Perimenopause & Anxiety: What No One Tells You About Hormones & Mental Health

But when we look at these compounding effects of what's happening within the body, it can make a woman be like, wow, okay, I'm not crazy. There are things happening here. There are actual changes going on. And now how do I take care of that stuff? Hey there and welcome to let's Talk about it with Laurie Streeter. A space to talk honestly and get real about mental health, therapy and all things wellness. I'm Lori, licensed therapist, speaker and your host, here to bring you insights to tools and information you can actually use, whether you're navigating anxiety, healing your relationship with food, or trying to figure out which techniques will work for your life. I'm so glad you're here. Let's dive in and let's talk about it. Welcome back to another episode of let's Talk about it with Laurie Streeter. I'm Laurie and today I really want to cover perimenopause and anxiety because perimenopause, menopause is for some reason a hot topic right now. Or maybe it's because I'm in my 40s and I just happen to be seeing more of this. A lot of my clients are dealing with some of the symptoms. So these are rabbit holes that I'm currently going down personally and professionally. So maybe it's just my algorithm and the reasons that I'm seeing it so often, but I do feel like perimenopause is being talked about a lot more. And, and we know there is such a huge connection between mental health and hormones and these transition times and fluctuations and all of that. So I want to cover this today. Why women come into my office and tell me they feel like they're losing it, why they're like the biggest catastrophizers, what's going on. I just want to cover all of it. What some of these women are doing, what we're seeing in social media, how do we help ourselves, how do we advocate for ourselves and what's actually, actually happening during this time that has such a significant impact on our well being, on our mental health. So we're gonna kind of touch on all of it and I really hope this gives you a really good overview of what's going on here so that you, if you're struggling with this or you have a woman in your life struggling with this, you can know what questions to ask, how to advocate for yourself and just how to feel better. Because this is definitely a time in lives where we can get to the point where we're not feeling very good. If you have been Feeling more anxious, more forgetful, or just off. Especially if you're in your 30s or 40s currently, it's not your fault and you're not alone. And we are gonna run the gamut today and talk about all of it. So many women all of a sudden feel different or they're just frustrated by a sudden onset of anxiety. And I'm go continually relate this back to anxiety, but I am going to cover a lot of things. But because I specialize in anxiety, this is a lot of what I hear in my office. Some overview here. Perimenopause typically starts in your mid ish 30s or 40s. We kind of know in general those are common ages, you know, mid-30s into your 40s is when we start to see some of these symptoms, if these symptoms are going to show up. Some women feel great and they experience very little during this transition into menopause. And other women struggle significantly. So menopause means when you've gone 12 months without a menstrual cycle, without a period. Perimenopause literally means around menopause. It's the transition time into not having a period anymore, not, you know, being in your child bearing years. So menopause is just kind of the meaning of it is when you haven't had a period for 12 months. The perimenopause period is around menopause. And unfortunately the perimenopause period is when all of this stuff is happening in these hormonal drops and these fluctuations. And it can last for years and it can get better and it can get worse and there's just, there's so much happening. So it is this natural transition time into menopause. Body wise, it's when ovulation starts to become unpredictable and eventually stops. And symptom wise, physically body wise, right. These symptoms come through in terms of hot flashes, your mood can be impacted, your menstrual cycle lengthens. Right. So it's a little more unpredictable or you go longer in between periods. And all of this is because of significant changes in hormones. So if we kind of look at what's happening hormonally during this time, and like I said, I'm going to do my best to give you an overview of what's happening physically, but like also how all of this impacts women, again in their 30s and 40s and beyond and stuff like that. So hormonally there's three hormones that are really associated with this. Estrogen, progesterone and testosterone. Okay, estrogen during the perimenopause period all of these hormones, all three of these for women, are decreasing significantly over time. And again, that's what's causing these physical and emotional symptoms. So estrogen, when estrogen drops, we see mood changes, we see intimacy being impacted, we see things like night sweats, hot flashes, sleep issues. On average, like I had mentioned, a lot of women experience symptoms, some women don't. They say, on average, about 50% of women experience symptoms like these in this perimenopause transition as