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The link between stress and menopause

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hormones senior
Published on 29 November 2023

We all experience varying degrees of stress throughout our lives. As we age, how we react to stress and the impact it has on our body changes. Women who are going through menopause and women who are in perimenopause can find that stress can trigger the symptoms of menopause and, in some cases, make them worse. Many women feel as though they are on an endless loop of having to cope with stress-induced menopause and stress making their menopause symptoms worse.

Is there a link between stress and menopause? Is there such a thing as stress-induced menopause? What is the connection between menopause stress and anxiety? Are there effective menopause stress relief techniques?

During menopause the levels of hormones such as cortisol change over time. These hormonal changes can have serious impacts on woman’s mental health and their physical health. Stress is believed to be not only a symptom of menopause but may also contribute to the onset of early menopause.

In this article, we examine exactly what is the connection between stress and menopause. We’ll look at the above questions about stress and menopause and delve into the impacts of stress on menopausal women. Lastly, we’ll outline ways that menopausal women can lower their stress levels. If you are a woman who is entering perimenopause or menopause, keep reading to learn valuable information about how stress affects you.

What is Menopause?

The transition to menopause is a completely natural and normal stage of a woman’s midlife. Menopause is not a disease or a health condition, although it can have some unwelcome effects on both mental and physical health.

Menopause is defined as the point in time 12 months after a woman had her final period. It denotes the cessation of a woman’s menstrual cycles. While most women enter menopause in their midlife between the ages of 45 to 50, on average women from industrialised countries begin menopause between 50 and 52 years of age, according to one study.1 Perimenopause, the time before menopause, usually starts at the age of 47.

The age at which a woman may enter menopause can vary depending on a range of factors. Factors that impact oestrogen metabolism such as body mass index (BMI), diet, alcohol intake, and exposure to tobacco smoke are thought to affect the age at which a woman enters menopause. Menopause can last anywhere from seven to fourteen years.

In perimenopause, a woman’s periods may become unpredictable. They may be lighter or heavier, last for varying amounts of time and have varying amounts of time between them. During menopause, a woman’s oestrogen levels first fluctuate and then drop considerably. The changes in hormone levels in the body during menopause can bring about a range of negative side effects.

Common Symptoms of Menopause

Menopause has a range of different effects on the body. Of course, the main change that menopause brings about is the cessation of menstruation. However, menopausal women also experience a variety of other physical changes and symptoms.


Hot Flushes

One of the most common menopausal symptoms is hot flushes, also known as vasomotor symptoms. Approximately 75% of all menopausal women experience hot flushes. Hot flushes are thought to be related to decreasing oestrogen levels. During a hot flush, skin temperature rises, perspiration occurs, and the heart rate rises. Dizziness is a common side effect of hot flashes. When experienced during the night hours, hot flushes are referred to as night sweats. Usually, hot flushes last for two years or less although some women experience them for longer periods of time.


Decreases in Bone Density

Bone density decreases as a result of menopause, which can put some women at greater risk of developing fractures or suffering from broken bones.


Weight Gain

The body retains fat much more easily during menopause. Some menopausal women may experience weight gain.


Sleep Issues

Night sweats and changes in hormone levels can make it difficult to fall asleep. Night sweats can cause menopausal women to wake during the night while drops in oestrogen levels can disturb natural sleep patterns.


Vaginal Atrophy

Menopause can cause tissues around the vagina and urethra to become thin and dry out. This can lead to vaginitis, urinary tract infections, and cystitis, and cause pain during sex.


Urinary Issues

The pelvic muscles relax as a result of menopause which can cause incontinence and increases the risk of organs such as the bladder, urethra, uterus, or rectum extending into the vaginal area.


Cardiac Issues

Changes in hormone levels can cause cardiac issues that result in dizziness numbness, prickling, tingling, heightened sensitivity, and heart palpitations.


Mental Health Issues

The fluctuating oestrogen levels combined with the disrupted production of serotonin and lower amounts of progesterone in menopausal women can result in mood swings and mental health issues. Many menopausal women report increased feelings of depression, anxiety, and stress according to a university study.2

Does Menopause Increase Stress Levels?

