HOW HORMONES CAN IMPACT ANXIETY
Women are almost twice as likely as men to be diagnosed with an anxiety disorder in their lifetime. While there are likely numerous factors that contribute to this discrepancy, one to consider is how hormonal fluctuations that occur during the menstrual cycle, pregnancy/postpartum, and perimenopause/menopause create a unique vulnerability for women to develop anxiety symptoms.
A Very Basic Understanding of Hormonal Changes Women Experience
An advanced study of female hormones is beyond the scope of this article and my training/expertise. We’ll keep things very simple here and focus on two hormones in particular: estrogen and progesterone.
The Menstrual Cycle
Estrogen and progesterone levels vary throughout the menstrual cycle. Estrogen levels rise rapidly during the first half of the cycle. When estrogen levels peak, ovulation occurs. After ovulation, estrogen levels start to decline. Progesterone levels then rise to prepare the uterus in the event that pregnancy does occur. When it does not, progesterone levels also fall quickly alongside estrogen. Most women go through this sequence of hormonal change roughly once a month.
Pregnancy & Postpartum
During pregnancy, estrogen and progesterone levels surge to support the developing fetus. Immediately after birth, these same hormones plummet back to their normal pre-pregnancy levels.
Periomenopause & Menopause
Perimenopause is the time during which the body starts moving toward menopause, which is reached once a woman has gone 12 months without a period. During perimenopause, estrogen and progesterone levels fluctuate significantly and unpredictably, though with an overall trend of declining estrogen levels. When menopause is reached, the ovaries stop producing estrogen and progesterone entirely.
Estrogen, Progesterone, and Your Mental Health
Why does all of this matter? Because estrogen and progesterone affect the brain and therefore women’s mental health.
Estrogen raises levels of serotonin and dopamine, the neurotransmitters that regulate mood, support emotional stability, foster motivation, and enhance cognitive functioning. As such, when estrogen levels are higher, many women report feeling happier, more energetic, mentally clearer, and more social. In contrast, when estrogen levels fall, women can feel irritable, sad, anxious, and fatigued in addition to other symptoms like trouble sleeping and difficulty concentrating.
Progesterone is a calming hormone and it boosts production of GABA, a neurotransmitter that supports sleep and lowers anxiety. Rising progesterone levels, therefore, tend to mean lower anxiety levels. When progesterone levels are low, cortisol increases. Greater amounts of this stress hormone can amplify anxiety symptoms. Falling progesterone levels can also lead to brain fog and disrupted sleep.
What You Can Do About It
If you suspect that hormonal variations might be negatively affecting your mood or anxiety levels, you have many options. These include:
Implementing general healthy lifestyle strategies, including ensuring adequate nutrition, getting regular physical movement, and prioritizing habits that support good sleep.
Practicing intentional stress management, such as by routinely utilizing mindfulness or breathing techniques.
Going to therapy. Treatments that are evidence-based for anxiety and depression generally will also be helpful for anxiety and depression that are hormonally influenced.
Exploring hormone therapies, like birth control or hormone replacement therapy. If this path interests you, make sure you work with a qualified OB/GYN or endocrinologist to find the regimen that best supports you.
Overall, know that you are not alone and that this is not in your head. Hormonal impacts on mental health are real, worthy of attention, and, when they rise to the level of causing you distress or diminishing your ability to function, deserving of treatment.
Please note: This content is for informational and educational purposes only. It is not a substitute for professional diagnosis or treatment. Always seek the advice of a licensed mental health provider or other healthcare professional for guidance related to your specific mental health or medical concerns.
