Perimenopause Anxiety in the Morning

Perimenopause is a time of hormonal transition before a woman’s menstrual cycle stops altogether. Due to the drastic hormonal shifts, many women in perimenopause report various uncomfortable symptoms. 

In this article, we’ll review why you may experience perimenopause anxiety in the morning and offer tips to reduce this symptom.

Women have two main reproductive hormones: progesterone and estrogen. Each of these hormones play a different role in your menstrual cycle and overall health. During perimenopause, progesterone levels usually decline first. Progesterone is known as your calming hormone and has many benefits like lowering anxiety and promoting healthy sleep. On the other hand, estrogen controls puberty, your menstrual cycle, and bone health (to name a few). During perimenopause, your estrogen levels may fluctuate and cause symptoms like intermittent hot flashes and/or night sweats.

Mood disorders, like anxiety and depression, are common during perimenopause due to hormonal shifts, life changes, and stress. Anxiety in perimenopause is likely due to the low progesterone nature of this transition. Your body only produces progesterone after ovulation. Irregular ovulation is commonly seen in perimenopause as your body transitions to the eventual cessation of your menstrual cycle. This leads to sporadically low progesterone levels. 

Women may particularly experience anxiety in the morning due to naturally higher levels of cortisol, your prominent stress hormone, during this time of day. Let’s review a few interventions that may help reduce perimenopause anxiety.

Make it a priority to wake up 10-20 minutes earlier each morning so you can practice some relaxation techniques to lower cortisol and anxiety levels. We often recommend box breathing, mindfulness apps like Headspace or Calm, journaling, and meditation.

The majority of Americans are not meeting their magnesium requirements from their diet. Magnesium is an essential mineral that also offers calming and relaxing benefits. Increase your daily intake of magnesium-rich foods like nuts, seeds, beans, and leafy green vegetables. You can also try taking 200 milligrams (mg) of magnesium at night to optimize sleep and reduce anxiety in the morning.

Two of the most important B vitamins for perimenopause mood symptoms are vitamin B6 and B12. These vitamins work for perimenopause anxiety by assisting in the production of GABA, a calming neurotransmitter. If you are vegetarian/vegan or do not eat many animal products, taking a B complex vitamin will be particularly important for you.  You can also increase your intake of foods rich in B6 and B12 by eating more chickpeas, salmon, chicken, beef, and bananas.

Avoid drinking too much caffeine in the morning as this can exacerbate your perimenopause anxiety. A good rule of thumb is to stick to 12 fluid ounces of coffee or less each morning (that’s about the size of a “tall” Starbucks drink). If you find yourself craving more caffeine, try half-caff or tea for a lower dose. Read our article on perimenopause fatigue.

Your breakfast can make a big difference in your mood each morning. Skipping breakfast or eating a breakfast high in sugar can lead to a drop in blood sugar and worsen anxiety. Plus, the hormonal shifts that occur during perimenopause may cause an increased degree of insulin resistance. This means your body cannot metabolize sugar as effectively. Aim to have a source of protein, fat, and fiber-rich carbohydrate in each breakfast with around 30 grams of protein for best results. We often refer to this way of eating as the PFC method. 

Bioidentical progesterone therapy is sometimes recommended for women suffering from perimenopausal symptoms. This is often the most effective treatment because it directly addresses the most common root cause of perimenopause anxiety: low progesterone levels. Talk to your doctor if you think you may benefit from a prescription for progesterone.

Research consistently shows that physical activity is an effective method for reducing anxiety. In fact, menopausal women who exercise are less likely to report anxiety than women who do not exercise (1). Regular exercise can also reduce fatigue and promote better quality sleep during perimenopause (2). Choose the form of exercise that is most enjoyable and realistic for your lifestyle. Even ten minutes a day can make a big difference in your anxiety levels.

Unfortunately, poor sleep is a common symptom of perimenopause due to insomnia from low progesterone, hot flashes, and/or night sweats. Inadequate sleep is a major trigger for anxiety. While bioidentical progesterone can improve sleep quality, you can also implement other ways to ensure you have a better night. For starters, sleep hygiene is particularly important during this time. Keep your bedroom cool and dark, avoid caffeine and alcohol in the evening, and limit screen exposure before bed. Exposing yourself to natural sunlight, especially in the morning, can also support your natural circadian rhythm. Our Sleep Support supplement offers a calming blend of herbs and minerals known to promote quality sleep. 

Perimenopause is a time period of drastic hormonal shifts that may lead to mood symptoms, like anxiety. A supportive lifestyle to include relaxation techniques, exercise, and sleep hygiene is essential. Following the PFC method of eating is also crucial to balance your blood sugar and increase intake of important nutrients like magnesium, vitamin B6, and B12. Finally, taking bioidentical progesterone is very effective in treating the root cause of perimenopause anxiety and reducing other symptoms during this time.