Menopause-Related Anxiety: How Long Will It Last, and Can HRT Provide Relief?

There’s a valid reason menopause is called “the change of life.” Many women suffer physical and mental health symptoms not only during menopause, but also during perimenopause, the period preceding menopause. 

Board-certified family nurse practitioner Letrice Mason, MSN, APRN, FNP-C, with Her Down There, provides menopause services including hormone replacement therapy (HRT) to women with menopause symptoms causing disruptions to daily life. 

If you’re in your 40s or early 50s and undergoing perimenopause or menopause and find yourself undergoing mood swings involving anxiety, irritability, and/or depression, you’re not alone. Although some women manage to sail through menopause, many do not. Mood changes may be accompanied by symptoms such as insomnia, brain fog, memory loss, hot flashes, night sweats, heart palpitations, hair loss, and more. 

Perhaps part of your job involves speaking in public, and you lose your train of thought. At the same time, you experience a hot flash so severe that your clothing becomes wet and sticks to your skin, causing embarrassment and consternation. 

Experiences such as this can cause anxiety in addition to other symptoms. You never know when you’re going to experience another embarrassing hot flash or forget someone’s name. 

You may wonder whether your heart palpitations are going to lead to heart disease. Oprah Winfrey revealed on a 2025 TV special on menopause that she had heart palpitations for two years that doctors couldn’t explain. She now knows they were menopause symptoms. What causes these troublesome and anxiety-provoking symptoms?  

Menopause mental health symptoms occur in up to 50% of women

During perimenopause and menopause, changes in your female reproductive hormones can produce mental health symptoms such as anxiety and depression. Physical symptoms caused by hormonal changes can cause and reinforce feelings of anxiety and depression. Not knowing when another severe hot flash is coming is anxiety-provoking. 

A 2023 study found that up to 50% of women in perimenopause and menopause experience mental health symptoms like anxiety or depression as well as cognitive/neurological symptoms such as memory problems and insomnia. The more severe your menopause symptoms are, the more likely you are to experience mental health symptoms such as anxiety and/or depression. 

Hormonal changes cause mental and physical health symptoms 

Your female reproductive system is winding down in perimenopause and effectively comes to an end during menopause. Your ovaries produce less and less estrogen and progesterone, major female reproductive hormones. They’re no longer needed to help prepare for childbirth. 

During perimenopause, your estrogen levels can “go rogue” and fluctuate wildly. Your brain’s amygdala, which helps control your emotions, reacts to extreme changes in estrogen levels. 

Lower estrogen levels lower serotonin levels in your body. Serotonin is the “feel good” chemical in your brain. You may experience anxiety or depressive symptoms as your hormones experience dramatic changes, finally plunging as you reach menopause. 

In addition to affecting your emotions, the lack of estrogen can sometimes produce severe physical symptoms: joint aches and pains, bloating, hot flashes, night sweats, and insomnia. All of these can disrupt your normal daily routine as well as cause stress and anxiety about when more hot flashes or heart palpitations are coming.  

How long do anxiety and other mood-related symptoms last? 

Symptoms can last for years, depending on how long you’re in perimenopause, which can last from 3-4 years and in some cases up to 10 years. But, you don’t have to suffer life-changing menopause symptoms for years on end. There is help. 

HRT aids menopause mental health and physical health symptoms 

At Her Down There, we specialize in women’s health. We provide compassionate care for you when you’re experiencing perimenopause and menopause symptoms that disrupt your life. 

Hormones play an integral role in your overall health. HRT helps many women regain quality of life during perimenopause and menopause when your hormones are in flux. We assess whether HRT is right for you.  

HRT isn’t prescribed just for anxiety. By rebalancing your body’s natural hormones, HRT helps stabilize your mood, helping to relieve you of feeling anxiety, irritability, or depressive symptoms. 

Call or message Her Down There today if your life is upset by menopausal symptoms. We can help at our offices in Houston and Arlington, Texas. We offer telehealth appointments through our Arlington office.