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Anxiety and menopause

Most women make the transition into menopause without experiencing a major mood disorder. Estimates of the prevalence of mood disorders are inconsistent and vary greatly but range from 12% to as many as 50% of women who will experience mood symptoms or disorders during this transitional time in their lives. Although many studies have assessed risk of depression during the perimenopausal transition, few have systematically investigated the relationship between menopause and anxiety, although prevalence of anxiety in midlife women is substantial. Cognitive changes that frequently occur during perimenopause are not typically associated with neurodegeneration, they may lead to undue worry about early-onset dementia. Since there are parallels and overlapping symptoms between hot flashes and panic attacks, women prone to panic attacks cannot always differentiate between the two. As many as 51% of women aged 40 to 55 years report occasional tension, nervousness or irritability and 25% report frequent irritability or nervousness.

Hormone changes, life stresses, sleep problems, worries about body image, infertility, and aging are all factors linked to menopause that can contribute to mood swings, stress, anxiety, and a decreased sense of well-being in women. Few scientific studies support the idea that menopause contributes to true clinical depression, severe anxiety, or change behavior. Studies report that 23%of women experience symptoms of anxiety during perimenopause and that these symptoms of anxiety are not necessarily linked to depression. Additionally, symptoms of anxiety—tension, nervousness, panic, and worry—are reported more frequently during perimenopause than before it, regardless of whether symptoms of depression are present or not. At the same time, hormone fluctuations, life stresses, sleep troubled by night sweats, and concerns about body image, infertility, and aging can all cause emotional distress that may lead to mood swings or, in more severe cases, depression. Many women report symptoms of depressed mood, stress, anxiety, and a decreased sense of well-being around the time of menopause. The hormonal changes that happen during menopause can also drive feelings of anxiety. Changes in levels of hormones called estrogen and progesterone in particular, can have an impact. The variability in estrogen levels rather than the diminished levels, per se, may be associated with mood symptoms. It is known that fluctuating levels of estradiol increase the risk of vasomotor symptoms, which positively correlate with anxiety during perimenopause. It is also possible that impaired gamma-aminobutyric acid (GABA) receptor modulation of the hypothalamus-pituitary-adrenal axis during the menopausal transition may prolong the stress response, thereby increasing anxiety. Many women experience panic attacks during the menopause. Because people that have had panic attacks before are more likely to experience panic attacks during perimenopause, doctors think that panic attacks are a reaction to rather than a symptom of menopause.When someone has a panic attack, they experience intense feelings of anxiety or “doom.” These feelings may be accompanied by physical symptoms, such as:heart palpitations, shortness of breath, dizziness, weakness, sweating, nausea, tingling sensations.Many people experiencing a panic attack for the first time worry that they are having a heart attack or a nervous breakdown. Panic attacks can be among the most terrifying experiences of a person’s life.If someone has panic attacks, they should speak to their doctor.

Depression, mood, and sex. The relationship between sexuality and depression or mood state is often complicated. Depression can be both a cause and a result of a sexual problem. For instance, a woman’s loss of desire may contribute to her depression, yet she also may see her desire decline as an effect of depression. Additionally, mood affects emotion, which affects relationship issues, which in turn have implications for sex.

Although low desire is the most frequent sexual side effect of depression or anxiety, other aspects of sexuality can also be affected. In women, orgasm may be more difficult to achieve when depression is present.

Women with moderate to severe depression or anxiety will often be prescribed the popular antidepressant drugs known as SSRIs (selective serotonin reuptake inhibitors). Although the SSRIs are often effective in improving depression or anxiety, for many women (and men) they carry sexual side effects that include diminished sexual desire, trouble achieving and maintaining arousal, and difficulty achieving orgasm.Doctors believe that following a healthful lifestyle both helps with menopause symptoms and reduces panic attacks.Regular, gentle exercise can significantly reduce anxiety. Women who are going through perimenopause should pick their favorite form of exercise and try to make it part of a daily routine. Whether it is walking, running, swimming, or yoga, regular exercise can help to burn off nervous energy and improve symptoms of anxiety.Getting good-quality sleep is important for reducing anxiety. However, women going through menopause often sleep poorly due to night sweats caused by hormone surges. Importantly, women should make sure that they take time out for themselves. Certain activities, such as gardening, reading, meditating, practicing mindfulness, or yoga, are all good ways to focus on oneself and create feelings of well-being and relaxation.

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