Dr. Shereene Idriss explains that sudden anxiety and panic attacks in women in their 40s often stem from perimenopause, when fluctuating estrogen affects mood and stress response. She stresses ruling out serious conditions like heart attacks first, then tracking symptoms alongside cycles and sleep to show doctors. Grounding techniques like slow breathing and ice can help manage acute panic.
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If you are suddenly experiencing anxiety and panic attacks and you are in your 40s, it can be a symptom of perimenopause. So many of you are sharing with me that this happened to you in perimenopause, but you didn't make the connection until years afterwards. And as a physician, that really pisses me off because we are not preparing women for this hormonal phase of their life. Puberty number 2. Estrogen doesn't just affect your period, it also affects your brain, your mood, and your behavior. And during perimenopause, it fluctuates so So much that imagine being sleep deprived and now your stress response isn't what it used to be, more erratically and so much more dramatically. And that anxiety that you feel is like nothing you've ever felt before. Here's where I want to be super clear. Knowing anxiety can be part of perimenopause is important, but it doesn't mean that every new symptom should just be blamed on hormones or written off as a panic attack because heart attacks and panic attacks can feel the exact same way. And missing something super serious can obviously have deadly consequences. If this is a brand new symptom, you are feeling intense chest pressure, Pain, shortness of breath, go get evaluated. Do not self-diagnose it as anxiety because we do not want to fall in the bucket of deadly. Once something super urgent has been ruled out, track it with your cycle and your sleep pattern to notice if it is associated so that when you go to your doctor, you can smartly ask, could this be perimenopause, with multiple data points that you can turn back to. For some women, HRT will be part of that answer, but it's important that you recognize your panic symptoms so you have tools to help ground yourselves in the moment. For me, it was slowing down my breath, literally grounding myself. Ice helped me, and apparently even sour candy helps a lot of you guys. The takeaway isn't that your anxiety is just your hormones, it's that your hormones should be part of the conversation. Women shouldn't be spending their prime years thinking they're losing their effing minds. Curious if anybody ever told you that perimenopause could be the root cause of your anxiety, because nobody warned me.
