Why Hormones Can Trigger Anxiety In Perimenopause

Anxiety that starts in your 40s can make you question everything, especially when you have handled stressful jobs, family pressure, and life curveballs for decades. If you are waking at 2am or 3am with a racing heart, feeling on edge for “no reason”, or getting overwhelmed by everyday tasks, I want you to hear this clearly. You are not going crazy, and you are not weak. For many women, perimenopause anxiety is a hormone driven nervous system shift, not a personality change.

We unpack what is happening in the brain when oestrogen and progesterone fluctuate. I explain how oestrogen supports serotonin signalling and why mood can feel less steady when those levels swing, plus why progesterone is often the first to decline and how that affects GABA, your built in calming pathway. We also talk about the “overwhelm bucket”, cortisol dysregulation, and why a body that feels constantly “on” is often responding to a different hormonal environment rather than a suddenly harder life.

Then we get practical. You will hear simple strategies to stabilise blood sugar (including why protein at every meal matters), create moments of safety in your day, choose movement that regulates rather than punishes, and protect your sleep with small changes that add up. We also cover when it is time to talk to a menopause qualified GP or a clinician who truly understands perimenopause, including whether MHT could be appropriate, because there is no prize for struggling alone.

If this resonates, share it with a woman who needs reassurance, then subscribe or follow so you do not miss what is coming next. If you feel like leaving a five star review, you would absolutely make my day, and if you want personalised help you can book a free peri weight loss assessment via the link in the show notes.

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Transcript

Welcome And What To Expect

SPEAKER_00 0:00

Hi, I'm Susie Garden and this is the Ageless and Autumn Podcast. I'm an age-defying naturopath and clinical nutritionist and I'm here to bust myths around women's health and ageing so that you can be ageless and autumn in your 40s, 50s, and beyond. The Ageless and Awesome Podcast is dedicated to helping women through perimenopause and menopause with great health, a positive mindset, and outrageous confidence. Hit subscribe or follow now and let's get started. Hello, gorgeous one, and welcome to this week's episode of the Ageless and Awesome Podcast. I'm Susie Garden, your host, Perimenopause naturopath, weight loss nutritionist, and proud Perimenopause survivor. And today's episode is one that I know is going to resonate with so many of you because we're talking about something that can be really challenging and maybe even frightening when it first appears.

When Anxiety Shows Up Suddenly

SPEAKER_00 1:02

And a lot of women experience this, and this is anxiety. And not the kind of anxiety where you've always been a naturally anxious person or you've been diagnosed as having an anxiety type disorder. I'm talking about those of you who might get to, you know, your 40s, even your early 50s, and suddenly find yourself lying awake at two o'clock in the morning, three o'clock in the morning, really feeling like either your heart's racing or just feeling anxious. Or the woman who suddenly feels overwhelmed walking into the supermarket. I know this happened to me at Chermside Shopping Center. Um yeah, a woman who burst into tears over something that wouldn't have bothered her a few years ago. A woman who feels on edge all the time and you don't know why. You might have butterflies in your stomach for no apparent reason, and you might feel like your nervous system is just perfectly, sorry, permanently switched on. Like you're feeling wired all of the time. And perhaps one of the hardest parts is you might have absolutely no idea why. And if that's you, I want to begin today's episode by saying something I wish every woman was told before she entered perimenopause. And that is you're not going crazy, you're not weak, you're not suddenly unable to cope with daily life. And honestly, in many cases, this anxiety isn't actually coming from your mind, it's coming from your hormones. And so today's episode is going to focus on this. And I want to explain why it happens because I found that when women understand what's going on inside their bodies, when you get that light bulb moment of, oh, that makes sense. It just begins to open up that understanding and resolve some of the fear, I guess, around it. Knowledge, of course, is not going to remove your symptoms, but it can remove the uncertainty and help put you on a path onto like helping yourself. Because uncertainty is incredibly anxiety-provoking. So, you know, we don't want to get into that sort of a cycle. So let's get into it. One of the first, sorry, one of the things that I hear almost every week in clinic is this sentence. I've never been an anxious person, but, uh, and it's almost always the first thing women tell me. They say things like, I've I've managed stressful jobs, I've raised children, I've cared for aging parents, I've dealt with a relationship breakdown, I've started businesses, I've coped with all of life's big challenges. So why am I suddenly anxious now? And I completely understand why this can feel really confusing, annoying, frustrating, all of the things. Because many women assume anxiety must be caused by something psychological. They think, maybe I'm not coping, maybe I'm burnt out, maybe I've become too emotional, maybe something's wrong with me. Now, you know, don't get me wrong, life stress absolutely plays a role in this. And most women in their 40s and 50s are carrying enormous mental loads. But, you know, when you're looking after all of the other things that are going on in your life and looking after all of the other people that rely on you, it's a lot. But you know what? Here's what's fascinating is that two women can be living very similar lives. One might develop this anxiety and the other doesn't. Why would that be? Because hormones influence how our brains respond to stress. And during perimenopause, that response changes dramatically. And it's not going to happen with everybody. It certainly happened to me. Um, I didn't know what was going on at the time, but now I reflect back now I that I know what I know, and probably now that I'm on the other side of it, of course that's what was causing it. I had a lot of work stress going on at the same time, but I do feel now that definitely perimenopause had a big influence on what was going on with me.

