Hormone Changes And Low Estrogen May Increase The Risk For Anxiety Symptoms
One reason you may experience anxiety during menopause is due to changing hormone levels. As we mentioned, hormones during menopause typically start to fluctuate, change, and decrease. Low estrogen levels during this time are likely responsible for many menopause symptoms, like hot flashes and mood changes. Many believe estrogen also plays a role in anxiety during menopause. Many women notice their anxiety symptoms get better after beginning HRT with estrogen for their menopause symptoms. In fact, one 2009 study in Gender Medicine journal looked at the relationship between estrogen and behavior linked with anxiety and depression. The researchers found that higher scores for anxiety and depression were associated with lower estrogen levels. Therefore, low estrogen and hormone imbalances during menopause may contribute to anxiety during this stage of life.
Estrogen’s Effects On The Brain
Some of estrogen’s effects on the brain and nervous system include:
- Regulating neurotransmitter systems that affect mood, like serotonin, dopamine, epinephrine, and norepinephrine
- Sensitivity to the fluctuation of estrogen levels in the amygdala, which is linked to mood regulation
- Stimulating beneficial mood-related actions in the hippocampus
Some women may be exceptionally sensitive to changes in hormone levels, causing them to be more susceptible to depression when these levels are off.
Can Menopause Cause Depression
Jennifer Payne, M.D.
The time leading up to menopause is a physical and emotional roller coaster for some women. The so-called change of life comes with a host of symptoms triggered by hormonal shifts hot flashes, insomnia, mood fluctuations and even depression.
When women go through sudden hormonal changes like those that come with perimenopause, puberty, postpartum and even their monthly cycle, theyre at a higher risk for depression, says Jennifer Payne, M.D., psychiatrist and director of the Women’s Mood Disorders Center at Johns Hopkins. In general, women are twice as likely as men to develop the condition.
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Will Anxiety Get Worse
It may for a while, says Dr. Vaidya: Studies of mood and anxiety during menopause have generally revealed an increased risk of depression during perimenopause with a decrease in risk during postmenopausal years. The Penn Ovarian Aging Study, a cohort study, showed depressive symptoms increased during the menopausal transition and decreased after menopause.
Do Adrenal Glands Cause Anxiety
But when the signal of safety is far and few between your body adapts to keep you safe by shutting down your fertility.
Now I recognize that fewer and fewer women are wanting to become moms. In fact, in the last 3 decades weve seen less women reporting a desire to become a mom and more women embracing the concept of a childless life. There’s no right or wrong to this and whatever you choose for yourself is 100% your business and should be well respected.
But maybe youre thinking right now that this concept of shutting down your fertility is good thing? Its not.
Having a baby is an option. Having amazing health without being fertile is not.
Side Note: If youre in your fertile years then our goal should be to maintain your fertility. If youve gone through menopause then you should not be fertile and that is ok.
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How Can I Prevent Low Estrogen Levels
You cant avoid drops in estrogen associated with getting older. You can put healthy habits into place that lead to overall balance in your life including more balanced hormones. These changes dont always require hormone therapy. For instance, exercising in moderation and meditation can help with sleep disturbances and fatigue associated with low estrogen. Getting enough calories and the right kinds of nutrients can improve every aspect of your health. Using a lubricant can make sex more pleasurable.
Depending on whats causing your low levels and the severity of your symptoms, you may need medicine to help. Speak with your provider about your options.
Hormonal Ways To Relieve Social Anxiety
Although hormonal changes may be related to social anxiety, treatment with hormonal therapy is not currently a common recommendation. Instead, your best option is some form of traditional treatment for SAD as well as understanding and adapting to the role of hormones in your anxiety.
What is not helpful is self-medicating. Try to avoid temporary “fixes” like sugar, alcohol, smoking cigarettes, or other substances that give you a quick feel-good surge but don’t solve the long-term anxiety problem. Below are six tips to get you started.
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So What Is Happening Hormonally
Poorly functioning hormones can be a contributing factor to the onset of anxiety. It can be caused almost exclusively by hormonal imbalances, but more commonly a combination of hormones and previous mental health issues or nothing to do with hormones at all.
To have a better understanding it may be beneficial to take a closer look at how the hormones cortisol, estrogen/testosterone and thyroid maybe contributing.
Its often difficult to pinpoint as hormonal imbalance may have caused the anxiety or the anxiety may have caused the hormonal imbalance, but either way, through an improved diet and exercise regime, the symptoms can be eased and controlled.
What Are The Solutions Lifestyle Choices Naturopathic Solutions Medical Interventions Apps
Dr. Vaidya: There are several modalities, interventions, lifestyle changes, and diets that are available out there however, the most important thing is to create a program that is easy to use and adapt. We know from studies that lifestyle changes such as having a balanced diet and getting good exercise can have real benefits. Cognitive behavioral therapy as well as mindfulness and relaxation techniques have demonstrated significant improvement in symptoms of anxiety. Supportive groups, whether online or in person, are helpful as well however, it is important not to overwhelm yourself. Approach treatment at your own pace.
