Understanding Menopause and Anxiety: Support and Solutions

Transcript:

Teresa: Welcome to Dishing Up Nutrition, brought to you by Nutritional Weight & Wellness. Today's topic is the connection between anxiety and menopause, more specifically perimenopause. And if you are in the 35 plus crowd, this may feel very relevant.

What many women are beginning to learn is that menopause symptoms can begin long before you officially reach menopause. Menopause itself is defined as one single day, the day you've gone a full 12 months, 365 days without a menstrual period. Once you hit that day, you are considered post-menopausal.

Everything before that day falls under perimenopause and it often lasts much longer than people realize. On average, five to 10 years and sometimes even longer. Hormonal changes during this transition can start gradually and quietly, yet have powerful effects on mood, anxiety, sleep, and overall wellbeing.

So if you are a woman entering your late thirties or forties and noticing new or worsening anxiety, you're not imagining it and you're certainly not alone. That's not to exclude our post-menopausal ladies. They certainly can still feel that sudden or not so sudden onset of anxiety. For many women, though, it starts with no clear reason and it can be confusing.

Where is this coming from and why is this happening to me? Or maybe your heart starts racing, your mind feels on edge, and you can't tell if it's stress hormones or something else entirely. Perhaps you're feeling more overwhelmed, more irritable, or less like yourself than you used to. Maybe sleep isn't what it used to be, and now everything just feels a little harder to handle.

And if you've ever wondered, is this just anxiety or is it menopause? If you've been asking those questions, you are definitely not alone. Today, we're unpacking a bit of what's happening in your body during perimenopause and why anxiety can show up in ways that feel confusing, intense, and sometimes even scary.

We'll walk through what's causing it, how to recognize it, and most importantly, what you can do to start feeling like yourself again. First, let's take a moment to introduce ourselves. I'm Teresa Wagner, a Registered and Licensed Dietitian at Nutritional Weight & Wellness for nearly 11 years, and I am squarely in perimenopause, as are many of the women I know, and I don't think there's a day that goes by where this topic doesn't come up in one way or another.

With me today is another Registered and Licensed Dietitian, Leah Kleinschrodt, my brilliant colleague and hormone confidant. We've had many conversations on the topic, so it's about time we did a show on it together.

Leah: Yes. Well, thank you, Teresa. That was very kind of you and yes, this has been an episode a long time incoming. It comes up a lot. You know, you and I aren't too far away in terms of age, so it comes up a lot in our social groups, but a lot of times in the counseling room too, or when we teach classes, this is coming up in conversation a lot, which is great. I love that women love to talk about this and I think that there's more openness and that we can collaborate on some of this stuff a lot more.

But there's definitely still challenges that come along with this phase of life. And like Teresa said, women will come in and just say they don't feel like themselves anymore. Maybe they've never even been an anxious person before, and all of a sudden they're feeling these changes in their mood, their personality.

They just feel like they're a bit more on edge. So we are going to explain what that perimenopause anxiety is, why it happens. We're going to dive into some of those aspects, and most importantly, we're going to give you some nutrition related solutions that you can take away, start implementing. And so it kind of takes back some of that, that locus of control, because if you've been feeling more anxious, wired, overwhelmed, or just not like yourself, like you said, Teresa, like you're not the only one. You're not alone.

What is menopause related anxiety?

Teresa: No, you aren't. So let's get started with the basics. What is menopause related anxiety? It refers to new or worsening feelings of worry, nervousness, panic, or unease that occurred during perimenopause and menopause. And this is key. It can show up even in women who have never struggled with anxiety before.

So if someone is thinking, why is this happening to me all of a sudden, there is a real physiological reason. So let's talk about some of those causes. First, the obvious: hormonal fluctuations. The biggest driver is fluctuating estrogen and progesterone levels.

Estrogen affects your serotonin and dopamine, your feel-good neurotransmitters, and progesterone has a nice calming anti-anxiety effect. So when these hormones drop or fluctuate in perimenopause and are significantly lower in menopause, mood stability decreases and stress sensitivity increases. So your brain chemistry is literally changing. It can vary between women, but most find anxiety to be the most intense during perimenopause. Then it may improve after hormones stabilize post menopause.

