Have you suddenly started feeling anxious for no apparent reason? Perhaps you find yourself worrying about things that never used to bother you, waking in the early hours with a racing mind, or feeling overwhelmed by everyday situations. If you’re in your 40s or early 50s, these feelings could be connected to perimenopause. We often associate perimenopause with hot flushes, night sweats and irregular periods, but anxiety, irritability, low mood and disturbed sleep are also common experiences during this stage of life. The good news is that there are ways to support yourself naturally using nutrition, lifestyle changes and herbal medicines, in this article we’ll look at some of the ways you can naturally reduce these symptoms.
Why does perimenopause cause anxiety?
Perimenopause is the transitional stage leading up to menopause, when your hormones begin to fluctuate. Oestrogen and progesterone levels can rise and fall unpredictably, and these hormonal changes can influence several systems within the body, including those involved in mood regulation, sleep and the stress response. Oestrogen interacts with neurotransmitters such as serotonin, which plays an important role in emotional wellbeing. Progesterone is also involved in pathways associated with relaxation and nervous system activity. As these hormones fluctuate, some women notice changes such as:
- Feeling anxious or on edge for no obvious reason.
- Racing thoughts and difficulty switching off.
- Increased sensitivity to stress.
- Heart palpitations or a feeling of panic.
- Waking during the night and struggling to get back to sleep.
- Irritability and emotional ups and downs.
- Feeling overwhelmed by things that previously felt manageable.
- A loss of confidence or feeling unlike yourself.
5 herbal remedies that may help support anxiety during perimenopause
1. Lemon balm – traditionally used for relaxation and calming the mind
Lemon balm is often enjoyed as a herbal tea, making it a gentle addition to a relaxing evening routine. It’s been traditionally used for helping to calm down the nervous system when feeling stressed and irritable, restless and having difficulty relaxing and switching off.
2. Passionflower – traditionally used for nervous tension and supporting sleep
Sleep and anxiety can become closely connected during perimenopause. When you’re not sleeping well, even small everyday stresses can feel much harder to manage. Passion flower can be helpful when you have a busy racing mind, feel restless at bedtime and when experiencing feelings of nervous tension. This is one of my personal favourites as both a tea and tincture and will often add this into a clients prescription when there is trouble sleeping or when dealing with stress.
3. Chamomile – a great herb when anxiety is affecting the digestion too
A cup of chamomile tea before bed can become a lovely way to slow down and create a moment of calm. It helps to relax the mind and body, especially when there’s also digestive tension such as bloating and stomach cramps. Easy to incorporate as a tea after meals and in the evening, especially if night-time anxiety or difficulty switching off is becoming a problem.
Chamomile is generally well tolerated, although people with allergies to plants in the daisy family should take care.
4. Lavender – supporting relaxation and emotional wellbeing
Some research suggests lavender preparations may help with anxiety in certain circumstances, but the evidence varies depending on the preparation and how it is used. For perimenopausal women, incorporating relaxing sensory experiences into daily life may help create a greater sense of calm. Lavender is commonly used as an essential oil, you can either put a few drops on a tissue and inhale when feeling anxious, add to a diffuser or put a few drops into a bath where you inhale the vapours and absorb a little through the skin. Lavender as a tea tastes quite strong, so I usually add small quantities into a herbal tea blend with other herbs or into a tincture mix.
Always use essential oils diluted on the skin, and don’t ingest essential oils unless specifically directed by a suitably qualified healthcare professional.
5. Ashwagandha – an adaptogenic herb for stress support
Ashwagandha is an adaptogenic herb traditionally used in Ayurvedic medicine, adaptogens are herbs that help the body adapt to stress and they are some of my favourite herbs when it comes to anxiety and stress. Ashwagandha is traditionally used as a powder mixed into hot milk, but I prefer to use this herb as a tincture and like to combine it with other nervous system supporting herbs.
I would always recommend seeking professional advice before considering herbs because some of them can interact with medications and are not all suitable for everyone.
What about St John’s wort and black cohosh?
Two other herbs frequently mentioned in discussions about menopause are St John’s wort and black cohosh. St John’s wort is traditionally used for low mood and is sometimes marketed for menopause-related symptoms, this can be a very effective herb, but it does interact with most medications so I don’t use this herb very often for this reason. Black cohosh is often marketed for menopausal symptoms, particularly hot flushes and night sweats but this herb shouldn’t be used in isolated high doses for long periods, in my opinion it’s always best taken as a tincture along with other herbs.
There are lots of herbs that can hep balance the nervous system and are usually best combined together and taken over a long period of time. This is where a herbalist can select the herbs best suited to your constitution, current health conditions and can check for interactions with any medications you may be taking. If you’ve tried herbs and they haven’t worked for you then you probably weren’t taking the correct herbs or you weren’t taking enough, if the dose is incorrect then they may not be effective.
