisol, you may find yourself feeling more easily overwhelmed, jittery, ‘giddy’ or reactive to stressors that never used to bother you.
More Than Just Anxiety: Other Sneaky Symptoms of Perimenopause
While anxiety is a big one, perimenopause can bring a whole range of symptoms that you might not immediately connect to your hormones, including:
- Heart palpitations – A sudden awareness of your heartbeat, skipping beats, thudding or feeling like it’s racing, even when you’re at rest.
- Sleep disturbances – Waking up in the middle of the night for no reason (most commonly) or struggling to drift off despite feeling exhausted.
- Brain fog – Difficulty concentrating, forgetfulness, and feeling mentally sluggish.
- Digestive issues – Bloating, constipation, or sudden food sensitivities due to hormonal shifts affecting gut function.
- Joint aches – Feeling like you have suddenly ‘got older’ overnight as you’re experiencing stiffness and aching in the large and small joints.
What Can You Do About It?
If perimenopause-related anxiety is interfering with your life, the good news is there are ways to manage it:
- Balance Blood Sugar – Fluctuating oestrogen affects insulin sensitivity, making blood sugar crashes more likely, which can mimic anxiety symptoms. Eating protein, healthy fats, and fibre with each meal can help stabilise energy and mood.
- Prioritise Sleep – Poor sleep worsens anxiety, and vice versa. A magnesium supplement or herbal remedies like valerian root can support deeper, more restful sleep.
- Consider HRT or Alternative Therapies – Hormone replacement therapy (HRT) can help stabilise oestrogen and progesterone levels, reducing anxiety for many women. Others find relief through herbal supplements like ashwagandha or black cohosh.
- Move Your Body – Gentle exercise, especially walking or yoga, helps lower cortisol and boost endorphins, counteracting stress and anxiety. There was study published in the BMJ recently which showed exercise is JUST AS EFFECTIVE as ANTIDEPRESSANTS at tackling anxiety and depression!
- Cut Back on Caffeine & Alcohol – Both can overstimulate the nervous system, making anxiety symptoms worse. Try switching to herbal teas or a calming chamomile blend.
- Seek Support – Whether it’s therapy, coaching, or simply talking to a friend, sharing your experiences can make all the difference.
You’re Not Alone
Anxiety in perimenopause is incredibly common, but because it’s not as widely discussed as hot flushes or irregular periods, many women feel like they’re the only ones going through it. The truth is, if you’ve been feeling more on edge than usual, your hormones could very well be to blame—and there are ways to feel more like yourself again.
Have you experienced anxiety during perimenopause? Let me know in the comments—I’d love to hear what’s helped you manage it!
