If you’re 40-plus (or even late 30s), it’s very possible that your first unexpected, unwelcome, peri-menopausal symptom will be stomach-churning, sleep-affecting, anxiety. We believe that anxiety is one of the most common but misunderstood symptoms of menopause. And as there’s evidence that women who feel anxious may be more likely to suffer hot flushes - and frankly feeling inexplicably overwhelmed is horrible – it’s important to find ways to take back control. “Don’t You Worry ‘Bout A thing” if only we could take Stevie Wonder’s advice! But do you have an overwhelming sense of dread that’s hard to shake off? 

Your devastating loss of perspective and confidence can be blamed on depleting levels of oestrogen. When it’s up you’re up and when it’s down…you get the picture. Less progesterone also means less feel-good hormones, and more ‘not feeling like yourself’. Plus, your adrenal glands are now more sensitive to stress hormones produced during menopause, adding to your risk of panic attacks and anxiety. Physical symptoms may include an increased heart rate, difficulty breathing, sweating and stomach problems. Menopause and its accompanying symptoms may be the root of your anxiety, or it may aggravate pre-existing anxiety. 
And the good news is…. 
Simply realising that anxiety is a real menopause symptom, sharing your concerns, and admitting that you are not coping, can be the first step towards dealing with the cloud of dread that hovers over you. 

The best ways to deal with anxiety in menopause Think about when you feel anxious and if there are specific triggers? Simple diet adjustments may help you deal with it, alongside lifestyle changes and exercise. 

What to eat to help menopause anxiety

The good: Food can affect your mood, and according to the mental health charity MIND some people find eating a healthy diet helps them to manage their anxiety better. 
Keep blood sugar stable as sudden dips can make you feel tired and irritable. 
Switch from simple to complex carbohydrates. White bread, white rice and baked foods are not your friends. 
Opt instead for oats, wholewheat cereals, brown rice, quinoa, beans, peas and lentils. 
Have a happy sandwich! Tryptophan contributes to the production of serotonin so choose chicken, turkey, or cottage cheese for your sandwich filling. 
Oats, legumes, bananas and seeds are other good sources. 
Grab a handful of seeds B vitamins help support the nervous system, so snack on sunflower seeds, pistachios, dried fruit, and bananas. 
And remember to add tuna, salmon, turkey, chicken and avocados to your weekly shop. 

Choose calming foods: when your liver isn’t functioning properly, anxiety kicks in. According to a research study at the University of Edinburgh’s Centre for Clinical Sciences there are “important links between mind and body, and of the damaging effects psychological distress can have on physical wellbeing.” Suggesting that anxiety and depression may be indirectly linked to an increased risk of liver disease. 
Eat more: beetroot, tomatoes, collard greens, sunflower seeds. 
Eat little and often to help keep blood sugar stable - and prevent the production of anxiety creating adrenaline. Healthy snacks include nuts, seeds and fruit. But take time to sit down and eat slowly and calmly. 

What to avoid to help menopause anxiety

The bad: Step away from the biscuit tin. That chocolate cookie may give you a blood sugar boost but for every up there’s a down! 
Processed foods cause blood sugar surges and drops, which will increase those feelings of anxiety. 
Anxiety and alcohol don’t mix Alcohol is a depressant, and although we sometimes use it to help us relax, in reality it may exacerbate anxiety. 
Go caffeine free Caffeine is a stimulant that can make you feel jittery and more anxious. 
Black and green tea, cola and energy drinks all contain caffeine. Drink naturally caffeine-free herbal teas instead, such as peppermint, camomile and ginger. 