progesterone drops. That's what affects the menstrual cycle. And so we're not really going to cover the impacts of testosterone because I'm more concerned with the impacts that estrogen has. And that's generally where we're seeing a lot of these symptoms coming from. I am not a doctor, I want to be very clear about that. But a lot of times, if I'm looking at labs with a client or they've met with providers or a functional medicine doctor or an endocrinologist, whatever it might be, it's the estrogen that in my experience, and my understanding is, tends to have a significant impact. They all matter. But estrogen, usually with those drops in it, that's essentially what's causing a lot of these symptoms and stuff like that. So you can correct me if I'm wrong, but in all of my research and all of my experience and all of the providers that my clients have seen and come back to me with information, I'm specifically kind of going to speak on the estrogen piece today. And that seems to be what's having a huge impact. So when we look at decreasing estrogen, it matters because in the mental health terms, it has an effect on GABA and serotonin. And that's what potentially leads to the anxiety, the irritability, the depression, the mental health impacts that we see that I see in my office, gaba, G A, B A. It's an acronym for gamma aminobutyric acid. It's a neurotransmitter. It has a calming effect effect. It's kind of like a parent to an unruly toddler. It is kind of there as like a calming agent. So when there's less gaba, it can be linked to anxiety. And it's there because it kind of takes care of these excitatory neurotransmitters. Right? It's like that parent chilling out the unruly toddler. And so when it's not there, there's no one. There's other things there. But essentially the parent isn't there to like calm the child down so that when GABA decreases, it's not obviously as present to take care of the like excitatory neurotransmitters that can maybe cause anxiety and stuff like that. So GABA has a significant impact. And again, when estrogen is decreasing, it's causing the, the GABA and the serotonin, serotonin being like your quote unquote happy hormone. It's causing these neurotransmitters to decrease, which has, you know, a potential impact on your mood. The progesterone is also known for its calming effects. So it can also be contributing to anxiety as it's decreasing. We also know as we age, cortisol goes up. Cortisol is your stress hormone. So we know the impact, the significant impact that cortisol can have on your nervous system and your well being in general. When a doctor tells a patient you need to exercise and eat better and lower your stress, when they say lower your stress, they mean we gotta manage your cortisol because your stress levels are through the roof. So as we age, cortisol levels naturally go up. So as other hormones are decreasing and cortisol is going up, this is almost like a compounding effect on everything. And then everything inside is just unruly and it's going haywire. And you're thinking, oh my God, I feel off. I don't feel like myself. Am I going crazy? I'm thinking the worst about everything. Not because there's something wrong with you at all, but because there's literal hormonal changes. And sometimes they're so quick and significant or it can be a slow burn, but it's different. You feel different because things are different and things are being impacted. All of these physical symptoms are happening and they can impact you. So not only is all of this stuff going on, but when there are physical symptoms, they impact you. If you're not getting as good of sleep, that impacts your mental health, that impacts your mood. Right. And I don't want this to be like a defeatist thing or in this sense of like, well, I just got to like succumb to all of this. No, but when we look at these compounding effects of what's happening within the body, it makes things make sense. It can make a woman be like, wow, okay, I'm not crazy. There are things happening here. There are actual changes going on. And now how do I take care of that stuff? So you gotta think about all of these things having like a constant compounding effect. If you're again, in your 30s, 40s, and feeling off or feeling different or starting to experience these things, the quicker we can catch it and the more you can advocate for yourself and the more you know, the better you'll be able to have help and be able to feel because you'll know that, oh, this isn't just in my head. There's something literally happening here. A couple random things. Just as a side effect as estrogen drops. I actually never realized how significant of an impact estrogen has on our system. We see common things that we don't even associate with estrogen, with these hormones. I know now when a woman is randomly complaining that she has frozen shoulder or joint pain, and she's like, I'm not doing anything different. I'm like, ah, we need to maybe look at this. Or we start talking about these hormonal changes, and if this is something that's making sense to her because it's so weird. Frozen shoulder, joint pain, headaches, a lot of those things are also randomly associated with drops in estrogen. So again, if you're around this age and all of a sudden, randomly, you're just