Alice, a 49-year-old teacher and mother of two came into my office complaining of increased anxiety over the past few years which has progressed to occasional panic attacks, ultimately resulting in her inability to focus at work. She has been prescribed anti-anxiety and anti-depressant medications by her doctor to help her to take the “edge” off in order for her to focus on work and daily tasks. Unfortunately these medications do not come without side effects and her weight soared 20 pounds over the past few years, adding to her anxiety and stress. Alice has also been going through the “change” in the past few years with irregular cycles and at times going without one for a month or two.
Does this sound like you? Many suffer with debilitating anxiety not knowing the root cause. Hormonal imbalances can be a source of the problem.
Prevalence
Alice is not alone. Anxiety disorders affect twice as many women as men. Forty million American adults, or about 18.1 percent of the U.S. adult population over 18 years of age are affected by anxiety disorders. (Sources: Kessler 2010; Bullock 2011; Roberson-Nay 2011.) Anxiety is a multifaceted disorder with many types and origins. In the case of Alice, hormonal imbalance could play a large role in her symptoms.
Hormonal Cause
Anxiety due to hormonal imbalance is caused by an imbalance in the endocrine system. The endocrine system plays a very large role in our emotional state. The system regulates energy levels, how we deal with stress and keeps us calm. When this hormonal system gets out of balance, symptoms of anxiety, depression, irritability, mood swings, foggy brain, tense muscles, and sleep disturbances can all occur. Many women experience more anxiety when they are pregnant, postpartum, premenstrual, perimenopausal and menopausal than at any other time in life.
Most steroid hormones (i.e., pregnenolone, progesterone, estrogen, testosterone, and DHEA) are neurologically active. In fact, large quantities of these steroid hormone receptors are found in the brain. These hormones affect the brain in a number of ways, including regulation of mood. A number of studies have linked abnormalities in hormone levels to various anxiety disorders. (Sources: Cunningham 2009; Parcells 2010; Sundermann 2010; Bloch 2011). Studies suggest that levels of estrogen and serotonin may be linked, both affecting a positive mood during menstruation in young women (Kikuchi 2010). Likewise, the drop in estrogen during perimenopause and menopause, associated with reduced serotonin production has a negative impact on mood and cognitive function.
Progesterone also plays a role in anxiety. Researchers found progesterone decreased anxiety behavior through a mechanism similar to that of benzodiazepines (drugs like diazepam, lorazepam, alprazolam, etc.) by acting on GABA receptors (Frye 2006) in the brain. GABA (Gamma-Amino Butyric Acid) is a neurotransmitter in the brain responsible for calm and rest. Therefore, a drop in progesterone due to hormonal imbalance affects our mood and well-being.
Stress is another major cause of anxiety. Our adrenal glands are involved in making numerous hormones for normal functioning, such as blood sugar regulation; producing and maintaining the body’s energy levels in conjunction with the thyroid; and producing stress-monitoring hormones. Since the adrenals contribute to about 35 percent of premenopausal female hormones and almost 50 percent of postmenopausal hormones, compromised adrenal function profoundly affects hormonal balance. In response to stress, our body produces adrenaline, and adrenaline directly causes anxiety.
Thyroid problems are becoming increasingly common in today’s society. The thyroid cannot function by itself; it works in conjunction with other endocrine organs like the adrenals, pituitary, pancreas, liver and reproductive organs. The thyroid is required to work harder if other organs such as the liver or adrenal glands have been overworked or overstimulated by stress, food allergies, poor diet and or lack of sleep. Anxiety could be a result of either an overactive or underactive thyroid.
Perimenopause and Menopause
As estrogen decreases during perimenopause, periods may still be regular or can become irregular. Ovulation at this point is decreasing and there is only enough estrogen on board to make a real thin lining in the uterus. This is why in perimenopause women’s periods get shorter, breasts get lumpier, and brains get foggier. A pounding, racing heart is the second most common complaint associated with perimenopause. Menstrual irregularity is most common in the mid-40s as menopause approaches. These erratic fluctuations in your cycle are due to the highs and lows of estrogen and progesterone several times a day. The decline of estrogen creates the moodiness and anxiety most women experience. During this time women may become more emotional, as if they’re on a rollercoaster. This process of rhythmic loss can take up to 10 years. Alice was in this phase of her life as she gradually became symptomatic with anxiety and panic attacks.
At the start of menopause, many women have reported that they experience anxiety attacks along with night sweats and hot flashes. Dropping hormone levels such as estrogen and progesterone can trigger anxiety. Furthermore, stressed out adrenals due to emotional, mental, or physical stressors can exacerbate symptoms leading to debilitating panic attacks.
What to do
If you are between the ages of 40 and 55 and are experiencing anxiety, depression, irritability, and moodiness, and you suspect hormonal imbalance, get tested. Thyroid imbalances can be checked through a simple blood test, while hormonal and adrenal testing can be done through both blood and saliva testing. Alice had her sex hormones and adrenal hormones tested through saliva. In conjunction with her saliva test results, her symptoms were taken into account and through lifestyle coaching, nutritional supplementation, and some hormone supplementation, Alice slowly started to get her life back under control.
Conclusion
Anxiety is a very real and often debilitating condition. People with anxiety due to hormonal imbalances may think that they have a mental illness, but this is not always the case. It is simply the body’s way of telling them something is not right. One important point to note is when anxiety is related to hormonal imbalance, it must be evaluated, and hormone replacement or corrective measures must be taken. If you’ve been suffering from anxiety and have tried several approaches without success, get your hormones tested and evaluated. Sometimes proper diet and rest are not enough to correct hormone imbalances causing your symptoms.
Blood testing and saliva testing for hormones are available at TLC Medical Centre pharmacy. Please call to make an appointment for a free 15-minute consultation with our hormone specialist and clinical nutritionist if you are concerned that your symptoms may be hormonally related.