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What Tests Will Be Done To Diagnose Low Estrogen
There are three types of estrogen that your body makes. An estrogen test can measure all three: estrone , estradiol and estriol . Your provider will do a simple blood draw and send it to a lab for analysis.
- Estrone is the primary hormone your body produces during menopause and postmenopause. Its a weaker form of estrogen than estradiol .
- Estradiol is the primary hormone your body produces in your reproductive years.
- Estriol is the primary hormone your body makes during pregnancy.
Estrogen can be assessed when your provider is unsure about the status of your hormones . That being said, only a couple of conditions are FDA-approved for hormone replacement therapy.
Stop Overtraining And Undereating
You probably know how passionate I am about helping women heal their bodies from overtraining and undereating!
And unfortunately, hormonal imbalances, including low estrogen, are just another symptom of this all too common phenomenon.
Training too hard and for too long is a huge stressor on our bodies.
And when you combine overtraining with not consuming enough calories, hormone imbalances are bound to show up.
Stress and the inflammatory cytokines produced from constant, strenuous exercise actually down-regulate your sex hormones. This can lead to symptoms of low estrogen, along with a variety of other hormonal imbalances.
If you think you might be overtraining, heres an article I wrote on some of the classic signs to watch out for.
And if you need help shifting your mindset and routine from a pattern of overtraining and undereating to one that is more health promoting, Im here to help!
Ive helped hundreds of women, both in my online programs and as private coaching clients, recover their health from the effects of overtraining and undereating.
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Why Does Your Estrogen Level Matter
Estrogen is a hormone. Although present in the body in small amounts, hormones have big roles in maintaining your health.
Estrogen is commonly associated with the female body. Men also produce estrogen, but women produce it in higher levels.
The hormone estrogen:
- is responsible for the sexual development of girls when they reach puberty
- controls the growth of the uterine lining during the menstrual cycle and at the beginning of a pregnancy
- causes breast changes in teenagers and women who are pregnant
- is involved in bone and cholesterol metabolism
- regulates food intake, body weight, glucose metabolism, and insulin sensitivity
Girls who havent reached puberty and women approaching menopause are most likely to experience low estrogen. Still, women of all ages can develop low estrogen.
Common symptoms of low estrogen include:
Ways To Support Balanced Hormones And Reduce Anxiety
Hormone imbalances can feel like an emotional rollercoaster. Fortunately, there are several natural ways to support balanced hormones to reduce feelings of hormone-related anxiety.
Exercise daily: Regular exercise is linked to a reduced risk of developing an anxiety disorder by lowering cortisol and adrenaline levels and releasing endorphins.
Find strategies to manage stress: We now know that stress can cause the production of more stress hormones, creating a vicious cycle. Relaxation techniques like meditation and yoga have been shown to help some individuals manage their stress and anxiety levels.
Improve your diet: Research shows that filling your diet with fiber-rich foods, fermented foods, and omega-3s can reduce levels of stress/anxiety and potentially improve mental health. If you have a condition like IBS or celiac disease, learning which foods to avoid can also help improve your mental and physical health.
Get enough sleep: Poor sleep has been linked to multiple hormone imbalances. If you’re suffering from anxiety, take a look at your sleep routine to see where you might be able to make improvements.
If you suspect you may have a hormonal imbalance, consider testing your hormone levels. This can give you and your primary healthcare provider clarity on whether your anxiety is a symptom of a hormonal imbalance or not. Anxiety can be debilitating, so be sure to seek guidance from a mental health professional and/or call this national helpline at 1-800-662-HELP .
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Anxiety And Hormones Before Your Period
Now heres where that anxiety-hormone connection comes in.
What is left behind in the ovary once the egg is released is the corpus luteum. The corpus luteum is responsible for secreting progesterone for about 2 weeks following ovulationregardless if the egg is fertilized or not.
Progesterone in balance hits a womans brain with a sense of calm and deep sense of love and connection for the world around here. It does this by stimulating GABA receptors, which puts the shush on neuroexcitatory neurotransmitters.
Can High Cortisol Cause Panic Attacks
Your bodys chooses survival over fertility. Thank goodness for that! I mean, if there is a chance I need to run from a tiger then I do NOT want to be pregnant or toting a noisy little human .
When stress goes high, so does cortisol.
Ever heard of the pregnenolone steal? Sometimes it is called the progesterone steal because that is exactly what is happening. Your body steals away from making progesterone in order to make cortisol.
So, high cortisol and anxiety go hand in hand. All is well and good until that stress is chronic and you find yourself in a state of HPA-dysregulation . When this happens you find yourself pushing epinephrine and norepinephrine, which tell your brain to freak out and all the while you are reducing progesterone, which tells your brain to be calm.
Is it any wonder women suffer from anxiety?
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Set The Tone Of The Day
Start your day off with 5 deep breaths, a quick yoga sesh and some meditation to set the tone of the day.
Sound difficult? Heres how to do it.
When your eyes pop open, bring your attention to your breath. Begin to lengthen the breath, feeling your ribs expand laterally and your belly gently rise. Take 5 breaths like this.