like, what? What's going on with my shoulder? I again, am not a doctor. I don't know why this is a thing. But these are things that we're seeing and they are confirmed by doctors. This isn't stuff that I'm just like, ooh, this is a good connection. Let's make it. I'm not making this stuff up. This is stuff that, like, doctors have seen and talked about and these major impacts that as estrogen drops, there are sometimes these symptoms that we don't connect and a really good doctor will be able to connect and take care of and stuff like that. So just something to think about. If there's weird stuff going on and you're like, there is no good reason why this is happening to me. Maybe there's a reason. And again, you're not going crazy. It's not in your head. There could be something happening here. As someone moves through perimenopause, once there's a stabilization, this is amazing. Many women do start to feel a decrease in the anxiety. And it's highly individual, woman to woman, and it can be a rocky road to get there. But as that transition occurs and menopause is achieved, I. I don't know what we want to say here. Right. But, like, once it happens and your body's kind of, like stabilized, a lot of women do start to feel better, these symptoms to go away. Things are regulated again, right? Maybe there's just this, like, natural adjustment, but it's that rocky road of getting there that will drive us bananas and make us feel like, why is this happening? And why do I just not feel physically and mentally and emotionally like myself? So there is hope. There are things. And we're going to talk about ideas and things you can do. But we do know once the stabilization occurs, we see a decrease in symptoms in general. Obviously, every woman's different, but it is good to know that, like, there's a little bit of light at the end of that tunnel. One of my major frustrations for my clients is, and I kind of want to get into, like, self advocacy here, is how often they're dismissed by doctors or other providers. So we grow up right as we're growing up as women. And a lot of times people will say things like, oh, it's just your hormones, it's just your hormones, it's just your hormones. And then we get to a point where it could be our hormones. And doctors are like, it's all in your head. Go see a therapist. It's probably just anxiety. And it's just like, it drives me nuts because I have seen women time and time again be dismissed by providers and doctors and be told, it's just in your head. And then they're sitting in my office dealing with anxiety, which is fine. But then I'm talking to them about what makes sense here, what else could be contributing. Nothing else in your life has changed. And then I'm helping them find a provider that's actually going to help them with these symptoms, because other doctors or other providers have been like, this is. This is just in your head, or, we did your hormone levels. Everything is normal. That is something I hear a lot. And I have such compassion for my clients and women who go through this because I just hear so often that their doctors dismiss them or their doctor, their provider, whoever they're seeing is like, well, your hormones are normal, so it's fine. So work on your anxiety and your stress with your therapist. And it should work out just because things, quote, unquote, look normal in a blood test. I've seen really good doctors dig in a little more and do different kind of hormone paneling, and they uncover things and then they can treat it, and then the women also feel better. So it's not to say things can't be done to treat anxiety. That's my specialty. It's just very frustrating for me. And I have so much empathy for women who are just dismissed and then they're Left to be like, well, I don't know, this is just. This is my fault, right? This is a me issue, and it's really sad. Let's transition a little bit into what do we do? We've talked about common symptoms. Now what, what do you ask? How do you advocate for yourself? What can you do at home, lifestyle, all that stuff? Because how you take care of yourself is going to have an impact. Common symptoms that often aren't associated with fluctuating hormones that women are like, oh, this is just anxiety. Are things like racing heart, a feeling of intense dread, low frustration tolerance, fatigue, sleep disturbances, overthinking, forgetfulness, brain fog, catastrophizing. A lot of times when a woman is struggling with anxiety and perimenopause, these things can be exacerbated by the fluctuations in the hormones. So again, I treat them in therapy. And then also, if there's something going on hormonally, we can make a huge positive impact when that is also treated within the body. So if any of these things are happening and this is like your time in life, there also might be something hormonally going on. We just, a lot of times don't associate these symptoms with hormones. Like, we just are. Again, whether we're dismissed or it's like, no, this is just my anxiety, this can't be my hormones or whatever. Just. I just want you to think about it. If there's, you know, again, brain fog, catastrophizing, forgetfulness, hey, there could be something maybe exacerbating this going on here. And I will tell you, the women I see who are in the throes of perimenopause