Leah: Yeah, I heard an analogy to this, this phase of life. So there's a, a doctor out there, her name is Dr. Lisa Mosconi.

Teresa: Love her.

Leah: Yeah. Yeah. And she talks a lot about the effects of these hormone changes on the brain specifically. She studies neuroendocrinology. I heard her say recently on a podcast that perimenopause and that transition through menopause is like a home renovation project. Your brain is literally in the middle of a renovation project, so like you are losing some neurons, but they're also rewiring and reconnecting and, and getting clarity in what's going on.

And so what I thought was really beautiful about what she said with this is that actually on the other side, once you hit more of those post-menopausal years, that actually women tend to have more peace of mind, that they have greater empathy for others. They have greater life content. They react less to negative things around them.

So there's some really beautiful things that come out on the other end of this renovation project. But while you're living in it, and Teresa you mentioned you've renovated some parts of your house. I've never lived through a renovation, but I've talked to enough clients who have done that.

And let me say, I don't think anybody's happy usually during the renovation process, it is a mess. It's, it, there's this, it's chaos. There's a lot of emotions. There's unexpected things that come up during the whole process. But once you're done, once you're three months out from it, you're really happy you did it.

So same kind of thing in perimenopause. You're kind of living through this renovation project of your brain and there's great things that are to come after that perimenopause, but sometimes we're living a little bit more in the swirl of some anxiety and chaos in the middle.

Teresa: That is such a great analogy.

Leah: Yeah. So kind of to that point. So stress, I mean talk about stress and renovations and stuff like that you, with, with perimenopause and this transition through menopause, we tend to have increased cortisol sensitivity, which is our big stress hormone. So during these perimenopausal years, you'd become more sensitive to that stress.

There might, it just might mean like you react or have a bigger, more intense reaction to things that maybe didn't bother you as much before or that it takes more out of you and you, it takes a little bit longer to recover on the other side of that stressor.

Teresa: Yeah, I can't relate to that at all.

Leah: Yeah, nobody around here.

Teresa: I've never overreacted.

Leah: Yeah, never overreacted. Kids have never done anything. Yeah.

Sleep disruption can occur during perimenopause

Teresa: And what about sleep disruption? Hot flashes, night sweats and insomnia are huge in this stage of life. And poor sleep alone can amplify anxiety and reduce emotional resilience.

Leah: Mm-hmm.

Teresa: I have client after client lamenting about poor sleep in this phase of life. Generally falling asleep is okay, although there can be trouble there too. It's the night waking with anxiety, heart palpitations, spinning thoughts that keep them from falling back to sleep. Even without anxiety, I hear a very disrupted sleep: 4, 5, 6 or more wake ups each night.

Without that consolidated sleep, it's no wonder memory is shot. Relationships suffer. We're too tired to exercise and cook those real food meals that we always encourage people to do on this podcast, and by the end of the day, we just want to go to bed only for the cycle to start all over again.

Blood sugar can become a little more dysregulated during perimenopause

Leah: Right, and, and let's talk about when you don't sleep well, your blood sugars can be a little bit more dysregulated. And this is where we focus a lot as dietitians as far as what we can control from a nutrition aspect. Blood sugar swings can mimic or, or trigger that anxiety.

So think about symptoms. If you've ever had that experience of like, okay, I am hungry and now I'm really hungry, you can get shaky. You can get that racing hard type of feeling, you get irritable, or almost you could feel panicky. And so these blood sugar swings, the ups and the downs, the rollercoaster effect can cause some of these anxiety like symptoms. So imagine now that amplified on top of the hormone swings that are happening in those perimenopausal years also.

Perimenopause can be a high stress time of life

Teresa: Right. And let's not forget the life stage stressors. This is just in general, a very high stress time in a woman's life. You have aging parents who might be needing extra care, busy kids who are often active preteens or teens at this point, your evenings may be swamped with carpooling to all of their activities after you've had a full day of work, then people give well-meaning advice about self-care.

Leah: Yes.

