How Female Hormonal Changes Can Contribute to Anxiety and Panic Attacks

Some women are more sensitive to hormonal fluctuations than others. For many women, anxiety issues appear for the first time during periods of hormonal change. For other women, hormonal changes intensify previously existing anxiety symptoms. 

Anxiety is one of the most common symptoms of Pre-Menstrual Syndrome (PMS), post-childbirth, and perimenopause (the period of time before the onset of menopause). It may take the form of panic attacks, nervousness, sweating, intense fear, anxiety combined with depression, or other overwhelming symptoms. 

Here are several periods of hormonal change that can intensify or trigger anxiety in women. 

Puberty -- Developing girls experience hormonal changes as they prepare to begin their reproductive years. 

Monthly menstrual cycle -- Often girls and women experience PMS the week before their period. 

Following childbirth -- The severe drop in certain hormones following childbirth can cause dramatic physical symptoms and a temporary feeling of depression or anxiety; in some women, it is prolonged.

Perimenopause -- Perimenopause is the period of time when the body is approaching menopause. It may last from two to ten years. During this time the menstrual cycle becomes irregular as the hormone levels keep fluctuating, causing some women to experience PMS-like symptoms.

Although many of us may use the term "going through menopause" to describe this period of time, it is actually called perimenopause. Many women experience panic attacks for the first time during perimenopause. Other symptoms such as insomnia, hot flashes, rapid heartbeat, and sweating are also common. 

With surgical menopause (hysterectomy), you'll likely experience perimenopausal symptoms after the surgery, even if you did not experience symptoms prior to surgery. Symptoms can be prolonged and are due to the dramatic and sudden decrease of certain hormones as a result of the hysterectomy.  

In non-surgical circumstances, menopause occurs after a woman has no periods for twelve consecutive months. It lasts only one day. Many women report feeling better than ever mentally and physically after menopause, due to the fact that hormone levels stabilize.

Hormonal Change Triggers the Fight Or Flight Response

Due to the fact that hormonal change causes physical and psychological stress, it triggers our "fight or flight" response. The fight or flight response is the body's inborn, self-protective response to perceived danger. 

When we perceive that we are under stress, our bodies send out a rush of cortisol, adrenaline, and other brain chemicals to prepare us to "fight" or "flee" the danger. 

The fight or flight response triggers the physiological changes that we associate with anxiety, such as rapid heartbeat, increased blood pressure, sweating, muscle tension, narrowed mental focus, heightened emotion, and many other symptoms. 

These are the same physical sensations that many women experience when their hormone levels fluctuate. In other words, most of the symptoms women experience during times of hormonal change are really fight or flight reactions. While these physical sensations are not dangerous, they can be very intense and overwhelming.

Our fight or flight response mechanism can become "hypersensitive" with the various hormonal changes in our bodies that take place from puberty to menopause. Many of us are in a constant state of stress due to our lifestyle and thought patterns, which also causes hypersensitivity.

In other words, our bodies may be stuck in the "on" switch of fight or flight. What normally wouldn't trigger symptoms, now initiates symptoms and perpetuates an ongoing cycle. 

Fight or flight reactions in and of themselves are harmless. However, when our thoughts convince our rational minds that these symptoms are scary and dangerous, we create an anxiety cycle.

Anxiety consists of more than fight or flight reactions acting by themselves. Unproductive thoughts play a critical role in creating and perpetuating the anxiety we experience.
 
Our thoughts convert fight or flight reactions into anxiety, and a self-perpetuating cycle begins. Soon we find ourselves limiting our behaviors because of anxiety as well, which further entrenches the vicious cycle.

When a person is under stress, unresolved emotions and issues commonly come to the forefront. Because hormonal change is a major stressor, it can bring up internal conflicts and self-doubt in many areas of our lives. All of a sudden, we may find that the negative self-talk that we successfully pushed to the background of our lives during less stressful times is now playing center stage. 

During periods of hormonal change, we may also feel uncertain about our changing roles (e.g. maturing from girl to woman, becoming a mother, becoming a mature woman past childbearing years), which can add to our internal conflict. 

When we fail to successfully resolve internal conflicts and the unhelpful thought patterns that contribute to them, we create a breeding ground for anxiety. Combined with fight or flight symptoms, it's no wonder that these unproductive thoughts create and perpetuate the anxiety cycle! 

What can you do if hormone-related anxiety affects you?

Here's some great news! The same tools that you can use to overcome anxiety due to other reasons can help you to conquer anxiety related to hormonal changes too.

Research shows that cognitive-behavioral techniques that help you change unhelpful thoughts and behaviors, lifestyle changes, relaxation techniques, and nutritional strategies (all found in our Conquer Anxiety Success Program) can help women dealing with hormonal changes.

These types of strategies not only help women regain a sense of control over their lives, but actually achieve improved physical and emotional well being! Here are a few tips to get you started:

-- Focus on reducing preventable stress in your life that triggers the fight or flight response -- stop the yo-yo dieting; increase sleep to eight or nine hours a night; exercise regularly; don't skip meals; cut back on your frantic schedule; and decrease stimulants, such as caffeine. 

The body isn't designed for constant stress. When we are bombarded with stress, our ability to cope can become overwhelmed because the elevation in stress hormones makes the fight or flight switch remain "on."

-- Learn how to train your body to respond differently to stress so that you can automatically turn the false alarm "off" when the fight or flight response is triggered. Relaxation techniques such as deep breathing, yoga, meditation, and progressive muscle relaxation can help you achieve this goal.  

-- Most importantly, learn how to change how you think. Our thoughts are what convert the harmless fight or flight response into a vicious cycle of anxiety. Remember, just as our thoughts hold the key to creating anxiety, they also hold the key to eliminating it!