The transition into menopause can be stressful for many women. Studies have shown that the lack of sleep and sleep disruption that menopause causes can significantly raise stress levels.3 Other university and research studies have shown that menopausal symptoms have significant negative effects on the mental health and economic situation of menopausal women which also causes stress levels to rise.4

However, there are arguments to the contrary. One university study found that although neuroendocrine changes during menopause were possibly exacerbating the negative effects of stress, this was not proven to the satisfaction of the authors.5 It does seem obvious, though, that the mental and physical changes brought about by menopause in midlife will most likely lead to a rise in stress levels.

Can Stress Make the Symptoms of Menopause Worse?

Cortisol is known as the ‘stress hormone’. When we are stressed, our bodies increase cortisol levels and boost our adrenaline levels. These changes can increase our heart rates, raise blood pressure, increase the brain’s glucose use and alter the immune system’s response.   Oestrogen helps to maintain optimum levels of cortisol in the body. During menopause, Oestrogen levels drop, and cortisol levels rise. University studies have shown that cortisol levels are higher in women in the late stages of menopausal transition.6

Stress can certainly heighten the symptoms of menopause. Mood swings can be more easily triggered if a person is under a great deal of stress. Stress can also cause us to feel more anxious which can act as a trigger for hot flushes. Stress causes our magnesium levels to drop, which can lead to increased appetite, leading to weight gain. Stress also causes significant digestive problems for women in menopause. Indigestion, constipation, and bloating are common experiences for menopausal women.

Can Stress Cause Early Menopause?

There is much debate in university classes and among health professionals about whether or not stress can induce early menopause. One university study stated that stress levels and the reduced age at natural menopause were not conclusively proven. Another study of Korean women between 40 and 70 showed that women with high-stress levels in their daily life showed a reduced age at natural menopause. 7 A study by French researchers also pointed towards a link between stress levels and early menopause.8

Many women with increased cortisol levels display symptoms that are very similar to but are not menopause. As far as the scientific community are concerned, increased stress levels do not cause the onset of early menopause. More research, however, is required on the subject before a truly definitive answer can be reached.

How to Manage Stress and Menopause

There are different approaches to managing the stress brought about by menopause. Some women choose to use hormone replacement therapy (HRT) as a way of managing the symptoms and stresses of menopause. HR treatment involves taking medication that combines oestrogen and progesterone during perimenopause and menopause. While HRT can dramatically reduce the symptoms and therefore the stress of menopause, it also has some serious downsides. Studies have shown that HRT can increase the risks of stroke and blood clots and can increase the likelihood of developing breast cancer and ovarian cancer.9,10,11 It is not surprising that many women look at alternative ways of lowering their stress levels during menopause.

Natural ways to alleviate the stress of menopause can include practising mindfulness techniques such as medication or deep breathing exercises. Getting enough exercise is also recommended as this helps to boost the levels of natural endorphins in the body. Health experts advise menopausal women to avoid alcohol, fats and sugars and maintain a diet that is rich in foods that contain antioxidants, probiotics and magnesium, Vitamin A, Vitamin K, Vitamin C, calcium, and omega 3s.


The midlife transition to menopause can be stressful for many women. While menopause itself can bring about stress, stress can also exacerbate the symptoms of menopause. For this reason, it is vital that menopausal women take steps to lower their stress levels. Mindfulness techniques, regular exercise, support from family and friends and a healthy diet can all help to lower the stress associated with menopause.

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1 PubMed: DOI: 10.1016/j.ogc.2011.05.002
2 PubMed: DOI: 10.1089/jwh.2012.3719
4 PubMed: DOI: 10.1089/jwh.2012.3719
5 PubMed: DOI: 10.1097/GME.0000000000000579
6 PubMed: DOI: 10.1097/gme.0b013e318198d6b2
7 PubMed: DOI: 10.4082/kjfm.2015.36.6.305
9 PubMed: DOI: 10.1001/jama.288.3.321
10 PubMed: DOI: 0.1016/s0140-6736(03)14065-2
11 PubMed: DOI: 10.1016/S0140-6736(07)60534-0