Teresa: Or you might be transitioning into an empty nest, which is a huge life adjustment and a stressor in its own. You may be going through career transitions or have a lot more responsibility at work, more than you did earlier in your career days, and you might be experiencing other new health concerns that come with aging. All in all, this stage of life often comes with a lot of stress and a heavy emotional load.

Leah: Yeah, very demanding. And so we've covered some of those big players behind perimenopausal and menopausal anxiety. I mean, one might ask too, how common is this? Because everyone's hormone journey looks a little bit different, but the research shows us that it is fairly common; more, actually, probably more than most people realize.

Up to 40 to 60% of women experience mood changes during that perimenopausal transition. I would hazard a guess, just based on the women that we work with. It's probably on that higher end of the range. And anxiety symptoms often increase, as you mentioned, Teresa, during those perimenopausal years.

So it's, it doesn't wait until you're actually skipping through periods and stuff like that. Like this is, this can be the canary in the coal mine for some women that, that some changes are afoot. And those perimenopausal years for some people only last maybe 2, 3, 4 years. And for some women it is actually, could be up in the double digits.

Teresa: Yeah, and like you said, with 40 to 60% of women experiencing mood changes at this time in life, it's no wonder that about one in four women are on antidepressants.

Leah: Yeah.

Teresa: At this age.

Leah: Yeah.

Teresa: Right? Are we really depressed or is there something else going on? And that's what my clients, my friends, and the women that I am around in general, are now asking.

Leah: Yep.

Teresa: What's going on? Also important is that, or something to even take note of is that women with a history of anxiety or women who have had difficult menstrual cycles are more likely to experience increased anxiety during perimenopause.

How might perimenopause-related anxiety be different from ordinary worry?

So something to know and something to keep track of your history is definitely going to be an indicator of what your future might be like. In thinking about that and thinking about how anxiety works, maybe we need to ask the question, how is this anxiety different from ordinary worry?

Leah: Mm-hmm.

Teresa: And there's a very important distinction there. Hormone related anxiety often feels more physical, more sudden, and less tied to logical thoughts. I hear clients say things like, it came out of nowhere. I feel anxious, but nothing is wrong. Or my body feels panicked, but my mind doesn't. Or why can't I logic my way out of these illogical thoughts?

Leah: Mm-hmm. Yeah, yeah. In short, there's, there are some key differences between that ordinary worry and perimenopausal and menopausal anxiety. That ordinary worry usually is tied to a situation. It may be a gradual buildup. You can reason your way through it. You can have do some self-talk or have that person or two that you can call up and just kind of like debrief with them, and soon you start to feel better about the situation, whereas that perimenopausal anxiety comes with that sudden onset, almost like that wave or a tide that just kind of bubbles up from underneath the surface.

It's physiologically driven, meaning it's hormonal, it's neurological, not necessarily connected to any one thing, again, like parents' health or what's going on with the kids or, or something going on with the house. It's often disproportionate to the circumstances. You may have nothing super stressful going on in your day, but still it feels like the anxiety flares up out of nowhere.

Teresa: There are emotional symptoms like persistent worry, irritability, feeling overwhelmed, mood swings and panic attacks. And there are cognitive symptoms like racing thoughts, difficulty concentrating, brain fog, or catastrophic thinking, like worst case scenario worry. 

Leah: Then there's physical symptoms, and this is where it can feel especially scary when you start feeling these things happening in your body. I've heard often either like rapid heartbeat or those palpitations come up. You can feel some chest tightness. You might feel a little short of breath, dizzy, nausea, sweating, shakiness, just feeling tense all over.

And here's where it, it can get even trickier. I mean, these overlap with hot flashes, with some of those blood sugar rollercoaster symptoms, thyroid issues. So it's not, it, it takes some detective work or it takes a little patience sometimes to kind of figure out what's, what's causing what.

Teresa: Right. Because it's not so obvious.

Leah: Yeah.

