Anxiety and Panic: Early Signs of "Peri-Menopause?"
You pull up to the grocery store, locate a parking space, but just as you put your car in "Park" and shut off the ignition, you're overcome with a wave of heat. You develop a lump in your throat, your heart begins to race and you can't seem to open the door to exit your car. Your lungs feel crushed and you wonder if you're going to die, right there in the grocery store parking lot. Are you having a heart attack? Should you go to the emergency room?
Well, maybe, but if you're a woman in her mid thirties-to-late-forties, you're more likely having anxiety.
Hormonal Transitions Can Span Four (or more) Years
The hormonal transition to menopause begins, on average, four years before you actually stop menstruating. One of the first signs of these hormone transitions can be anxiety and panic attacks. The average age a woman ceases menstruating is 52 but some women experience the worst of their symptoms as early as the mid-thirties or mid-forties.
Erratic Fluctuations in Hormone Levels During Transition
During the "pre-menopausal transition" your levels of estrogen and progesterone (the ovarian hormones) decline with each cycle. But they don't decline in a nice, smooth, orderly fashion. Instead, it's a herky-jerky ride down the hill. You can actually have dramatic hormone surges (very high levels of estrogen) while your ovaries are transitioning to menopause--think of these as "sun flares". They are extremely high levels of hormones followed by "crashes". It's the crashes that can precipitate anxiety and panic attacks.
Hormones and Their Pre-Molecules Can Relieve Anxiety
Ovarian hormones and their precursors (estrogen, progesterone, and their building-block molecules) are natural "anxiolytics". This means they naturally interact with the "anxiety-control" receptors in your brain (gaba-receptors) to keep your mood even, cope with stress, and prevent panic. Fluctuations of one molecule in particular, allopregnenalone, have been found to be crucial in triggering peri-menopausal mood swings, anxiety, and premenstrual syndrome.
External Factors ("Life") Can Exacerbate Symptoms of Hormone Change
Anxiety in the peri-menopausal transition is often confounded by job factors and family changes. You may find you're having more conflicts with your boss or employees--perhaps you are older or a different gender than them and this creates tension. Children may be growing up and leaving (or not) home. Your relationship with your spouse may be changing as your sexual and other interests evolve.
Sometimes anxiety causes "dysphoria", an emotional state like a "funk"--this can be mis-diagnosed as "depression."
You Can Manage Anxiety
So what can you do about peri-menopausal anxiety? First, talk to your health care provider because sometimes anxiety is severe enough it needs to be treated. There are many good treatments for anxiety. Untreated anxiety can lead to heart disease, depression, and a host of other health problems. So anxiety needs to be identified and taken seriously by both you and your health care provider.
Medications and Nutrition Support
Although hormonal changes can precipitate anxiety, taking external hormones may or may not be the best thing to treat your anxiety, depending on the character and timing of your symptoms. There are cognitive (mental) techniques for managing anxiety as well as medications such as benzodiazepines (sedatives) and anti-depressants that work well for anxiety. Exercise, Vitamin D, and a B-Complex (plus a multi-vitamin) can support your body physically and mentally as you're going "through the change". Many women's anxiety responds well to the cognitive techniques and paying attention to physical and mental health.
Peri-Menopause--More Than A Flash
So while hot flashes have received a lot of "press" as the harbingers of "menopause", many women experience anxiety long before hot flashes set in. This anxiety can be the first sign of peri-menopausal hormone transitions.
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