The Link Between Progesterone and Anxiety in Perimenopause
My blogging theme for December has officially become “anxiety in perimenopause.” Part of this is due to my fibromyalgia diagnosis and the mini crisis (read: anxiety) I’ve been experiencing as a result. The other part is due, as I have said in other posts, to the frequent comments and questions I receive from women who suffer with anxiety in perimenopause. It’s definitely a troublesome symptom.
I recently asked the Chief Medical Officer of the physician’s group, Body LogicMD, Dr. Jennifer Landa, why it is that so many women suffer with intense anxiety during perimenopause. While her answer probably won’t be news to some of you – since I’ve discussed this topic fairly often – it’s always good to hear it (again) from a physician!
Dr. Landa, so many women suffer with anxiety and panic attacks when they begin to enter perimenopause. What causes it, and more importantly, what can we do about it?
From Dr. Jennifer Landa:
Anxiety during perimenopause is a very common issue. All too commonly it is treated by primary care doctors, psychiatrists and even gynecologist using SSRI medications like Zoloft or Prozac. But, alas, as I am fond of saying, these women DO NOT have a Zoloft deficiency. It is more likely that they have a progesterone deficiency.
In a normally cycling woman, the hormones estrogen and progesterone exist in perfect harmony, rising and falling at set times in a woman’s cycle to control her bleeding but also to keep her feeling her best. Around age 30, but many times even younger, progesterone levels start to fall. The problem begins here because progesterone is a woman’s calming hormone.
Without progesterone women may begin to feel more overwhelmed and easily stressed. In many women, this leads to anxiety issues, including tension headaches, palpitations, digestive issues and more - and in some cases, even full blown panic disorder.
When stressed, the human body manufactures the stress hormone cortisol. All hormones are made from essentially one parent hormone. To keep up with stress, the body will preferentially make cortisol, therefore all the other hormones suffer, chiefly progesterone. So, the more stressed an individual is, the more suppressed progesterone production becomes, often exacerbating anxiety symptoms.
The Role of Estrogen Dominance
Compounding the whole problem is the issue of estrogen dominance. When progesterone declines, women often suffer from estrogen dominance, which means that she doesn’t have enough progesterone to keep up with the amount of estrogen.
This leads to symptoms like anxiety, sleeplessness, irritability, mood swings, breast tenderness, weight gain, bloating and more. This problem is further aggravated by the presence of xenoestrogens – estrogen-like compounds that exist in the environment. These can be in the form of chemicals in household products, such as shampoo and body lotion. Harmful ingredients in these products include parabens, like methyl, ethyl and propylparaben.
People are also exposed to hormones through food. Sadly, hormones are injected into chicken and cows that are raised to be a part of the human food supply.
The solution is to decrease your exposure to xenoestrogens and decrease stress through relaxation techniques, such as meditation, yoga, tai chi, massage, deep breathing, etc. It is important to evaluate stressors in your life and remove what you can. There are supplements that may be helpful for decreasing cortisol production including B vitamins, vitamin C, magnesium and ashwagandha - just to name a few.
Some women may need support with progesterone supplementation. If you suspect these issues, you can obtain hormone testing with a hormone specialist who can guide you in the proper supplementation of progesterone that will help restore balance and your peace of mind!
Magnolia Miller is a certified healthcare consumer advocate in women’s health and a women’s freelance health writer and blogger at The Perimenopause Blog.