are some of the most catastrophizing humans I have ever met. And I don't say that in a bad way, but there is something about this decrease in serotonin and GABA and the increase potentially in the anxiety and the irritability that causes them to just think such catastrophic thoughts. And they've told me things like, I know I struggle with anxiety. I know I'm an overthinker, but I have never felt like this to this level. And that's when I. I mean, I'm always paying attention, right? But when they say things like, I'm catastrophizing way more than I used to, I really note that. And I'm like, okay, this is maybe being exacerbated by something going on potentially with hormones. So not that this is the be all and end all and always the answer, but if I'm seeing an Adult woman in this age range, I'm listening for that stuff. I'm listening for these symptoms. And if they're saying things like, I know I'm anxious, I know I'm an overthinker, but lately I just think the absolute worst, and I can't get out of this headspace. So I'm not sure exactly what the correlation is and why there is such catastrophic thinking. But that is a huge piece that I generally look for as I'm assessing for symptoms and diagnosis and doing an intake and things like that. I try to take a very thorough, holistic approach to someone and talk about, you know, also, like, what medications are taking, what other providers they're seeing, and things like that. So, because we want to make sure someone is getting the best care possible. And a lot of times, like, it doesn't. It's not just me. They're seeing other doctors, and I want to make sure they have all the information that they can advocate in the best way they can for themselves. So what do we do about all this? We got some basics. I've told you about symptoms, and now again, I don't want you thinking, well, I'm just screwed. No, not at all. There are things we can do. Therapy can help. We know this. This is what I do. Right? We can do things in sessions and outside of sessions to practice managing the overthinking and the anxious symptoms and the catastrophizing and all of that stuff, and body work and breath work and meditation and lifestyle stuff. All the things I do are going to help decrease the anxiety and treat those symptoms. But if there's other stuff going on, I always try to help my clients find the best care team for them. So the medical aspect of finding a doctor who understands this period of life can be frustrating. But it is also important. I finally have some really good providers that I can refer to here. I know who I can trust and who's really going to dig into this stuff. So, you know, just making sure that you know how to advocate for yourself and the questions and everything like that. Okay, we're gonna flip a little bit into what you do at home. And again, I'm not a doctor. You have to do your own research and work with your healthcare provider. But in my experience, in my personal life, clients who have come back to me and seen, again, functional medicine, doctors, naturopaths, endocrinologists, these doctors that really dive in, these are some of the supplements that they've seen help and that can help manage the symptoms. And, yeah, Google it. Do your research, ask your doctor. Hey, is this maybe something that's going to be good for me? You have to do what's best for you. But here's a few common ones that I can encourage my clients to ask their doctor about and see if it would be beneficial. Okay, so the first one is magnesium, but not magnesium glycinate or citrate or the common ones. We hear it's the magnesium L Threonate. This one supports cognitive function and stress. This can be really good for decreasing those cognitive symptoms, the overthinking and things like that, helping manage stress. Number two is ashwagandha. Maybe you've heard of this one before. It's gotten kind of mainstream lately. I love it. I take it every night before bed. It's very calming. It's great for regulating cortisol. So they make ashwagandha tea, they make drops, I take like a little dropper, they make capsules, they make all kinds of stuff infused with ashwagandha. And my clients who struggle a lot with anxiety, whether or not it's perimenopause or not, often they find that ashwagandha can be very helpful for managing cortisol, helping them sleep at night, things like that. So ashwagandha is a great one. Number three, rhodiola. This is another herb, great for reducing stress. And this one also helps improve mood and memory, that cognitive functioning again. Right. So now we're looking back at that brain fog and the forgetfulness and stuff like that. So these supplements kind of touch on different symptoms that you might be experiencing. And so rhodiola is pretty good for like that forgetfulness and stuff that I see a lot in women. Number four, L Theanine. This can influence gaba. So remember a while back we talked about gaba being this like parent, that's the calming force of the unruly toddler. So L Theanine can help influence, like increase GABA a little bit and increase relaxation. So this is really good again for stress, anxiety, irritability, stuff like that. Number five, Omega 3s. These we know are really good anti inflammatories. They also help regulate mood. They're really, really good for brain health. But