Most women are familiar with feelings of anxiety. Whether it’s a few pre-menstrual jitters, anxiety about work, or worrying about your child on their first day at school or college, we know what it’s like to experience that sense of panicky dread and uncertainty. But during midlife, a new kind of anxiety emerges. One with no particular rhyme or reason but enough power to make you think you’re losing your mind.

Katherine Tyack-Grant, from Yorkshire, UK, was in her early forties when she began to experience overwhelming anxiety.

“We had recently moved house and the cat went missing for a few days, which made me feel a little anxious,” she explained. “But then it began to increase. I was incredibly anxious about everything and felt like I couldn’t breathe properly, and my heart was racing.” 

Her doctor dismissed the idea of this anxiety being linked to hormone changes, saying she was “probably too young for that.” It wasn’t until more physical signs of menopause began to appear, like night sweats and brain fog, that Katherine got the help she needed to manage her anxiety.

Katherine is not alone in her experience. When I recently asked about anxiety in a chat group for menopausal women, the response was huge. It seems like anxiety is one of the biggest midlife challenges women are dealing with, and often in silence. So, what is happening when we reach midlife that makes us feel so anxious?

What are the causes of midlife anxiety?

The hormonal ups and downs of perimenopause are one of the most common causes of midlife anxiety. When progesterone and estrogen start to fluctuate in the run-up to menopause, our mental resilience changes and we become more prone to feeling anxious.  And not just about big events that might normally be expected to instigate anxious feelings. This new midlife anxiety takes hold of everyday things like driving, shopping, and socializing. 

Progesterone levels are the first to drop as we have fewer ovulatory menstrual cycles. Without ovulation,, we don’t produce progesterone to counterbalance estrogen. Then, as we get closer to menopause, estrogen declines too.  Both estrogen and progesterone affect mental well-being and mood balance; estrogen influences brain energy and has a protective effect on cells, while progesterone helps the brain adapt and cope with stress.  

In a study of 129 healthy perimenopausal women aged 45-56, those with relatively higher levels of progesterone experienced lower levels of perceived stress and depressive symptoms, highlighting the role progesterone plays in our capacity for resilience.

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This is just a short slice of the article — read the whole article, including Sally Duffin’s nutrition tips — here on the brand-new Midst Substack.