Oestrogen Serotonin And Mood Shifts

SPEAKER_00 5:24

So let's talk about the fact that your brain is changing, and that's not a bad thing. When we think about estrogen, most of us think about periods of fertility and reproduction. But estrogen is also one of the brain's most important hormones. In fact, there are estrogen receptors throughout the brain. So this estrogen is actually influencing communication between your brain cells. It influences memory, it influences motivation. As I talked about recently, it influences sleep. And importantly, for today's conversation, it influences mood. And one of estrogen's jobs is to support serotonin. Now, you've probably heard serotonin described as a happy brain chemical. That's a little simplistic, but serotonin certainly plays an important role in emotional well-being. And it helps us feel emotionally steady, it helps us to feel more resilient, more optimistic, better able to cope. And when estrogen begins fluctuating during perimenopause, serotonin signaling can also fluctuate. And that means your emotional baseline may start to feel less stable. And this is one of the reasons women often describe feeling more sensitive or more emotional, more reactive, more overwhelmed. And not because, you know, they're becoming weaker or anything like that. It's because the chemistry that's been supporting emotional resilience for decades is changing. And remember, this doesn't happen overnight. Perimenopause can be up to 10 years or of hormonal fluctuations. And some months are gonna be easier, some months are gonna be a little bit more challenging, some weeks you feel like yourself again, and then suddenly, seemingly out of nowhere, anxiety returns. And that unpredictability can be incredibly unsettling.

Progesterone GABA And Feeling Wired

SPEAKER_00 7:36

And while estrogen gets most of the attention, I actually think progesterone deserves a lot more credit. Progesterone is sometimes called the body's natural calming hormone. You may have heard that before. And the reason for this is because it interacts with receptors in the brain that use a neurotransmitter or brain chemical called GABA. So think of GABA as your brake, sorry, your brain's brake pedal. It slows things down, it quietens busy thoughts, it helps you relax, it helps you drift off to sleep. It's one of the reasons many women notice they feel karma during certain phases of their menstrual cycle. But during perimenopause, progesterone is usually the first hormone to decline and it doesn't tend to come back up, unlike oestrogen, which surges. So when progesterone is declining, ovulation becomes less regular. Without regular ovulation, progesterone production falls. Suddenly, your brain has less of its natural calming influence. And it's almost as though someone has taken away part of your nervous system's buffering capacity. So the world hasn't become more stressful overnight, although sometimes it does feel like it has. But your ability to absorb stress has changed. And that's why women will often say things like, I just don't seem to cope, like I used to. And I certainly can relate to that. The sentence actually breaks my heart every time I hear it because I felt that. And I know it does not feel good. It carries so much self-judgment. Because the reality is you're probably coping with more than you ever have, right? You're simply doing it with a different hormonal environment. And that's a really important distinction.