Some thoughts on hormone replacement therapy

Teresa: A lot of times when a client comes in to meet with me and is going through these things that we've talked about, she'll ask me about my thoughts on hormone replacement therapy. My short answer is it can definitely help. It's just one tool to use. If the other lifestyle factors aren't in order, HRT can only do so much, and it can help by increasing the amount of calming progesterone, stabilizing estrogen levels, supporting serotonin and dopamine production, improving sleep by increasing that calm, decreasing night sweats and hot flashes, reducing mood swings.

It tends to work best when anxiety is strongly tied to hormonal fluctuations, hot flashes, or sleep disruption. It's a great idea to talk about HRT with a medical professional trained in this area. This is a very hot topic with a wide array of opinions. Finding someone who is up on current research is so important when looking for help in this area. Your PCP or regular GYN may not be your best resource.

Leah: They may be a great place to start though. Ask and say what is, what's your experience with this? And if you're not the person, who's my next in line? Who's the next, yeah, who's next up? So yes, so we actually need to take our break.

We'll be back on the other side to talk a little bit more about nutritional solutions that we have to help manage some of these perimenopausal anxiety symptoms. We'll be right back.

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Welcome back to Dishing Up Nutrition. Teresa and I were just wrapping up a little conversation because this comes up in with my clients too. We talk with our clients about HRT or they come in asking questions. Again, I think just the landscape of where social media is at, like there is a lot of information out there and I think just have, making sure women have the tools in their toolbox available to them is so important to make sure that we're being served at this time in life.

How can perimenopausal anxiety be managed through diet? (Tip #1: balanced blood sugar is key)

But like you said, Teresa, the HRT can be amazing for some women, but we also still have to do the foundational work to set the terrain for that HRT to work well, and it's not the only solution that's out there. Nutrition and lifestyle still make a big impact, so we can't discount these things. So let's talk about it. How can we manage that perimenopausal anxiety through diet? We have seen firsthand how much food can be hugely impactful for managing moods, anxiety, brain health, during what can be some tumultuous years.

And so first, the first thing that comes to my mind, probably no surprise to our regular listeners, but we focus on blood sugar balance. This is a huge foundation. I mentioned earlier in the show when that when our blood sugar is on a roller coaster, when we're spiking and we're dipping all throughout the day, our cortisol is also going to be on that rollercoaster. Our adrenaline is going to be on that rollercoaster and our anxiety is going to be on that rollercoaster.

So what do we mean when we say blood sugar balance? Keeping a very high level, very basic, we want to have a balanced meal, so a meal that has a good whack of protein. It has some healthy fats in the mix, and we also want some real food carbohydrates, mainly our vegetables and a little bit of starchy vegetables or some starches to go along with it.

We have like a good sustaining type of meal, and we're probably eating every, maybe every three hours, maybe more like every four hours, maybe five hours, just depending on how big that meal was. But we're trying to eat on a regular rhythm, get a good pattern in during our day so that we're catching our blood sugar before it gets too low, and we're not feeding in a ton of refined foods or processed carbohydrates that spike those blood sugars.

So an example of a balanced meal might look like some grilled chicken or some leftover steak. Pair that with a little sweet potato for your starch, some roasted vegetables, and maybe you've roasted those vegetables with a little bit of olive oil drizzled over them. That would be an example of what a great balanced meal would be.

Protein is critical

Teresa: If you've been listening to Dishing Up Nutrition for a while, taking any of the classes or challenges that I lead or have been or are a client of mine, you know I always like to emphasize the importance of protein for women, but especially at this stage of life.

Leah: Yes.

Teresa: I find that women tend to skimp on protein as they age, so I emphasize that this is a top priority for putting a meal together. Protein not only is a key to balancing blood sugar, but it provides the amino acid building blocks needed for neurotransmitters like serotonin and dopamine. I set targets high for women at this age, approximately one gram of protein per pound ideal body weight.

To figure out ideal body weight, it is 100 pounds for the first five feet and five pounds for every inch thereafter. Give or take 10%. So if the average woman is five four, that ideal body weight is anywhere from 108 pounds to 132 pounds.

Leah: Mm-hmm.

Teresa: Now, I'm not saying that this is what you should weigh if you're five four.

Leah: Yeah.

Teresa: That's just the equation.

Leah: Yeah.

