Anxiety is normal in perimenopause. But new research finds that it’s also common when you’re postmenopausal. The anxiety can last for years—and it’s strongly associated with severe symptoms that can really interfere with your quality of life. Whether it’s the anxiety that’s making the menopausal symptoms worse or vice versa isn’t known—but the good news is that the same remedies that reduce menopausal symptoms such as hot flashes also may help you feel less anxious.

Background: It’s well-known that the symptoms of menopause can be extremely bothersome and disruptive for some women. It’s also known that many women experience an increase in anxiety in perimenopause. But are there links between bothersome symptoms and anxiety in postmenopausal women, too? A recent South American study examined the issue.

Study: Researchers analyzed records of 3,503 postmenopausal women. The women answered questionnaires that measured, among other variables, their anxiety levels and 11 menopausal symptoms.

Results: Anxiety and severe symptoms were strongly linked. The likelihood of having severe symptoms—especially hot flashes, sleep problems, a racing heart, and muscle and joint pain—was five times higher in postmenopausal women who reported that they felt anxious. Anxious women were also more likely to have severe urogenital symptoms such as bladder problems and vaginal dryness. Like menopausal symptoms, the anxiety lasted for some women in the study long after their last menstrual periods.

Mind/body links: While this study doesn’t demonstrate whether anxiety contributes to severe symptoms or severe symptoms bring on anxiety, there are physiological reasons to believe the connection is a two-way street, according to the researchers. For example, anxiety boosts stress-related neurotransmitters such as norepinephrine, which are known triggers for hot flashes and night sweats. According to research at Harvard and Emory University, estrogen may protect against feelings of fear, so when estrogen levels plummet, the result can be stress and anxiety.

Bottom line: It’s a wake-up call for women with anxiety and bothersome menopausal symptoms to get help, since the combination makes things so much worse—and may not go away for years. If your menopausal symptoms are making your life miserable and you’re feeling particularly anxious, the good news is that that you can improve the situation from either direction—managing your menopausal symptoms may reduce your anxiety, and learning nondrug ways to get calm may help you have fewer really bothersome menopausal symptoms. Anxiety might be improved with relaxation, reducing caffeine or regular exercise. Some botanical remedies accomplish both goals simultaneously—hops, for example, has been shown to reduce both hot flashes and anxiety. So has aromatherapy with neroli oil. If your anxiety persists, however, get professional help to determine whether hormone therapy or other mood medications might be helpful for you.

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