Why Overwhelm Hits So Hard

SPEAKER_00 9:29

So let's talk about something I think almost every woman in perimenopause, probably menopause as well, has said at some point. I just feel so overwhelmed. And it's not because something huge has happened, but because suddenly the washing feels overwhelming. Dinner feels overwhelming, an email feels overwhelming. Your child's messy bedroom feels overwhelming. Even deciding what to cook can feel like too much. And then, of course, because we're women, we start to feel the guilt. What's wrong with me? I used to be able to juggle 10 things at once. Does this sound familiar to you? One of the reasons this happens is because your brain is processing stress differently than it did 10 or 15 years ago. So think of your nervous system like a bucket. And when we're younger, the bucket is often quite large. Stress still goes in, but we've got plenty of capacity. As we move through perimenopause, several things happen at once. Our hormones fluctuate, the sleep often deteriorates, inflammation increases, our life responsibilities increase, and suddenly that same bucket becomes much smaller. And it doesn't take nearly as much to just overflow that school email, the traffic, your partner asking what's for dinner, the dog barking, your phone ringing. None of those things are huge on their own, right? But together, overflow. And that's not because you've become less capable. It's because your nervous system has less reserve. And it's one of the biggest goals during perimenopause is rebuilding that reserve. And also obviously in menopause.

Cortisol Stress And The On Switch

SPEAKER_00 11:18

So let's I have to bring in cortisol into this conversation. Um, it's a major player in this story. I mean, I know cortisol is getting blamed for everything these days. It's become a bit of a buzzword. We're seeing it all over our socials, but cortisol is actually an incredibly important hormone. Without cortisol, we wouldn't wake up in the morning. We wouldn't regulate our blood pressure, we wouldn't respond to danger. Cortisol isn't the enemy. The problem is when cortisol stays elevated for too long or becomes dysregulated. So it's up higher in the evenings when you want to go to sleep, and it's too low in the mornings when you're trying to wake up. So if you think about the average woman in her late 40s, early 50s, she's working, managing a household, perhaps. Maybe there are kids, maybe looking after aging parents. There can be financial pressures, relationship changes, poor sleep. That's enough, right? But then you've got the hormonal fluctuations on top of that. And that's a lot for one nervous system. And when your brain perceives this ongoing stress, it keeps cortisol circulating. The trouble is your brain doesn't distinguish particularly well between physical stress and emotional stress. Running late, scrolling bad news, skipping meals, over-exercising, not sleeping, an argument with your partner, they are all interpreted as stress. And if your brain is already more sensitive because estrogen and progesterone have changed, that cortisol response becomes louder. And that's why some women describe feeling as though they're constantly on. They can't switch off, they feel wired all of the time. Even when they're just sitting on the couch. Now

Blood Sugar That Feels Like Anxiety

SPEAKER_00 13:17

I want to bring in another element, which is the blood sugar anxiety connection. And this surprises most women. And it's one of my favorite things to teach because so many women have an aha moment. Have you ever noticed that sometimes your anxiety feels worse when you're hungry or you become shaky, a little irritable, perhaps your heart starts racing, you suddenly feel emotional. What's happening? Very often it's blood sugar. Your brain needs a steady supply of glucose. And when your blood sugar drops too low, your body sees that as a potential emergency. Remember, your brain's job, or one of your brain's jobs, is to keep you alive, not to keep you comfortable. So when glucose starts dropping, your body releases adrenaline and cortisol because these hormones raise blood sugar quickly. It is a brilliant survival mechanism. But here's the problem: adrenaline feels almost identical to anxiety. Your heart races, you feel jittery, your breathing changes, you feel restless, your thoughts speed up. This is all your fight or flight response. And it because it feels like anxiety, you assume you're anxious. When in fact, your body may simply be trying to rescue your blood sugar. Now, if you layer perimenopause on top of this, when you think about estrogen, it helps support insulin sensitivity. So as the estrogen fluctuates, blood sugar regulation will often become less efficient. And it means these highs and lows can become more common. And this is one of the reasons I'm always talking about making sure you're having protein at every meal. Not because protein is also a trend, uh, not because I'm obsessed with macros, because I'm really not, but because protein slows the uptake of blood sugar into the bloodstream and helps stabilize your blood sugar. Did I just say stop putting blood sugar into the bloodstream? Sorry, glucose into the bloodstream, if that's what I said. So when your blood sugar becomes steadier, many women notice their anxiety softens too. And I see this a lot in the Glow Protocol in the first week or two when we get that blood sugar stabilization, because that's a big part of the first sort of step of this protocol. Often women start saying to me, I feel a sense of peace. My sleep has improved. I'm just feeling a lot calmer. And a lot of that ties back into this blood sugar stabilization. And it's one of these beautiful examples of how nutrition isn't just about weight control, it's about brain function, it's about so many other things in the body. But about in this example, it's using food as medicine for your brain.

