The Stress–Anxiety Spiral in Perimenopause & Menopause: How to Break It Before It Breaks You

Science says: stress management is vital.
Real life says: I call it “stress management,” but it’s really just staring at the fridge and hoping for answers.

If that made you nod, you’re definitely not out on your own. During perimenopause and menopause, stress isn’t just a background issue, it quietly amplifies almost every symptom, especially anxiety, sleep dispruption and emotional overwhlem women experience.

Why stress matters in menopause

Anxiety is one of the most common and least talked about symptoms during this transition. It’s not just emotional, it’s psychological, and stress plays a role.

1. Menopause affects more than hormones.
   The transition triggers changes in mood, sleep, cognition and energy. Studies show that women with higher stress levels often report more intense symptoms such as anxiety, memory problems and irritability.

2. Stress makes symptoms feel worse.
   High perceived stress is linked to greater fatigue, poorer sleep and lower quality of life during perimenopause and postmenopause. (PMID: 29189603)

3. Managing stress works.

• A systematic review found that mindfulness-based interventions significantly reduced stress in menopausal women. (Frontiers in Public Health)

• Another review showed that yoga, tai chi and similar practices improve sleep and reduce fatigue. (PMID: 38669625)

• Early recognition and management of stress symptoms can make a major difference to overall wellbeing. (PMID: 35964446)

So, yes, stress matters. And while staring at the fridge might offer a moment of quiet, it’s also a signal… your body and mind are asking for something more nourishing, more sustainable and more supportive.

 What stress is doing behind the scenes

• When stress hormones like cortisol stay elevated, they can disrupt sleep, appetite and mood, and intensify feelings of anxiety and restlessness, making it harder for your body to respond positively to nutrition and exercise.

• Combine that with fluctuating oestrogen and progesterone and you’ve got the perfect mix for feeling out of sync.

• Studies show that women with lower resilience and higher perceived stress experience more troublesome symptoms. (Frontiers in Psychiatry).

Anxiety often shows up as racing thoughts, chest tightness, or a sense of dread even when nothing specific is “wrong.” These are real, physical responses to hormonal and neurological shifts.

The result? You feel more tired, crave quick fixes and lose the motivation to do the very things that would help you feel better.

 What to do about it (real-life strategies that actually work)

1. Recognise your stress triggers.
Notice what’s really behind the craving or the short fuse, work pressure, lack of rest, skipping meals or simply feeling overstretched. Anxiety often masks itself as irritability or indecision, so naming it helps. Awareness is the first step to change.

2. Start small.
Research shows even 10–20 minutes of yoga, mindfulness or gentle movement can make a measurable difference. Small steps count.

3. Nourish your body.
Whole foods, protein and steady blood-sugar balance all support better stress regulation. When your body feels stable, your mind follows.

4. Prioritise sleep.
Poor sleep amplifies stress, anxiety and mood swings. Treat rest as a cornerstone of your wellbeing, not a luxury.

5. Build resilience gradually.
Every small win whether it’s taking a deep breath before reacting or choosing a walk over another coffee strengthens your ability to cope with life’s pressures and ease anxious tension.

6. Be kind to yourself when things slip.
The goal isn’t perfection. It’s awareness, adjustment and consistency. One moment staring at the fridge doesn’t undo your progress.

The real takeaway

Menopause isn’t just a hormonal shift, it’s a whole-life transition. Stress and anxiety can make this stage harder but it can also be a teacher. By learning how your body responds and giving it what it truly needs, through movement, nourishment, sleep and mindset you begin to rebuild your energy and confidence from the inside out.

You don’t have to “push through.” You can work with your body instead of against it. Because when stress becomes something you understand rather than fear, it loses its grip and that’s when real change begins.

If you’d like support building a calm, sustainable rhythm that fits your real life, not a perfect one, let’s talk.

Book your free chat

References

1. Rubinow DR, et al. The Longitudinal Relation of Stress during the Menopausal Transition and Early Postmenopause on Inflammation. PMC. 2016. PMC4844901. PMC

• Investigates perimenopause as a sensitive period for stress exposures and health.

2. Liu H, Cai K, Wang J, Zhang H. The effects of mindfulness‐based interventions on anxiety, depression, stress, and mindfulness in menopausal women: A systematic review and meta-analysis. Menopause Rev. 2023. PMID: 36699873. PMC

• Shows that mindfulness-based interventions significantly reduce stress in menopausal women.

3. McCurry SM, et al. Cortisol Levels During the Menopausal Transition and Early Postmenopause. PMC. 2008. PMC2749064. PMC

• Examines how cortisol levels rise in some women during the late menopausal transition.

4. Thurston RC, et al. Perimenopausal vasomotor symptoms and the cortisol awakening response. Menopause. 2020. PMID: 33110049. PubMed

• Studies the relationship between vasomotor symptoms (hot flushes) and cortisol in perimenopausal women.

5. Badawy Y, Desai R. Stress, depression, and anxiety: psychological complaints across menopausal stages. PMC. 2024. PMC10917984. PMC

• Looks at perceived stress, anxiety and resilience across early-perimenopause to post-menopause.

Coaching Benefits & Client Experiences

1. Reducing depression during the menopausal transition with health coaching: Results from the healthy menopausal transition randomised controlled trial (PMID 27621237)

   A RCT showing that health coaching during the menopausal transition improved mental health measures and reduced symptom severity. PubMed

2. Effectiveness of coaching for enhancing the health of menopausal Japanese women (PMID 27571777)

   Coaching intervention increased self-efficacy and improved quality of life in menopausal women. PubMed

3. Effects of health coaching on menopausal symptoms in postmenopausal and perimenopausal women (PMID 36070877)

   Health coaching significantly reduced menopausal symptoms, depression scores and improved quality of life in perimenopausal/postmenopausal women.