I have issues with perimenopausal anxiety a couple of weeks per month and don’t want to turn to SSRIs.

My challenges with anxiety have been hormonal. I’ve had issues with both postpartum anxiety and now perimenopausal anxiety a couple of weeks per month as I’m approaching menopause. I don’t want to turn to SSRIs but some days are pretty miserable and most other days I feel fine. Any info you have to share regarding this topic or any natural solutions would be of great interest.

When I’m working with a client who reports symptoms like this we start with serotonin and GABA support; determine if they have low zinc, low vitamin B6 and low iron. I also always ask the question: are you on the birth control pill (now or in even in the past).

I’ve blogged about much of this in the past so I’m going to share snippets and blogs for further reading.

Serotonin support with tryptophan for immediate worry-type anxiety relief

In a study published in 1999, A placebo-controlled clinical trial of L-tryptophan in premenstrual dysphoria, tryptophan was found to reduce symptoms of PMS when used in the luteal phase or second half of the cycle (i.e. after ovulation).

This is very typical when I’m working with someone with both PMS (premenstrual syndrome) and perimenopausal anxiety, depression, irritability and mood swings. It typically takes 2 to 3 cycles for an amino acid like tryptophan to have an impact on the cyclical nature of your perimenopausal symptoms.

However, tryptophan does typically start to work right away on the less severe anxiety and mood symptoms assuming you find the ideal dose for your needs. I use the trial method to help my clients figure this out.

When you boost serotonin you also reduce the worry-in-your-head and ruminating type of anxiety, and end to panic attacks and phobias, a boost of confidence, no more depression and negativity, imposter syndrome that is no more, an end to your anger issues and irritability, an improvement in sleep and no more afternoon/evening cravings for something sweet.

You can read more about tryptophan here: Tryptophan for the worry-in-your-head and ruminating type of anxiety

GABA support for relief from tension-type anxiety

During perimenopause progesterone is often low and when it is low, we can expect GABA to be low too. Research confirms low GABA and high glutamate-glutamine in premenstrual dysphoric disorder (PMDD) and that shifting hormones may lead to dysregulation of GABA which contributes to HPA axis dysfunction. The HPA (hypothalamic pituitary adrenal) axis is your stress response system and when it’s not functioning well you are more susceptible to the effects of stress and more likely to feel depressed and anxious.

If your GABA levels are low you will feel increased physical tension and insomnia. The amino acid GABA, opened on to the tongue, can provide calming results within minutes.

Dee likes the instant calm and compares how it worked as well as Xanax had worked for her in the past:

I have taken Xanax in the past for panic attacks. My functional medicine doctor suggested this product as I wanted a natural product. I was amazed how it works just like the Xanax did – instant calm feeling within 10 mins of taking 2 capsules. I use them as needed when I am having heightened stress and anxiety.

Low zinc, low vitamin B6 and/or low iron?

Low iron/ferritin is common if you’re still having a period and it’s one of the important -cofactors for making serotonin, thyroid hormones and the sex hormones. Low iron, together with low vitamin B6 plays a role in anxiety and panic attacks. In one study premenopausal women who had been admitted to the emergency room with panic attacks were found to have both low iron and low vitamin B6. I have an entire blog post on this topic here

The other key co-factor for making serotonin is zinc. You’ll want to look into and address pyroluria if you feel more anxious in social situations like family gatherings, going to church events or community picnics, or even while doing business networking or in work meetings. The key nutrients for pyroluria are zinc and vitamin B6 and both help with PMS and perimenopausal anxiety, and hormone balance.

Are you on the birth control pill?

I recently reviewed Beyond the Pill A 30-Day Program to Balance Your Hormones, Reclaim Your Body, and Reverse the Dangerous Side Effects of the Birth Control Pill by Dr. Jolene Brighten.

If you currently on the pill or have been in the recent past read the above review and get the book to give you an excellent understanding of what may be going on with your body.

Dr. Jolene shares that mood disruption is common and mentions a study in the Journal of the American Medical Association which reports the following:

women who began the pill were more likely to be prescribed an antidepressant – which means it contributes to a bit more than moodiness

She writes in great detail about Post–birth control syndrome (PBCS) which is “is a constellation of symptoms women experience when they discontinue hormonal birth control.” She has found the symptoms of PBCS typically occur in the first 4-6 months after stopping the pill. As well as mood swings and anxiety, you may also experience heavy bleeding or no period, acne, headaches, infertility, pill-induced PCOS (polycystic ovarian syndrome), hypothyroidism, gut issues and even autoimmune symptoms.

You also want to reduce your stress levels. Here are some ideas for you:

• Get into nature and experience the incredible benefits of forest bathing
• Do some bird-watching in your backyard or at a nearby park: People living in neighborhoods with more birds, shrubs and trees are less likely to suffer from depression, anxiety and stress
• Get outside and start bouldering or go and “play” in a climbing gym: A growing body of research suggests that bouldering, a form of rock climbing, can help build muscle and endurance while reducing stress

All the above is a great starting point. You also want to consider adrenal support if needed; and support liver health, together with dietary changes, addressing gut health and thyroid health, getting toxins out of your life and figuring out whatever your own root causes may be.

Here is the link to the amino acids and pyroluria supplements I use with my clients.

Have you found that any of the above has helped you with your PMS or perimenopausal anxiety?

Do you have any stress-relief tips to share with other women who find themselves so stressed out at this age?

Feel free to post questions here too.