Night Waking And The Anxiety Loop

SPEAKER_00 16:06

Now, I do want to connect this back to sleep, um, as I briefly mentioned before. So imagine you're waking at, say, like 2:30 or 3 o'clock or something in the morning, your cortisol rises, maybe your blood sugar has dipped, if you haven't eaten well or if you've had a big dessert or alcohol that night before, um, your heart starts racing, your brain wakes up. And because your logical brain isn't really functioning at its best in the middle of the night, every problem suddenly feels enormous. Have you noticed that at 2:30 a.m., you can convince yourself I'm failing, my business isn't going well, my kids are struggling, my relationship is falling apart, what if something terrible happens? All the things. And then morning comes, and those same problems don't seem quite so catastrophic in many cases. And it's because sleep deprivation changes the way we interpret the world. It amplifies threat, it reduces your emotional resistance, it makes uncertainty feel dangerous. So poor sleep doesn't just make you tired, it makes your anxious brain louder, and then that anxiety makes it harder to sleep, and it becomes this vicious cycle. Poor sleep increases anxiety and anxiety disrupts sleep. Even sometimes that anxiety, and I've experienced that a lot, but that anxiety around, I can't get to sleep, and I've got so much to do the next tomorrow, and I can't get to sleep, I can't get to sleep. So this cortisol anxiety sleep connection is real. We know that higher cortisol generally, so if you're producing more cortisol during the day because you're stressed, that higher cortisol increases the night waking and round and round it goes. But the great news is that when we start improving just one part of that cycle, the whole system often begins to calm down. And that's why I rarely look at symptoms in isolation. Everything in the body is connected. So

Small Practical Steps That Help

SPEAKER_00 18:19

let's talk about the practical side now. We've talked about what's happening, why it's happening. Let's move into what we can do about it. Because while understanding why you're anxious is incredibly validating and somewhat reassuring, perhaps. I also want you to leave this episode feeling like you've got some ideas about what you can do to get on top of it. I want you to know there are things you can do to support your nervous system, your hormones, and your overall well-being. And no, you do not have to do everything all at once. In fact, I really want to encourage you not to. Perhaps take some notes, write down the list, but then choose one thing. Or if you really want to, choose two things that resonate with you and start there. Small, consistent changes are almost always going to be more powerful than dramatic overhauls, particularly if you're doing it on your own without support. So, my first one, which I mention possibly every week, is feed your brain consistently. One of the kindest things you can do for your nervous system is to stop putting it on a blood sugar roller coaster. And that means don't skip breakfast. This is a big one. I know a lot of people talk about fasting and that, but for women in perimenopause and postmenopause, you need to manage blood sugar. So don't skip breakfast and include protein with every meal. Eat your three meals a day. Don't wait until you're ravenous before you eat. I know I'll touch on it again. I know intermittent fasting is quite popular. I think it's getting a bit less so as people are learning more about it, particularly women. For some people, it works beautifully, particularly men. But if you're waking through the night, if you're feeling anxious, shaky, overwhelmed, and you're fasting, it might be worth even trialing three meals a day rather than doing the intermittent fasting. You know, it might be really worth asking yourself whether these long periods without food are actually helping your body or stressing it out. And I know if you've been doing it for a while, you might be in a really good routine with it and you might really enjoy not having to have dinner, for example, or you might really enjoy not having to have breakfast. But if you're feeling this anxiousness, feeling this overwhelm, I really think it's worth having an experiment to see if three meals a day, beautifully balanced protein-rich meals can help. But the thing is, this is where personalized advice becomes so important because there isn't one approach that's right for every woman. And you really do have to have these meals uh beautifully balanced with your macros. Make sure you're having enough protein, enough veggies, salads, bread, etc. Uh, and without getting that worked out for you professionally, it's hard to know.