Teresa: But I do find that that equation works really well when we are trying to find what sort of protein target we're looking for. So anywhere from 108 grams of protein to 132 is what we're aiming for.

Leah: Yeah.

Teresa: And when I say protein, I'm talking about animal proteins. This could look like eggs, fish, chicken, beef, yogurt, cottage cheese.

Leah: Mm-hmm.

Teresa: Anything that comes from an animal.

Leah: Yeah, absolutely. And I do find it helpful to give women a range for that protein. It's not like hit this specific number, you're over, you're under. It's like when we have a range, I feel like it just introduces some of that flexibility of like some days you might feel a little hungrier. Some days you might just feel like eating a little bit less.

We still prioritize that protein, but it's okay to like, if we fall within this range, there's just more grace and flexibility in that approach. In addition to protein, we want to get in those healthy fats to stabilize blood sugar and support brain health.

So these are our great fats like olive oil, avocados, nuts and seeds, coconut milk, butter, and really that healthy fat, I usually describe that as an anchor for our blood sugar. Protein is a great anchor for our blood sugar. These healthy fats are another great anchor for that blood sugar.

Then the carbohydrate piece, this one, sometimes it takes a little bit of tinkering to figure out, but we do want to find that sweet spot of the right amount of carbohydrates so we don't spike that blood sugar too high, but that it does give us a little lift, a little boost.

It gives us that good energy that we're looking for. And getting, like I said, getting the right amount may take some experimenting. Carbs are not the enemy, which is a little bit hard to undo in our brain sometimes. We've lived in the low carb culture, I feel like for most of the last 15-ish, 20-ish years.

But, carbs are not the enemy. They do support some of that serotonin. They support good sleep, but we wanted to go get them from real food sources. So mainly vegetables, but then have some fruit to go along with that. Have, like I had a purple sweet potato this afternoon as part of my lunch. Love it. It was leftover from another meal, but that was a great filler in for a lunch for me.

This is like wild rice and brown rice. This is your quinoa, this is your winter types of squashes, beans and lentils if your gut does okay with those. So we do want to pair some of those great vegetable carbs with something that's a little starchier.

Cutting/limiting caffeine can help with perimenopause anxiety

Teresa: All right, Leah, for this suggestion, I'm glad I'm on this side of the microphone and not in person with people. Some women find that they need to cut out caffeine during the space of life.

Leah: Yeah.

Teresa: Even if you used to drink caffeine with no problem earlier in your life, you may still want to experiment with this. Some people just become more sensitive to caffeine with age, and it makes sense that it could trigger feelings of anxiety because caffeine can trigger a racing heart, jitters, and even sleep disruption. Even having one cup of coffee in the morning can still affect your sleep at night if you're highly sensitive to caffeine.

Some women find that they need to cut out caffeine completely, while others may just need to cut back significantly. And I don't just say this without knowing how difficult this can be. A couple years ago I decided to experiment with giving up caffeine myself.

Leah: Mm-hmm.

Teresa: And I am a person who I don't just love coffee. I adore it.

Leah: Yeah.

Teresa: I adore it, but I was like, I got to figure out my sleep. So I'm giving up caffeine. I got to tell you, that first week I felt like I was hungover.

Leah: Yeah.

Teresa: For seven days.

Leah: Yep. Brutal.

Teresa: And I was in the car driving to work, drove past my favorite coffee shop and burst out into tears. It was the hardest thing I had ever given up.

Leah: Oh gosh.

Teresa: So when I say this to women, I am not saying it flippantly.

Leah: Yes.

Teresa: This is something that if you're really struggling with sleep and you really want to figure it out, I suggest trying it. You can do it. We can get through it.

Leah: Yep.

Teresa: If it does help you sleep, it might be worth it. And I've got to say, I did it for months. It was just really that first couple of weeks that was really difficult. And then after that I got used to it.

Leah: Yeah.

Teresa: And so, you know, with time, like anything, you know, we can adjust.

Leah: Yeah.

Teresa: Just as more depressing news, decaf coffee also has a little bit of caffeine in it. So some women that are super sensitive cannot even have a decaf.

Leah: Yep.

