Perimenopause and Anxiety: Is It Your Hormones or Something Else?

If you're in your late 30s or 40s and suddenly experiencing unexplained anxiety, panic episodes, or mood swings, you're not alone. Many women report increased anxiety during the years leading up to menopause—often without realizing that hormones may be the cause.

At Complete Healthcare in Richland, WA, Dr. Richard Lorenzo and Kortney Jones, ARNP, understand the complex relationship between hormones and mental health. This blog will help you understand how perimenopause affects anxiety, how to tell if hormones are playing a role, and what you can do to feel better.

What Is Perimenopause?

Perimenopause is the transition phase before menopause, when the ovaries begin to produce less estrogen and progesterone. This stage can last anywhere from four to ten years. While most women expect physical symptoms like hot flashes or irregular periods, emotional changes—especially anxiety—are often unexpected and deeply disruptive.

Many women who have never struggled with anxiety suddenly find themselves overwhelmed by worry, racing thoughts, or restlessness. Others may notice that previously mild anxiety becomes more intense or harder to manage.

How Hormones Affect Anxiety

Fluctuations in estrogen and progesterone directly affect the brain. These hormones influence neurotransmitters like serotonin, dopamine, and GABA, all of which help regulate mood and emotional stability.

When estrogen levels decline or become unpredictable:

• Serotonin levels may drop, increasing feelings of sadness or anxiety

• Cortisol (the stress hormone) may spike, leading to irritability and restlessness

• Progesterone levels may fall, removing its natural calming effect on the nervous system

These hormonal shifts can trigger or worsen symptoms of:

• Generalized anxiety

• Panic attacks

• Social withdrawal

• Insomnia

• Feeling overwhelmed or emotionally fragile

At Complete Healthcare, we often hear women describe feeling "not like myself"—a phrase that reflects just how significant this change can feel.

Common Symptoms of Hormone-Related Anxiety

If you're experiencing one or more of the following symptoms and you're between the ages of 35 and 55, hormonal changes could be a contributing factor:

• Sudden or frequent panic episodes

• Racing thoughts, especially at night

• Trouble falling or staying asleep

• Irritability, mood swings, or anger outbursts

• Physical symptoms like heart palpitations or dizziness

• Increased sensitivity to stress or stimulation

• Crying easily or feeling emotionally raw

If these symptoms are new or worse than usual, you’re not imagining things—and you’re not alone.

How We Evaluate Anxiety at Complete Healthcare

At Complete Healthcare in Richland, WA, our approach is thorough, supportive, and personalized. When you come in for an evaluation with Dr. Richard Lorenzo or Kortney Jones, ARNP, we may recommend:

• A full review of your medical history and menstrual changes

• Blood tests to check hormone levels, including estrogen, progesterone, and thyroid function

• Screening for other contributors such as iron deficiency, vitamin D levels, or autoimmune conditions

• Lifestyle assessment: sleep, stress, caffeine use, and physical activity

This comprehensive view helps us determine whether anxiety is primarily hormonal or whether additional factors need to be addressed.

Treatment Options

Once we understand the underlying cause, we can recommend one or more of the following options:

1. Hormone Therapy. For many women, low-dose estrogen or progesterone can significantly improve anxiety, sleep, and mood.

2. Non-Hormonal Medications: Selective serotonin reuptake inhibitors (SSRIs) or anti-anxiety medications may be useful in some cases, especially when symptoms are severe.

3. Lifestyle and Nutritional Support. We may recommend specific changes in diet, exercise, sleep habits, or stress management techniques like meditation or CBT.

4. Supplements: Magnesium, B-complex vitamins, and adaptogens such as ashwagandha may help support mood and hormonal balance when used under guidance.

5. Thyroid or Adrenal Support: If testing reveals imbalances in these systems, we tailor treatments accordingly.

At Complete Healthcare, we prioritize evidence-based, individualized care that addresses emotional and physical health.

When to Seek Help

You do not need to wait until symptoms become severe. You should schedule a visit if:

• You feel anxious more days than not

• Panic episodes or mood changes interfere with daily life

• You are between 35 and 55 and suspect perimenopause

• You feel dismissed by providers or unsure where to turn

Dr. Lorenzo and Kortney Jones take every concern seriously and are here to provide

compassionate, judgment-free care.

Whole-Person Care for Women in Richland, WA

Hormone-related anxiety is real, and it is treatable. At Complete Healthcare in Richland, WA, we are committed to helping women understand and manage the emotional symptoms of perimenopause with expert medical support and personalized treatment plans.

We believe you deserve to feel calm, clear, and confident—regardless of age or hormone levels.

Call 509-392-6700 to schedule your consultation today.

Richard Lorenzo, D.O.

Kortney Jones, ARNP

Complete Healthcare – Women’s Health and Wellness care in Richland, WA