Anxiety, and Why it Can be Worse in Perimenopause.
Anxiety affects many, and not just perimenopausal women.
However, many women find that as they reach their late 30s, early 40s either anxiety becomes worse, or women develop anxiety who have never experienced it before. While the most obvious reasons are things like the stress and pressure of our daily lives, there are internal imbalances that can make it worse. Furthermore, as our hormones start to change, the impact can be greater. As always many of these imbalances can be addressed through diet, lifestyle and sometimes botanical/supplemental support.
Before we dive into what you can do, let’s first look at why anxiety can occur, as the solution to each person’s anxiety is tied to the root cause.
Hormones.
Now when I say hormones I don’t just mean sex hormones, we have around 100 other hormones in the body, all working as chemical messengers, letting your different organs know how to function based on feedback and signals from other hormones and the environment.
There are 4 categories of hormones we will look at that have the greatest impact on anxiety when out of balance.
Cortisol.
This hormone is released in response to stress, which can be physical, or phycological, (poor diet, poor sleep, too much/too little exercise, demanding work/life, unhappy relationships etc ) It also helps give you the energy to get up in the morning, and declines at night so you can go to sleep. It helps us think clearly and run for our lives when in danger. When this hormone gets disrupted most often through chronic stress, you can get too much or too little being produced resulting in fatigue, insomnia, reproductive issues, digestive issues and an increase in anxiety due to cortisol interfering with brain neurotransmitters.
Sex Hormones.
During the perimenopause transition, oestrogen is fluctuating high and low, before it levels out post-menopause, and at the same time progesterone, which has a calming effect on the brain is also declining, and so is testosterone. Our sex hormones do so much more than regulate our menstrual cycles, making babies and giving us our female features, they support
Bone health
Mood/brain function
Bodyweight and composition
Sleep
Skin and hair health
Metabolism
Cardiovascular health
Any hormone imbalances present before going through perimenopause can result in increased anxiety and depression among other things. This is why testing can be so beneficial to uncover these imbalances and reduce any symptoms you might be experiencing.
Thyroid Hormones
Your Thyroid hormones control your metabolism and that includes energy to your brain. When your thyroid isn’t functioning as it should, this disruption of energy can result in anxiety, depression, brain fog, fatigue, weight gain, feeling cold and more. Thyroid dysfunction is very common in women and the risk increases in women over 40. It’s also underdiagnosed in mainstream medicine, many women have suboptimal thyroid function really affecting their health, but their labs appear normal. This is because often only TSH and T4 are tested. To get a real picture of thyroid health we test all the thyroid hormones and consider any thyroid-associated symptoms, so we can support optimal thyroid function.
Insulin
This hormone is secreted by the pancreas, and its main function is to take glucose, which is the breakdown product of carbohydrates from your food, out of the blood and into the cells for energy. When we eat too many carbohydrates, in particular from a high sugar/refined carb/processed diet, resulting in more insulin being produced. When this happens over a long period of time the body can become resistant to insulin, which results in even higher insulin and glucose levels which can cause inflammation in the body and brain, which will alter neurotransmitters and mood. Eventually, this insulin resistance can lead to Type 2 diabetes. An expanding waistline can be a sign of insulin resistance and women over 40 are more susceptible to this, as oestrogen plays a protective role in our 20s and 30s against it. As oestrogen declines, we can’t get away with the poor diet and lifestyle habits that we may have had when younger. With the right healthier habits it’s easy to turn this around.
Gut Health
We have known about the link to over health and wellbeing to the gut, but we now also know there is a direct link between your gut health and brain health. For anyone coming in with anxiety, depression or other brain mood disorders, we always investigate the gut. Sometimes you will have obvious gut issues, however, it’s equally likely that you don’t have gut issues, and it would only be discovered through a comprehensive stool test.
Nutrient Deficiencies
Certain vitamins and minerals are crucial for brain health, and while I believe in diet first, we live in a world where it’s often really difficult to get all we need from diet alone. Even for those who have the perfect diet, I always recommended a multi on top of that as a kind of ‘insurance policy’.
The following nutrients are needed for brain health and neurotransmitters.
Magnesium is very calming and unless you’re constipated, in which case magnesium citrate is good, get magnesium glycinate, or bisglycinate.
Vitamin B complex with B12 (as methylcobalamin NOT cyanocobalamin), B6 helps to make neurotransmitters like serotonin, B2, choline, B9 (as Folate not folic acid) helps methylation, a process in the body that profoundly affects neurotransmitter production.
Omega 3 fats (EPA and DHA) tackles inflammation, which is often a contributor to anxiety/depression. Make sure you buy a good quality brand, that’s 3rd party tested for heavy metals and is stored correctly as these can become rancid easily.
There are other adaptogenic herbs and supplements that can help, however, you need to work with a qualified practitioner to make sure they are right for you.
7 Tips to Help with Anxiety
1. De-Stress
Adopt stress management activities into your daily routine, everyone is different so find out what works for you. Read some tips here.
2. Lower Carb
If you think you have insulin resistance, a lower carbohydrate diet will help. You needn’t be very low carb, just eliminating sugar, processed foods, baked goods, is a good start! If you would like more info, you can download my free guide here.
3. Support Thyroid
If you suspect an underactive thyroid, get it properly tested, is it just underactive due to lack of supportive nutrients, is it autoimmune, is it due to other hormone imbalances?
Nutrients to support the thyroid are iron, vitamin A, vitamin D, zinc, selenium, iodine. (If you do have an autoimmune thyroid condition, Hashimoto’s, then work with a practitioner if using iodine).
4. Look After Your Gut
Eliminating foods that you might be sensitive to for a few weeks to notice how you feel, I wrote about this in my ‘Feeling Bloated’ article.
Eat foods rich in probiotics such as yoghurt, sauerkraut, kefir, kombucha (homemade is best) to promote healthy gut bacteria.
5. Exercise
Exercise benefits health from head to toe. So it’s no surprise that it helps with stress relief and anxiety!
6. Herbal Support
Quality is important for any noticeable effect, try to get these from a herbalist or other qualified practitioner.
Ashwagandha (may not be suitable if you have an autoimmune condition, check with your practitioner)
Rhodiola
Lemon Balm
Chamomile
7. Get Tested
As always, getting to the roots cause is the ideal situation, and if you feel you need help, get in touch especially if you feel your anxiety/depression is not due to any current emotional or life stresses, or if you feel your ability to deal with stress is making it hard to cope.