Leah: Yeah. I tell women when I'm in counseling, I'm like, I try not to touch people's coffee if I can help it. It's often, I will say, often not the first whistle stop, but like you said, when we are trying to figure out sleep or just trying to figure out ways to feel better, sometimes we can't leave any stone unturned and the caffeine, the coffee, maybe that has to go temporarily, at least to say that we've tried it.

Teresa: Yes.

Limit or avoid alcohol

Leah: Yeah. Similarly, so something we also tend to drink a lot during this stage of life, but it tends to work against us a little bit more. A lot of women at this stage of life notice that alcohol tends to hit harder than it used to. We know alcohol disrupts sleep for anybody, but this can be amplified greatly during that perimenopausal transition.

And it also then increases that likelihood that we're going to struggle more with night sweats, nighttime anxiety, and just throwing, rocking those blood sugars even more. You might notice that like caffeine, you used to be able to handle it. No problem. Sleep like a baby. You used to be able to have that drink, that glass of wine or two at the end of the day and still be able to sleep great or function well the next day. And now it feels just that the side effects are bad enough that it's not worth it.

It's like it's not worth the trade off. I work a lot with women, honestly who decide to cut out alcohol from their lifestyle because of those side effects. And it just, at some point, they decided it just wasn't worth it to feel crummy for a day or two afterwards. So that's part of what we do is sometimes we do strategize or just try to drum up some ideas of like, how are we going to replace this alcohol? What could be some options that we look to? Sometimes it's even exploring like, what purpose did that alcohol serve in the first place, and how then can we take a few steps back and say, how can we still meet those needs, but without the alcohol?

Stay hydrated

Teresa: And kind of on the same topic, remember to stay hydrated.

Leah: Always.

Teresa: Even mild dehydration can increase fatigue, irritability, and anxiety symptoms. So if we had to summarize a diet for perimenopause anxiety, eat regularly, prioritize protein, include healthy fats and be careful with those carbohydrates. When you eat them, get them from real food sources. Getting the right carb amount may take some experimenting and working with a dietitian to find that sweet spot. And then really pay attention to caffeine and alcohol if that's making your symptoms worse. And you haven't made that connection yet.

Key supplements that can help with anxiety during perimenopause

Leah: Yes. Great summary. Let's talk about supplements. Because I think that's another one, just another tool in the toolbox to help with that anxiety. We always start with the food and the beverages as the foundation, but there's some key supplements that can help in these situations. My first go-to, I think this is true for most of us, is magnesium.

Teresa: Yes.

Leah: We know three quarters of the population approximately is deficient in magnesium. So it's, it's a great mineral to start with. It does help with blood sugars, it helps with some of that anxiety, the sleep piece of things, cravings, restless leg, leg cramps. So it's such a, it casts such a wide net.

And so it's, it's usually a great first move if somebody is not doing magnesium already. Magnesium Glycinate for those who, need some more of those just overall benefits; Magnesium Citrate, or our Mixed Magnesium, if you struggle with constipation in addition to all of these things.

I tend to think about magnesium. I also tend to think about progesterone cream. Like we mentioned earlier in the show, with progesterone kind of declining through these perimenopausal years, we lose some of those benefits with GABA or that anti-anxiety factor.

So even rubbing a little progesterone cream on some thin areas of your skin every night before you go to bed, after a couple of weeks, you may really notice that that anxiety, that edge starts to come off. We start to sleep a little bit more through the night. PMS symptoms in general get better. So I, that tends to be another kind of go-to that I keep in my pocket for this age group.

Teresa: Yeah. And I like it generally more for the younger side of the ladies. It seems to work a little bit better.

Leah: Yeah.

Teresa: Just because they have more progesterone naturally.

Leah: Yeah.

Teresa: Yeah.

Teresa: I like the B complex vitamins.

Leah: Yeah.

Teresa: That's really helpful for converting some of our amino acids into the neurotransmitters. Theanine is wonderful anxiety.

Leah: Yep.

Teresa: Yes. L-theanine and I have, I've got to say it is amazing for those who it works for, right? That's, I don't know if we've had this conversation about this before, but I really think that L-theanine it really works for who it works for and then for the people it doesn't, it's kind of like, meh.