5 natural ways to support your nervous system during perimenopause
Beyond herbs there are plenty of other ways to support your nervous system, It’s important to take a holistic approach and not just rely on herbal medicines because there may be other areas of your life that are also contributing to your symptoms.
1. Prioritise blood sugar balance
Have you noticed that your anxiety feels worse when you’re hungry or when you’ve gone too long without eating? Blood sugar fluctuations can contribute to feelings such as shakiness, irritability and feeling on edge because blood sugars is tightly connected to the nervous system. Try to:
- Eat regular, balanced meals.
- Include protein with breakfast.
- Combine carbohydrates with protein, fibre and healthy fats.
- Avoid relying on sugary snacks for energy.
- Notice whether caffeine makes you feel more anxious.
A balanced diet helps provide the nutrients your body needs to function well throughout this hormonal transition. This is where a nutritionist can help, by looking at your 4 day food diary it can highlight any excesses or deficiencies that may be contributing to your symptoms.
2. Look after your sleep
Sleep disruption is incredibly common during perimenopause, and poor sleep can make anxiety feel much worse. Try creating a relaxing bedtime routine such as:
- Going to bed at a similar time each evening, the body likes routine.
- Keeping your bedroom cool and dark.
- Reducing screen time before bed.
- Enjoying a caffeine-free herbal tea like some of the teas mentioned above or a ready made sleep blend.
- Practising gentle breathing or relaxation exercises.
3. Move your body regularly
You don’t need to spend hours in the gym, walking, swimming, yoga, Pilates and strength training can all be helpful ways to incorporate movement into your routine. It’s also about finding balance, some people are doing too much exercise or the wrong type such as high amounts of cardio, this can contribute to overstimulation of the nervous system. The important thing is finding something you enjoy and can maintain.
4. Consider magnesium-rich foods
Magnesium plays an important role in normal nervous system and muscle function and can be helpful for sleep where there’s insomnia. This vital mineral is often low in peoples diets, magnesium-rich foods are:
- Pumpkin seeds.
- Almonds.
- Spinach and other dark green leafy vegetables.
- Dark chocolate.
- Beans and lentils.
- Wholegrains.
5. Make time for relaxation
This might sound obvious, but how often do you actually give yourself permission to stop? Many women in their 40s and 50s are juggling careers, children, ageing parents, relationships and countless other responsibilities. It’s easy to put yourself at the bottom of the list. Try introducing small moments of calm into your day:
- Five minutes of deep breathing, especially when you’re feeling anxious and before meals if your digestion is also affected.
- A walk outdoors especially in nature, looking at the colour green has been found to calm the nervous system.
- Gentle stretching or exercises like Qigong where the mind switches focus onto the movements rather than racing thoughts.
- Meditation to learn how to clear the mind which is typically racing with thoughts.
- Time spent gardening, many people find connecting with nature through gardening has helped with reducing anxiety.
- A relaxing bath, as part of your bedtime routine, add some Epsom salts or magnesium flakes to relax tense muscles and a few drops of lavender essential oil.
The NHS also recommends regular exercise, adequate rest, relaxation and talking to others as ways to support emotional wellbeing during perimenopause.
If anxiety is persistent, worsening or affecting your everyday life, speak to your GP. Menopause-related anxiety can sometimes benefit from menopause-specific cognitive behavioural therapy (CBT), and hormone replacement therapy (HRT) may be worth discussing where symptoms are associated with the menopause. You don’t have to choose between natural approaches and conventional healthcare. They can sometimes work alongside one another. I find many clients can manage their symptoms better when using herbal medicine and making a few diet and lifestyle changes, but if you still feel like you need extra help then it’s worth looking at whether including some HRT might be of benefit. HRT can be a valuable tool if needed, but if we’re overlooking sleep, nutrition, blood sugar regulation, stress, nervous system regulation, movement and emotional wellbeing, then you’re missing a huge part of the picture. You are not just a collection of hormones, and supporting your mental wellbeing means supporting your whole body.
This stage of life can bring unexpected changes, but it can also be an opportunity to reassess your health, your lifestyle and how well you’re looking after yourself. If you’re struggling with perimenopause symptoms and would like a more individualised approach then feel free to contact me to arrange a free 15 minute call where we can discuss your symptoms and how I may be able to help.
Written by Tina Prajapat DipCNM, mANP, rGNC – Registered Nutritional Therapist, Herbalist and Naturopath specialising in women’s health, hormone balance and gut health using nutrition, herbal medicine and lifestyle approaches.
This article is for general educational purposes and is not intended to diagnose, treat or cure any medical condition. Herbal medicines and nutritional supplements can have side effects and may interact with medicines. If you are pregnant or trying to conceive, or take prescribed medication, seek advice from your GP, specialist or appropriately qualified healthcare professional before making significant changes to your diet or starting supplements or herbal medicines.
