Anxiety is often one of the first changes women notice as they enter perimenopause — and it can be unsettling. Because it’s not widely talked about, many women don’t immediately connect feelings of nervousness, restlessness, or unease with this stage of life. For some, anxiety shows up as a constant undercurrent of worry; for others, it comes in waves, triggered by hormonal shifts and sleepless nights.
If you’ve felt these changes, you’re not alone. Let’s explore why anxiety is so common during perimenopause, what symptoms to look out for, and gentle, natural ways to help you feel more grounded again.
What causes anxiety during perimenopause?
The primary driver is hormonal fluctuation.
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Estrogen supports the production of serotonin — one of your “happy” neurotransmitters. As estrogen levels rise and fall unpredictably, serotonin balance is disrupted, leading to mood swings and anxiety.
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Progesterone, often called the body’s natural calming hormone, steadily declines during perimenopause. This reduction can remove its stabilising effect, leaving you more prone to unease, nervousness, or agitation.
Add in common menopause symptoms like hot flashes, poor sleep, and fatigue — and your nervous system is under constant stress.
Signs of perimenopausal anxiety
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Persistent worry or nervousness
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Restlessness or agitation
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Feeling of unease or loss of control
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Difficulty concentrating
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Irritability
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Racing heartbeat or panic attacks
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Sleep disturbances
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Racing thoughts or overwhelm
Natural ways to ease anxiety
The good news: there are many lifestyle shifts and natural supports that can help calm anxiety during perimenopause.
Herbal Support
St. John’s Wort
Long used in traditional herbal medicine, St. John’s Wort is one of the most researched natural remedies for mood balance. Studies show it can be as effective as some pharmaceuticals for mild anxiety and low mood, with fewer side effects. Its active compounds support neurotransmitters like serotonin, helping to restore calm and emotional stability.
Saffron
Known as the “sunshine spice,” saffron has a growing body of scientific support for its role in boosting mood and easing anxiety. Compounds like crocin and safranal help regulate serotonin and dopamine, while its antioxidant properties add extra support for overall wellbeing. Clinical trials have shown saffron extract to be as effective as certain prescription medications in reducing anxiety.
Lifestyle Shifts That Help
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Exercise regularly — Even a brisk daily walk supports endorphins and relieves stress.
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Balanced nutrition — Omega-3s, magnesium, and B vitamins are key for mood stability.
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Mindfulness & relaxation — Deep breathing, meditation, or yoga calm your nervous system.
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Sleep hygiene — A consistent bedtime routine, cool environment, and screen-free evenings improve rest.
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Stay connected — Sharing experiences with loved ones or support groups reduces feelings of isolation.
Finding your balance again
Studies suggest that 60–90% of women experience some level of anxiety during perimenopause. If you’ve had postnatal depression or severe PMS, you may be even more sensitive to hormonal changes. While occasional worry is a normal part of life, during perimenopause these feelings can become frequent and harder to manage.
The important thing to remember is: you don’t have to just “push through.” Whether it’s lifestyle changes, natural supplements, or talking to your doctor about HRT, there are options to help you regain balance.
