Is It Anxiety—Or Is It Perimenopause?

Before you get that prescription for anti-anxiety meds, let’s have a real talk. You’re in your late 30s or early 40s. Life is good—or at least, it should be. You’ve got your career, maybe a partner, maybe kids, maybe a mortgage. You’ve handled stress before. But suddenly, things feel different. Your heart races for no reason. You wake up at 3 AM with a sense of dread. You’re snapping at your partner over nothing, your patience is razor-thin, and everything—literally everything—feels overwhelming. 

If you’ve recently found yourself spiraling into newfound anxiety and stress, I need you to hear this: it might not be just anxiety—it might be perimenopause.

Perimenopause and Anxiety: The Hidden Connection

Most of us were taught that perimenopause is just about periods getting weird before they stop altogether. No one warned us that it can throw our nervous system into chaos, rewiring our stress response and making us feel like we’re unraveling.

Dr. Mary Claire Haver, a menopause expert, has been outspoken about how perimenopause affects mental health, stating:

“Hormonal shifts during perimenopause can have a profound impact on mental clarity, stress resilience, and anxiety levels. Estrogen plays a key role in serotonin and dopamine production—when it fluctuates, so does your mood.”

Translation? Your hormones are messing with your brain chemistry. The declining estrogen and progesterone that regulate mood stability are fluctuating wildly, and your body is struggling to adjust. That can manifest as heightened stress, racing thoughts, or even panic attacks—even if you’ve never had anxiety before in your life.

“I Thought I Was Losing My Mind”

Emma, 39, a high-powered attorney and mother of two, had never dealt with anxiety before.

Suddenly, she was experiencing full-blown panic attacks: “I was convinced something was seriously wrong with me. I couldn’t focus at work, my heart would start racing randomly, and I felt this constant sense of doom. My doctor wanted to put me on anti-anxiety meds, but I knew something deeper was happening.”

Similarly, Jessica, 42, shared:

“I woke up every morning feeling a pit in my stomach. The smallest things made me want to cry or scream. I thought I was depressed. It wasn’t until I started tracking my symptoms that I realized they were syncing up with my cycle.” 

These women aren’t alone. Thousands of us are experiencing these symptoms, but we’re being told it’s just anxiety. And while medication has its place, before you take that prescription, first evaluate your other symptoms.

5 Steps to Identify If Your Anxiety Is Actually Perimenopause

1️⃣ Track Your Symptoms. Anxiety is one thing, but is it showing up with other changes? Irregular periods, brain fog, fatigue, night sweats, or mood swings? Log your symptoms daily.

2️⃣ Take the NNABI Quiz. It’s designed to help you see if your symptoms align with perimenopause. You’ll walk away with clarity and the right questions to bring to your doctor. Take the NNABI Quiz here

3️⃣ Get Your Hormones Checked. While hormone tests aren’t always conclusive for perimenopause, they can provide insight. Ask your doctor to check your estrogen, progesterone, and cortisol levels.

4️⃣ Explore Natural Anxiety Management. Perimenopausal anxiety doesn’t always need pharmaceuticals. Consider magnesium supplements, adaptogens like ashwagandha, mindfulness practices, and breath work. Exercise (even just walking) can be a game-changer.

5️⃣ Advocate for Yourself. Too many doctors dismiss perimenopausal anxiety. If yours isn’t listening, find one who will. Be clear about your symptoms and push for the right care.

You Are Not Crazy—You Are in Perimenopause

If you’re feeling anxious, irritable, or like your stress response is on overdrive, don’t gaslight yourself into thinking you’re just “too stressed.” Your hormones are shifting, and they’re taking your nervous system along for the ride. The good news? Once you know what’s happening, you can start taking action.

Get informed, take the NNABI Quiz here, and start making choices that support your body. You don’t have to suffer in silence—or take a medication you might not actually need. Let’s take back control. 

Because perimenopause might be inevitable, but losing yourself in it? Absolutely not.