Leah: Yeah. Yep.

Teresa: Whatever. But it's so nice. And what I would say, the way I love to use it, one for anxiety, general anxiety during the day.

Leah: Yep.

Teresa: It can be very helpful. But also if you're one of those people who wakes up through the night, having some theanine in the middle of the night is really helpful for calming you down and being able to fall back asleep.

Leah: Yep.

Teresa: What's wonderful about theanine is that it's not drowsy.

Leah: Yep.

Teresa: And so you can take it in day, and at night you can take it at 5:00 AM if you don't have to get up at until six.

Leah: Yeah.

Teresa: And it won't affect how you wake up.

Leah: Yeah. You're not going to drag getting out of bed that morning.

Teresa: I really like ashwagandha for help with cortisol.

Leah: Yep.

Teresa: Do you use ashwagandha with your clients?

Leah: I feel, I feel like I come and go with that one. It's like it'll be on my radar for a while. It'll fall off for a while. But yes, it's like I love those adaptogen types of, of herbals that you know it, we're not giving extra hormones or supplementing anything extra.

It's just naturally like. Balancing you out. It's, I, I describe it as like we're, we're trying to kind of groove that communication between the brain and the adrenal glands, the brain and the ovaries, and just trying to help that communication process a little bit better. Because that is something that does go wonky, again, as our hormones start to go a little more offline.

Teresa: Yeah. In thinking of progesterone, zinc is very important for the production of progesterone. It's another mineral that we tend to be low in, so zinc can be helpful. I personally like taurine.

Leah: Yeah.

Teresa: Taurine is a precursor to GABA. GABA is a calming neurotransmitter. So that can be very helpful. Are there any other supplements that you want to talk about, Leah?

Leah: No. I, those, those are the, the big hitters I would say, especially if it's more, it's, it's almost like if we're trying to more hit the brakes on that anxiety, if we're trying to down regulate a little bit more, that's the magnesium, that's the progesterone cream. That's the GABA, the L-theanine, the ashwagandha.

I think that all of those make a lot of sense. I think they all have their place. We might not always hit the nail on the head the first go around when we're trying some of these supplements, but it's like, it's great to have this arsenal for the, the people that it works great for, but also some tools if, if it's just, if we don't hit the nail on the head right away.

Teresa: Right. And I, yeah, there's a lot of tinkering.

Leah: Yeah.

Teresa: Using a word you used before and then we also don't use all of them with everyone.

Leah: Yeah. Correct.

Teresa: Right. It's very specific for the person, and so you don't necessarily have to take 10 different things to try to manage this.

Leah: Mm-hmm.

Gut health importance

Teresa: Well, Leah, I think we would be remiss if we did not cover a little bit about gut health.

Leah: Ooh, my favorite.

Teresa: I know you love it and its connection to anxiety. Everything is connected to the gut, and we have so many shows where we talk about gut health. So we're really not going to talk about gut health today. But one thing I just wanted to say is that we have nerves that go through the enteric nervous system.

So your gut lining is lined with these nerves. These nerves are connected to the central nervous system, which is your brain and spinal cord. They're connected together by the vagus nerve.

Leah: Mm-hmm.

Teresa: We have certain bacteria in our gut that regulates heartbeat, breath rate, stress hormones, and thus anxiety.

Leah: Mm-hmm.

Teresa: And so giving our gut a little TLC is also really important for helping with anxiety during this phase of life.

Leah: Yep. Yeah. And everything that we've talked about so far with real food, everything we talked about with balancing those blood sugars, the healthy fats, the carbohydrates, especially like that's a great realm where it's like that's where we get most of our fiber from.

That's when we include some fermented vegetables or some fermented foods to feed that good gut bacteria, all of these things can just foster a good, wide variety of bacteria in the gut, which, like you said, actually, then it turns around and it, it does have great impact on extracting some of those nutrients from our food, or making some of those amino acids for neurotransmitters. So surprise, surprise. It's all connected.

