Every woman experiences menopause in her own way, but most women know roughly what to expect: physical changes such as vaginal dryness and hot flashes, and changes in libido. But what about anxiety? Studies show that menopause is closely associated with increased anxiety, and yet too few women are prepared for this.
If you don't know that anxiety can be part of menopause, you might think that you're the only one experiencing it. Norma Goldman, director of The Menopause Exchange, says, "The impact of anxiety is often underestimated and many women are reluctant to seek help, instead suffering in silence. Emotional and psychological menopausal symptoms are often the hardest ones to tackle, but there's no need for women to suffer in silence."
Sometimes anxiety is related to changes in your libido or in your enjoyment of sex. You might worry that your partner won't understand how you're feeling, or that your relationship will suffer. If you're with a new partner, you might find it awkward to say when sex feels uncomfortable or you need extra lubrication. Sometimes anxiety is related to poor sleep - menopausal women frequently find that sleep is disturbed or that even when they've slept they still don't feel rested.
Much of the time anxiety seems to be related to changes in your hormones. There's a clear link between the physical symptoms of anxiety and hot flashes, with women who experience strong hot flashes also frequently reporting feeling anxious for no apparent reason at the same time. And suffering with anxiety when you're premenopausal can be a predictive factor for severe hot flashes too.
So anxiety might be related to the changes in your self-image and sexual behaviour, but it's more likely to simply be another symptom of menopause, just like all the physical changes you're experiencing. This means that what you're feeling is normal and natural and that it's OK to talk about it with your doctor or health professional.
HRT will often help with the changes in your mood, but not every woman wants HRT. Thankfully there are plenty of treatments for anxiety that can make a difference. If there is a support group available, consider going along. A Danish study found that menopausal women who were doing exercise as a way of dealing with anxiety didn't show long-term improvement, but that when a group session was added the benefits lasted much longer. Simply being able to talk to other women about your feelings can make a tremendous difference.
If group work isn't an option, consider Cognitive Behavioural Therapy (CBT). A CBT-trained therapist will offer you a few sessions (rarely more than six and sometimes only two or three) and help you to learn ways to address and reduce the symptoms of anxiety. CBT teaches you a set of skills that you then use for self care.
A 2017 study published in the Journal of Medicinal Plants found evidence that valerian extract was beneficial in reducing anxiety associated with menopause. As with any herbal remedy, if you're taking any other medication then do check with your doctor first. And finally, if you're experiencing anxiety at levels that are preventing you from getting on with daily life, ask your doctor about prescribing some medication to help in the short term.
Anxiety is a normal part of menopause. It's not something that you simply have to put up with; there is help available. Talk to your doctor or health professional about psychological therapies such as group work or CBT, and consider whether herbal remedies or a short course of prescription medication might help.
By Stephen Humphreys