omega 3s, in terms of mental health, anxiety, they've seen some really good research and information on not only again, them being anti inflammatory, but helping to regulate mood, which is great, right? We want to feel more stable and less fluctuating. If that's. That's not a word. I know that's not a word. And the Last one, valerian root. I do have a lot of women who they'll again, valerian root tea or there's other like ways it comes. But valerian root can be really good. And the thought is, is that this also has an impact to increase GABA and can reduce the hot flashes and promote relaxation. So now you're talking about the valerian root being able to increase the gaba, which is relaxing. But then if it's also reducing the hot flashes and helping you sleep at night, that's also going to positively impact sleep and your mood and stuff like that. So all of these things kind of have a different function and you have to figure out what works best for you. And again, do your own research, ask your provider, get approval, make sure it's going to be good and it's not, not contraindicated with anything else you're taking. But those are the supplements that I have seen most associated with not only anxiety, but specifically these perimenopausal symptoms. And the last thing I want to touch on is lifestyle. Your lifestyle, how you're taking care of yourself, not only is going to help your health overall through this transition time, but when we take care of ourselves, we just feel better, right? We feel more productive. At the end of the day, it's like, oh, I'm proud of myself. Like, all that stuff has a good impact on our mental health. We know this. But there are specific things that, if I'm looking at this connection between mental health and perimenopause, all of this stuff is important. But there are specific things that I will strongly encourage my clients to do to help manage some of these symptoms. Okay, the first one is strength training. This is always important. No matter what phase of life you're in, no matter what age you are, it's always important. We know the importance of strength training, resistance training, progressive overload, having some muscle on your body, it can help all kinds of things. I mean, we, we know the significant effect that, that having some muscle has, but it can also be especially helpful with lowering cortisol. And it also has the positive effects of exercise like on your mood and impacting your self esteem and confidence. So there's often an intense struggle that women have during perimenopause with self esteem. Obviously we talked about stress and stuff like that, but with self esteem, because life is transitioning and things are changing and maybe their body's changing or they're going through some of these symptoms. And if we are honest and I tell you about the women that have come into My office struggling with this stuff, they're like, I feel like shit, like I don't feel good about myself. And sometimes their self esteem suffers or their confidence suffers. So strength training is something that can have a really good impact on us physically and we know the importance of muscle, but also on the self esteem. Knowing that like, hey, I did something difficult is incredibly positive. That feels good. And knowing that you lifted something heavy is an improvement on your confidence. When we feel physically capable, we tend to feel more emotionally and mentally capable. So strength training is generally always something that I recommend to my clients and, but especially if self esteem and these other symptoms are occurring during perimenopause. Something else I recommend are things like breathwork and meditation. These are incredibly great for calming your nervous system, lowering cortisol, grounding yourself. They are very important for in the moment, like putting out a fire of anxiety or irritability or stress. But also if you can practice them systematically throughout the day, when you're okay, when you wake up before bed, you will overall bring down the level of anxiety and overthinking and all of the other things that are happening. But they will also be more accessible in a moment of need. So anytime I teach a technique to my clients, I also encourage them to make sure that they're not just doing it when they need it, that they're practicing things like grounding and meditation and mindfulness and breath work when they're okay, so that they can then deploy the technique when they need it most and it's more accessible. Couple things in relation to nutrition, and this is super interesting to me. It always is. And usually when I'm explaining this to a client, they're like, wow, that's really interesting. And now I know why I need to do that, which makes them kind of want to do it even more. When we know the why behind something, it makes it make sense and then we're way more willing to do it. So nutrition wise, eating protein, protein is very good for maintaining satiety. And we know all of the good things that protein can do and we need it. And a lot of women don't get enough of it. So making sure that you're somehow prioritizing protein, hydrating with water, and limiting caffeine and sugar. I don't want to demonize caffeine and sugar, but one of the first things I ask, no matter who comes in my