Lifestyle habits to decrease stress

Teresa: Right. Okay. Let's talk a little bit about lifestyle habits. Lifestyle plays an important role, and like I talked about earlier, this is often a very stressful time in a woman's life. So there are many things out of your control, but there are some strategies to help calm your nervous system.

First, I want to talk about how to improve your sleep. I'm sure a lot of us can relate to poor sleep amplifying anxiety dramatically, so some sleep tips: consistent bedtime, cool dark room, and the temperature that's generally recommended is about 67 degrees. I think that's what I’ve learned.

Leah: Yeah. Kind of like those high sixties, maybe for some people low seventies, but high sixties.

Teresa: Yes. Chilly enough where you can have a nice, warm blanket.

Leah: Yes.

Teresa: Right.

Leah: Yep.

Teresa: We want to limit screens at night. Really what we want to do is we want to create a very routine pattern so that we train our brain that it's time for sleep, that it knows what to expect and it is ready to go offline or maybe online when we're thinking about the sleep aspect of things.

Leah: Yeah. Yep. And then just another lifestyle factor that we think about, we've been hearing a lot about these days that the importance of strength training for women, and this is huge during these perimenopausal years into that menopause transition, you know, regular strength training is another tool that helps regulate and stabilize those blood sugars.

And we, we've known for a long time exercise, whether it is strength training or running or whatever kind of exercise you like, you get that you can get those endorphins going. You can get that runner's high, you can get these feel-good chemicals going. So it does improve mood and there is reduced stress benefits to exercising.

So dabble in whatever feels good to you. I love like some of those gentle daily exercises. The walking, the yoga, the stretching to regulate the nervous system, reduce that stress. See if you can get in some kind of strength training two to three times a week and do something, again, that kind of gets your heart rate up at least a little bit, whether that's walking, running, something aerobic. And you might even just start with something simple like taking a 10 minute walk after a couple of your meals, finding a 20 minute yoga video on YouTube that you like. The possibilities are endless.

Teresa: I like to encourage clients to think about ways that they can reduce today's overstimulation and the constant input of news, social media, or multitasking. These can keep your nervous system activated from the moment you open your eyes in the morning until you close them at night. Maybe you don't look at your phone until after you've been awake for a while. You can adjust the setting so that certain people can still get ahold of you, but you don't get bombarded with notifications when you first wake up.

Leah: I actually, I do this with my phone too. I heard someone call it one time, like, you turn your smartphone into a dumb phone. And you block, some of those notifications, some of those popups. Again, you can block certain text messages, but I like, so there's a certain time that that flips on, on my phone at night and then it turns off in the morning at some point, and you can adjust those hours. I just, I love that analogy of turning your smartphone into a dumb phone or like, kind of those ear, those early versions of, of phones, you know, when they first roll out and all you could do was like, call and text.

Yes. So we've gone over a lot of material today. Maybe you want to go back and give this show a second listen, but here's the empowering part that we do want to drive home. With the right support, symptoms of anxiety in perimenopause and through that menopause transition can improve significantly.

It can definitely be scary, but it does not mean that something is wrong with you, and you are definitely not alone in feeling this way. It means that your body, and especially your brain, is going through that major renovation project. It just needs support along the way.

Teresa: And you might have more tools than you think. Food, sleep, movement, stress management, and medical support when needed. That's where we are here to help guide you. We work with women in this situation every day. There's help out there so you don't have to go through this alone.

If you haven't already, consider meeting with a dietitian like me or Leah, or one of the other dietitians at Nutritional Weight & Wellness, or maybe it's been a while since you've met with one of us and you need to check in.

You can find out more about our counseling at weightandwellness.com and see if we're in network with your insurance. Or give our helpful office staff a call at (651) 699-3438 and they can walk you through your options.

Schedule Nutrition Counseling

Leah: We hope this episode helped you understand more about perimenopause anxiety and gave you some practical tips to try to start feeling better as soon as possible.

And if you know someone who needs to hear this conversation, please share it. The best way you can support our podcast is to share it with someone you know and who could benefit.

Teresa: Our goal at Nutritional Weight & Wellness is to help each and every person experience better health through eating real food. It's a simple yet powerful message. Thank you for listening.