Build Moments Of Safety Daily

SPEAKER_00 21:30

Number two, in terms of what you can do, this is one I haven't talked about before. Build moments of safety into your day. What I mean by that is ask yourself when during the day does your nervous system feel completely safe? And quite often, when I ask clients this, they just they just kind of go, huh? What? What do you mean? Because they constantly on. They're answering emails while eating lunch. They're listening to podcasts while walking. They're watching television while scrolling their phone. They're folding washing while planning the next day. Their brain never gets a break. Your nervous system needs moments where it receives the message I'm safe. That might be five minutes sitting in the sun with your morning coffee. A slow walk without your phone. Taking three deep breaths before you get out of the car. Listening to music while cooking dinner. So that it's just there in the background, you're not attaching yourself to it. Even 60 seconds of intentional stillness and sends your brain a powerful signal that the danger has passed. And those moments matter more than you realize. The third thing kind of ties into this uh safety one as well, in many cases, if is to move your body but not to punish it. Moving the body is one of the effect most effective tools we have for reducing anxiousness, but the type of exercise matters. If you're already exhausted and highly stressed, adding six intense workouts a week may actually make you feel worse. Instead, think about movement that regulates your nervous system. Now, if you're like an ex-athlete or you're used to doing big exercise and you find that's a great stress management for you, have at it. But if you it's this is not your normal and you're just trying to do this because you're trying to manage your weight, let's have a think about this. Think about movement that regulates your nervous system. So walking, strength training, yoga, Pilates, just stretching. Time in nature. The goal isn't to burn as many calories as possible. The goal is to create a body that feels strong, capable, and calm. Now, you know, I have to bring sleep into this. So that's my next, my next um piece of advice is protect your sleep fiercely. If you've listened to this podcast for a while, you know I'm passionate about sleep. It's something I've struggled with. I struggle with it on and off. I've recently had a period of struggling with it again. I'm just, I've just turned a corner recently. So I'm really passionate about sleep, and I absolutely can empathize with anyone that's also struggling. And the thing is, you know, this is not about getting a perfect seven to nine hours every night because sleep influences almost every symptom of perimenopause. When you sleep better, your anxiety often improves, your cravings should improve, your mood improves, your concentration improves,

Move Gently To Regulate Stress

SPEAKER_00 27:03

your resilience. Create an evening routine that tells your brain, we're winding down now. As soon as you can, like I said, I've said this many times, as soon as we finish cleaning up after dinner, we dim the lights. So there's only floor lamps on, really, all the overhead lights go off. Almost all of my lights are on dimmers. Reduce screens as much as you can. And that I know again, for me, I after about dinner, really, I have my phone in another room. And my friends tend to know this that I that yeah, it tends to be another room. Unless I know I need to be contactable for some reason, my phone goes in the other room. I've tried every now and again, I get tempted. I go, no, I'm really disciplined and I want to message with my friends. And then I end up Googling stuff as I'm thinking about it. So that it's such a big addiction for most of us that I definitely leaving the phone in another room. So you have to make effort to go and get it if you want it, is ideal. Make sure your bedroom's cool. Make sure your bedroom's cool. It makes a huge difference in your ability to sleep.

Protect Sleep Like It Matters

SPEAKER_00 28:16

Also, be mindful of alcohol. Yeah, that's a big one that impacts sleep. It may help you get to sleep, but it really is involved a lot in waking and wakefulness during the night. If you really want to drink, maybe drink at lunchtime or something, uh maybe start looking at some of the alcohol-free alternatives or just really reduce your intake. Where if you used to have two or three, have one or even half. It makes a massive difference if you're struggling with these sorts of things. And remember, progress is better than perfection. If you just choose one of these things to focus on for the next week or two, you will find you will get an improvement. And then maybe you go to the next one and then the next one. And that all builds on each other. I'm still going though on my list. So don't dismiss the role of hormones. This is an important one. If your anxiety has suddenly appeared during your 40s, and if it's accompanied by irregular periods, hot flushes, sleep disruption, brain fog, mood changes, you know, all of those peri symptoms. Just don't assume it's stress. Talk to someone who actually understands perimenopause, and that might be your regular GP, or perhaps you may need to see a menopause qualified GP. I strongly recommend seeing a menopause qualified GP. They have the average GP does not have much training on menopause at all. I know when I did my nursing and even my naturopathy, the amount of attention menopause got was minimal. And I don't think perimenopause was even mentioned. So you really need to get a GP that understands and has had training in menopause and perimenopause. So whether it's a doctor, whether it is a naturopath or a nutritionist that has expertise, again, has expertise in this area, not just a standard sort of naturopath or nutritionist or acupuncturist, etc. And sometimes lifestyle changes are enough. We can do so much with lifestyle, with nutrition, with herbal medicine, even. But sometimes menopause hormone therapy used to be known as HRT, now it's known as MHT. Maybe that is appropriate. There is no prize for struggling alone. And the evidence now supporting the use of MHT is pretty good. Pretty good. So I want to ask something of you. Please stop judging yourself for having symptoms, for feeling anxious or feeling overwhelmed. I know that that is easier said than done. But every time you tell yourself, I'm gosh, I'm weak. Why can't I do this? I should be coping better. I'm failing at everything.