Stepping out of bed and onto your mat, find a place in your home with enough room for a sun salutation. Using the Down Dog app, turn on a 10 minute yoga sequence of your choice. At the end, take a seat and create a comfortable sitting position.
Use your phone to set a timer for 5 minutes, close your eyes and focus again on your breath. Your mind may wander to other parts of your bodythats ok. Observe where your attention is being called and ask why.
If your mind wanders to thoughts of your email inbox or distracts you with your to do list, simply acknowledge and release them as you return to your breath. When your alarm goes off you are finished with your morning routine.
This all takes less than 20 minutes and can be incredibly transformative.
Cant give 20 minutes?
Start with 3 deep breaths, 5 minutes of yoga and 5 minutes of meditation.
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Why Women Worry: How Hormones Affect Anxiety And What We Can Do About It
Dr. Rebecca Schnatz helps us understand the causes of anxiety and tips for finding relief.
We have surpassed the one-year mark of the COVID-19 pandemic, and I want to take the opportunity to discuss something many people have been dealing with a lot over the past year: anxiety. Ive noticed a profound increase in anxiety, depression, and mood concerns due to the COVID-19 pandemic, with varied effects on womens lives. But there is also a lot that happens within a womans body that can contribute to anxiety.
As a womens health professional, I spend a large amount of my time with patients discussing the various aspects of female hormones and their effects on day-to-day life. Having a better understanding of how hormones affect our worries and perhaps finding ways to control them may be especially helpful these days. Lets take a look.
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Whats Happening Inside Your Body
Anxiety is the way the body prepares to respond to a stressful situation or threat. For a short while, the heart races, blood rushes to the brain, blood pressure spikes, and breathing becomes faster. These events are mediated by a flood of stress hormones like adrenaline and cortisol, which is triggered by the brain. As a result, youâre mentally and physically primed to handle the source of stress.
For people experiencing menopause, these hormonal shifts occur against the backdrop of steadily decreasing estrogen and progesterone. The role of estrogen in regulating mood is complex and not fully understood. Research has linked estrogen in the brain to increased serotonin, the production of endorphins, and the protection and growth of neurons. These effects may change as estrogen levels drop.
What Our Patients Say
As of March 2021, I have been a HerKare patient for 3 years. I have driven from the Austin to Ft. Worth and Southlake since March 2018. In fact, today I attempted to drive to Southlake to see the provider, Dania Khoncarly, because she is so amazing, but the roads were too dangerous with the current ice storm in Texas, so I visited the Mansfield location instead as it was closer for me. The patient care has been nothing short of amazing. In fact, I cant imagine my life without HerKare. I struggled with hormone deficiency since 2003 until March 2018. The treatment plan provided by HerKare has positively impacted my way of life socially, emotionally, and physically. One of my closest friends now drives from Copperas Cove to the Mansfield location. I have several friends in my age group mid to late 40s & early 50s who would benefit from HerKare. I understand with our nation experiencing COVID, now might not be the time to open a new location, however, your services could positively impact the well-being of so many women. When the time is right, please open more HerKare locations!
Patient since March 2018
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Which Hormones Cause Anxiety
A good step to take towards minimizing hormone-related anxiety is understanding which hormones can affect your mood and response to stress. These include sex hormones, stress hormones, thyroid hormones, and oxytocin. While each plays a pivotal role in the functioning of the bodyâs processes, too much or too little could cause complications.
What To Do Next:
- Connect with a mental health professional: A doctor, psychologist, psychiatrist, or licensed clinical social worker can talk to you about your anxiety symptoms and family and medical history, and provide a diagnosis, if needed.
- Discuss your treatment options: Your mental health specialist may recommend lifestyle changes, medication, psychotherapy, hormone therapy, or a combination. Since anxiety may subside once menopause ends, your specialist may also help you manage a timeline for your treatment.
- Find treatments that work for you: Listen to your body, paying attention to the treatments it responds to well. With the help of your medical provider or therapist, create a treatment plan that works best for you.
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Cross Talk Between Estrogen Receptors
The above discussion has focused on the individual contribution of each estrogen receptor in anxiety and anxiety-like behavior. However, evidence suggests that these receptor subtypes are capable of interacting with one another. One such example is the relation between ER and ER. Male ER knockout mice show decreased expression of ER protein within the medial preoptic area and increased expression within the bed nucleus of the stria terminalis, suggesting that ER expression can be modulated by ER. This observation can be coupled with a relative insensitivity to estradiols effects on ER expression, as assessed through gonadectomy and estradiol replacement although this lack of effect may be brain region dependent . GPR30 and ER have also shown some interdependence. A recent study by Hart et al. found that GPR30s agonist G-1 increased protein expression of hippocampal phosphorylated ER in male mice . In addition, an in vitro study using ovarian cancer cells reported that both GPR30 and ER were required for either estradiol or G-1 to induce an upregulation in expression of the oncogene c-fos . The relation between ER and GPR30 has not yet been assessed. In sum, these findings demonstrate that estrogen receptors do not function entirely independently of one another, which likely has implications for estrogen receptors mediation of anxiety.