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Is it just anxiety or perimenopause? A health expert reveals the hormonal signs many women miss

Is it just anxiety or perimenopause? A health expert reveals the hormonal signs many women miss

Mood changes, panic and overwhelm are common in perimenopause. A menopause expert explains how to spot the signs.

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MadeForMums team

Published: January 7, 2026 at 11:06 AM

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Feeling anxious, overwhelmed or not quite yourself? You are not alone. Almost four in ten women say they were misdiagnosed during perimenopause, often with conditions like depression or anxiety, which can delay the right support and treatment.

For many women, anxiety symptoms appear years before menopause officially begins, sometimes as early as the mid-30s. Because periods may still be happening, and life is often busy with work, children and mental load, hormonal changes are not always considered.

To help mums understand what might really be going on, we spoke with Hanna Yusuf, Prescribing Pharmacist and menopause health expert at Chemist4U, who explains how perimenopause can affect anxiety, how it differs from menopause and when to seek treatment.

Why perimenopause is often mistaken for anxiety

Perimenopause is the hormonal transition leading up to menopause, and it can last for several years. During this time, fluctuating hormone levels can have a significant impact on mood and emotional wellbeing.

“Perimenopause is the transitional phase leading up to menopause. During this phase, hormone levels, particularly oestrogen, begin to fluctuate irregularly. Women may experience symptoms such as irregular menstrual periods, hot flushes, night sweats, mood swings and changes in libido. Perimenopause can last for several years and continues until menopause is officially reached,” explains Hanna Yusuf.

Anxiety, panic attacks, low mood and irritability are all common during this stage. However, because these symptoms can look very similar to a mental health condition, they are often treated in isolation rather than as part of a hormonal picture.

Despite NHS guidance on early recognition, many women are unaware that perimenopause can begin well before the average age of 47, sometimes in the mid-30s. This misunderstanding can lead to anxiety being treated without addressing the underlying hormonal cause.

Anxiety in perimenopause, what does it feel like?

Anxiety linked to perimenopause can feel different to anxiety experienced earlier in life. Women often describe sudden feelings of panic, intrusive worries, loss of confidence or feeling emotionally overwhelmed for no clear reason.

These symptoms may come alongside physical changes such as disrupted sleep, night sweats, hot flushes and changes to menstrual cycles. When anxiety appears alongside these signs, hormones may be playing a role.

Recognising this connection can be empowering, helping women understand that they are not failing or losing control, but experiencing a biological transition.

When does menopause officially begin?

While anxiety and mood symptoms can start during perimenopause, menopause itself is defined by one clear rule.

“If you haven’t had a menstrual period for 12 consecutive months, you’ve hit menopause,” says Hanna.

“Menopause is officially defined as the point at which a woman has not had a menstrual period for 12 consecutive months. It typically occurs in the late 40s to early 50s but can vary widely among individuals.

“At this stage, the ovaries have largely ceased producing eggs, and oestrogen and progesterone levels have significantly decreased. Menstrual periods cease entirely, and many of the symptoms experienced during perimenopause continue into the early stages of menopause.”

Treating anxiety linked to perimenopause

There is no single treatment that works for everyone. Managing anxiety during perimenopause often involves a combination of lifestyle changes and medical support.

1. Regular exercise

“Regular exercise, including a mix of cardio, strength training and flexibility exercises, can help alleviate hot flushes and mood swings while also managing weight gain.”

2. Diet, rest and routine

“A balanced diet rich in fruits, vegetables, whole grains, lean protein and essential nutrients supports bone health and overall vitality. This will help with energy, mood fluctuations, and weight management.”

3. Hormone replacement therapy (HRT)

“When lifestyle changes haven’t worked, hormone replacement therapy (HRT) is one of the most effective treatments for managing a wide range of menopausal symptoms, including hot flushes, night sweats, vaginal dryness and mood swings.”

4. Other medication options

“Depending on your symptoms, there are other options available. For example, anti-depressants, like SSRIs and SNRIs are prescribed to address symptoms like hot flushes. Gabapentin is used to help with sleep disturbances, clonidine for migraines and hot flushes, vaginal oestrogen for UTIs and birth-control pills for hot flushes.”

When to speak to your GP

If anxiety symptoms feel new, worsening or out of character, and especially if they appear alongside cycle changes or physical symptoms, it is worth discussing perimenopause with your GP.

Understanding the hormonal link can help ensure anxiety is treated with the right support, rather than being dismissed as stress or something you simply have to cope with.

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MadeForMums team