office when I'm asking them about what their lifestyle's like and what they're eating and drinking, is if they are ingesting a Lot of caffeine and sugar because it has a very significant impact on anxiety or it can. And so that is something that I look at. We also know that sugar has a negative impact on our ability to stabilize blood sugar. Right? So if we're going to talk real quick about blood sugar, that can be really important in terms of symptoms. And the more stable our blood sugar is, it is going to help regulate some of these symptoms. We will feel, mood wise, more stable. So a quick, quick overview about blood sugar is you may have heard of glycemic index. The glycemic index, the GI is how fast a food can raise your blood sugar levels, right? How fast those blood sugar levels spike. That's the glycemic index. Glycemic load is a more comprehensive approach and that takes into account the glycemic index and the amount of carbs that that food has in a serving. The importance of this is low glycemic index foods, low glycemic load foods are very good for regulating blood sugar. So if you have no idea where your blood sugar's at, if you don't know where to start, you can google low glycemic load foods, you can google a glycemic load chart and you could be like, I'm going to start eating more of those foods. That is a very easy way to access some of this information and start to implement it like today. Because blood sugar can have such an impact on anxiety in terms of blood sugar and mental health and these symptoms. Low blood sugar can trigger feelings of fight or flight. High blood sugar can impact your mood and increase anxiety. So the more regulated your blood sugar can be with your diet and the things you're ingesting, the more you're also going to feel in control of some of these symptoms. It's not to say it's going to quote, unquote, fix everything, but it is a piece of the puzzle and a lot of people don't pay attention to the connection between blood sugar and their mental health because we A don't know a lot about it and B, we aren't taught a lot about it. So that is a very basic overview. And if that's something you want to get started with, go for it, Google it. But you can look up glycemic index chart. Even better, look up glycemic load and look for some foods that are great on the glycemic load and see like what you can start to eat more of and ingest more of and practice regulating your blood sugar. Kind of from that angle. And, you know, you might find it interesting. I. I think the impact of food on mental health is an incredible rabbit hole that we can go down another day. But I always love to teach clients about that. That was a bunch of info. I know it was. I told you I was going to give you a massive overview today on what perimenopause is, what's happening in your body, the impact of mental health, the symptoms, how to advocate for yourself, some of the supplements, the lifestyle stuff. That is a lot of information. But I wanted to provide that because the thing I dislike, I don't want to say the most, because there's a lot of things I dislike when it comes to how things are taught to people. But when a woman comes into me and they feel like they're losing it, my heart breaks. My heart goes out to them because there are usually other things going on that are being overlooked or they're not aware of or whatever. So I just don't want you to feel like you're losing it or like you're alone or like this is all in your head. If this is a point where you're at in your life, you're your 30s, 40s, and some of these symptoms are cropping up and you're feeling alone, Reach out. There is help out there. It's likely that your body is shifting, things are happening, and there are options. There's treatments, there's supplements, there's people to support you, and there are providers who will. Listen, girl, you're not losing it. I promise. There's, you know, it's not your fault. There's help out there. I just truly hope that gave you an understanding of what's going on. Because anytime I learn anything new, I'm like, I feel like I should have known that. And now I gotta tell all my clients, and now I gotta learn more about it. I just. There's always something, and if this gave you a really good overview, I am happy that I was the person to be able to do it. And now you can go and take that information and advocate for yourself and feel better and just do what you need to be your best at this time in your life, because we are in this together. And I just really hope that I can be a voice and provide some inspiration and education to help you navigate something that is being talked about. But I just don't feel like it's being talked about enough. And I want to be someone who adds to the conversation in a way that's helpful. All right. Until next time. Take care of yourself. Thanks for hanging out with me today on let's Talk about it with Laurie Streeter. If this episode resonated with you, it would mean so much if you'd leave a five star review, share it with a friend, or come say hi on Instagram loristreeter. Your support will help this podcast grow and I so appreciate appreciate you being here today. I want to help people just like you feel like they're not alone and gain the tools they need to grow. Until next time, take care.