When To Consider Hormone Support

SPEAKER_00 31:16

You're adding another layer of stress to an already stressed nervous system. Instead, what if you responded with curiosity? Instead of saying, What's wrong with me? Try asking, what is my body trying to tell me? That's a very different conversation. Because symptoms aren't your body betraying you, they're your body communicating with you. And when we listen instead of fighting them, everything changes. I want to finish today's episode by speaking directly to the woman who has quietly wondered whether she's losing herself. To the woman who's been listening to this episode and is just going, Oh my gosh, this is me. Maybe you thought I don't feel like me anymore. That sentence is something I hear so often in clinic. You are still you. Um when you're saying I don't feel like me anymore, often it's a loss of confidence, a loss of ease, a loss of emotional steadiness, the loss of the version of yourself that you recognize. If that's where you are today, please hear me. You are still you. Underneath those hormonal changes, the poor sleep, the anxiety, you are still there. Your intelligence hasn't disappeared, your strength, your resilience hasn't disappeared. Right now, they're just simply being obscured by a hormonal transition that nobody prepared you for. And transitions that by then well, by their very nature are

Self Compassion And Feeling Like You

SPEAKER_00 32:57

temporary. And with the right support, the right information, the right nutrition, the right care, medical care, health care, where appropriate, and a whole lot of self-compassion, you can absolutely feel like yourself again. Look, you may not be exactly the same version of yourself you were at 30, but you're gonna be perhaps an even wiser, calmer, stronger version and one who understands her body instead of fighting it. So if today's episode has resonated with you, I would love you to do two things. The first is to share this episode with another woman, because I can almost guarantee there's someone in your life who's quietly wondering why she suddenly feels so anxious. That was certainly me. Imagine the relief she might feel in hearing she's not alone. And secondly, if you're ready to stop trying to figure this out on your own, I would love to support you. Inside the GLO protocol, we don't just focus on weight. In fact, if you don't need to lose weight or want to lose weight, we just tailor that so that that doesn't happen. We look at the whole picture, your hormones, your metabolism, your sleep, your stress, your energy, your gut health, your relationship with food, everything. Because everything is connected. And if you'd like to explore whether it's the right fit for you, you can book a free peri weight loss assessment using the link in the show notes. We'll chat about what's been happening for you, what's driving your symptoms, and what your next best step might be. There's no pressure, it's literally just a conversation. So thank you so much for spending this time with me today. And I hope that this episode has given you something that I think every woman deserves during perimenopause and postmenopause. Not just information, but reassurance and strategies that can help. Understanding your body does change everything. So next week I'm gonna wrap up this little series with what I think might be the most important conversation at all, which is why you don't feel like yourself anymore. We're gonna pull together everything over the last few weeks and talk about how hormones can affect not just your body, but your identity, your confidence, and your sense of self. And I can't wait to share it with you. Until then, take care, be well, and I will see you next week. Thanks so much for joining me on the Ageless and Awesome Podcast. If you would like this episode, please make sure you click the little plus button if you're on Apple

Share This And Get Support

SPEAKER_00 35:36

Podcasts, or the follow button if you're on Spotify, so that you get each new episode delivered to you every single week. If you feel like writing me a five star review, you would absolutely make my day. If you found this episode resonated with you, head over to my Instagram and DM me at the Perimetaports Park. I would love to connect with you.