Lifestyle & wellbeing to help with anxiety in menopause

Exercise to beat the blues 
Regular exercise will help to burn off nervous energy. Pick a sport you like and you’re more likely to stick with it. The Royal College of Gynaecologists’ message is that consistent aerobic exercise e.g. swimming and running may help to reduce the menopause symptoms which could be causing, or adding to your anxiety. Walk more. It helps with breathing, calms you down and makes a very real difference to your ability to cope. 
Relax and rejuvenate 
Relaxation techniques for your body and mind will help manage feelings of anxiety. Find a calming activity that works for you. You could try yoga and breathing exercises,  
Mindfulness and meditation 
Could also help ease your anxiety. What about anxiety apps? According to the World Health Organisation, a staggering 615 million people suffer from a mental health condition, anxiety being one of the most common. There are plenty of apps claiming to help calm anxiety and ease your stress. 
Heal Yourself, Trello, Stress Check, Relax Lite, Sleep Genius and Buddhify, are all stress and anxiety-busting apps that you can download to your phone. If you like a gadget, the WellBe bracelet and mobile app claims to “support your emotional well-being”. The bracelet monitors your heart rate, using algorithms to establish your stress and tranquillity levels based around time, your location and the people you meet during the day. Nice to get confirmation of who presses your buttons and causes you stress! We haven’t tried it, so let us know if you have. Try the Clarity app, the first app designed with menopausal women in mind find out more about Clarity here. 
A problem shared 
Don’t feel isolated, talk to friends and family who might not realise that your perimenopausal, or menopausal. Once you start talking to other women, you’ll be as amazed, as we were, at how much you can learn from each other. Sunshine matters 
Vitamin D 
deficiency is linked to anxiety, seasonal affective disorder (SAD) and depression. Exposure to the elusive golden orb stimulates the body to produce vitamin D, just 15 minutes a day (without letting your skin redden) is all that’s needed. In the UK and northern Europe, it is recommended that we take a daily 10mg Vitamin D supplement between October and March due to lack of sunlight. An oral spray is one of the fastest ways to get vitamin D into your system. 
Poor sleep could be a major contributor to your menopause anxiety. Fluctuating hormones can affect our ability to get to sleep and to stay asleep. Try to follow the same bedtime routine throughout the week. Avoid catnaps late in the day to help you get the best quality sleep. Use calming techniques like deep breathing, mindfulness or visualisation to get to sleep, or back to sleep at night. If anxiety is having an adverse effect on your sleep, we give helpful tips on how to improve it in our symptoms section; Sleepless Nights & Insomnia 

Supplements worth trying for anxiety in menopause

St John’s Wort appears to be effective in treating anxiety during the menopause but it can interfere with other medication so it is important to speak with your doctor before taking according to the latest RCOG guidance. 
Vitamin D Research has shown that oral vitamin D sprays outperform tablet absorption as they deliver it straight to the bloodstream. 
Black Cohosh may increase oestrogen levels helping to balance the feel-good hormones serotonin and friends.
Valerian Root contains phytoestrogenic components and sedative elements which may help with anxiety and hot flushes Passionflower raises the chemical GABA which makes you feel more relaxed and reduces anxiety by decreasing brain activity. Check with your GP first as it may impact on other medicines such as blood-thinners or sedatives. 
Agnus Castus helps to stabilise the fluctuating hormone levels which add to feelings of anxiety Siberian Ginseng works on improving the function of the adrenal glands, suppressing the production of cortisol. 
AvenaCalm (A.Vogel) and Viridian’s L-theanine & Lemon Balm Supplement claim to help with menopausal anxiety. It’s essential that you talk to your doctor as supplements can have side-effects, impact on the function of prescription medications/or have time limits on how long you can take them for. 

Alternative help for anxiety

Cognitive behavioural support 
In their 2015 guidelines, The National Institute for Health and Care Excellence (NICE) concluded it was ‘an effective non-hormonal intervention for managing vasomotor symptoms’ (night sweats and hot-flushes to you and us). 
Aims to replace negative thoughts with positive ones, and includes counselling and advice on sleep and relaxation. A study published by the North American Menopause Society in 2013 found that self-help CBT ‘was as effective as 8 hours of group CBT’. Your doctor may be able to refer you for CBT on the NHS, or recommend self-help online CBT courses. 
What aromatherapy offers for anxiety 
Lavender, lemon balm, geranium and vanilla essential oils are all meant to have a calming effect. Put a couple of drops on a tissue and slowly inhale. Homeopathy Consult an experice homeopath to see which remedies can help to relieve specific symptoms of menopause,including anxiety. Acupuncture The British Acupuncture Council say that acupuncture may help menopausal symptoms by regulating hormones and raising feel-good endorphins. There are lots of studies to say that acupuncture has no discernible effect and that any benefits are purely a placebo effect. 
Who cares? 
If you feel better after treatment, you won’t mind how it works just that it has. Traditional Chinese medicine TCM focuses on restoring harmony to an unbalanced system. You can’t argue with the intention, so it may be worth considering? 

When to see your doctor about anxiety

If this sense of worry, dread and panic is impacting on your life, you should talk to your doctor. A 2016 survey by British Menopause Society found that half of all women don’t talk to their doctor about menopause. This is a tough time, but there are prescription medications available to help with this. 

And then there’s always HRT… HRT may treat the cause of your menopausal, hormonal imbalance. It will only work if your anxiety is linked to menopause. You need to talk to your doctor about your options. As always the Positive Pause caveat, there are pros and cons to taking HRT.


And we can help 
Your Fbl Team x