Hormone levels naturally decline as we age. Some will drop more than others, and the consequences can be severe. For example, a woman’s testosterone levels are more than 50% lower in her late 30s than they were when she was 20. Estrogen and progesterone are two other hormones that decline with age, resulting in perimenopause and menopause, as well as a slew of symptoms.

Menopause is the period in a woman’s life when her menstrual cycle ceases, which usually occurs after the age of 45. Menopause and all of its symptoms occur when a woman’s ovaries stop producing the hormones estrogen, testosterone, and progesterone. Menopause can cause unexpected anxiety, and some women may experience panic attacks. Unfortunately, many women are unaware that these are menopausal symptoms.

We hear a lot about anxiety and menopause, and they are certainly related, but it is critical to understand that panic attacks and anxiety attacks are not the same thing. Yes, both anxiety and panic attacks are associated with menopause and a drop in hormones, and they can have a significant impact on a woman’s quality of life, but panic attacks are far more severe.

Many women will have their first panic attack during peri- and menopause. I’m between the ages of 35 and 58. That is a very long period of time during which many other stressful life events and possible medical conditions may occur.

Each person who suffers from panic attacks has a unique set of circumstances, or triggers, that can cause a panic attack. Knowing those triggers is essential for gaining control of a situation that may feel out of control. Continue reading to learn more about menopause, as well as the differences between panic attacks and anxiety attacks.


What Exactly Are Panic Attacks?

Panic attacks typically occur suddenly and are characterized by intense and often overwhelming fear. They are accompanied by terrifying physical symptoms such as shortness of breath, racing heart, or nausea.

Panic attacks are classified into two types: unexpected and expected. Unexpected panic attacks occur when there is no obvious cause. A stressor, such as a phobia or a known trigger, sets the stage for a panic attack. Panic attacks can happen to anyone, but if you have more than one or two, you may have panic disorder.

Anxiety attacks are not the same as panic attacks. Anxiety attacks are a symptom of a number of common psychiatric disorders, and anxiety symptoms include worry, distress, and fear. Anxiety is typically associated with the anticipation of a stressful situation, experience, or event, and it can develop gradually.


What Exactly Is An Anxiety Attack?

Panic attacks and anxiety attacks can feel similar, and they share many emotional and physical symptoms. You can have both anxiety and a panic attack at the same time, believe it or not. For example, you may feel anxious while worrying about a potentially stressful situation, such as riding in an elevator. Anxiety may escalate into a panic attack when the elevator arrives.

Anxiety attacks can have both mental and physical symptoms.



  • Apprehension and worry
  • Distress and depression
  • Restlessness
  • Fear
  • Fear of dying or losing control
  • A sense of detachment from the world or from yourself




  • Heart palpitations or an accelerated heart rate
  • Chest pain
  • Shortness of breath
  • Tightness in the throat or feelings of choking
  • Dry mouth
  • Sweating
  • Chills or hot flashes
  • Trembling or shaking
  • Numbness or tingling
  • Nausea, abdominal pain, or upset stomach
  • Headache
  • Feeling faint or dizzy


Anxiety and Panic Attacks: What’s the Difference?


It can be tough to tell whether you’re having an anxiety episode or a panic attack. In your 40s, you may notice some of the symptoms of a heart attack for the first time. Some of the most frequent symptoms of menopause include mood swings, anxiety, and general anxiousness (3). Insomnia and exhaustion can exacerbate these symptoms. Keep the following distinction in mind between the types of attack:

  • Anxiety is often associated with something that is stressful or threatening. Panic attacks aren’t always triggered by stressors. They almost always happen out of nowhere.
  • Anxiety levels can range from mild to severe. Anxiety, for example, may be present in the background of your mind as you go about your daily activities. Panic attacks, on the other hand, are characterized by severe, disruptive symptoms.
  • During an anxiety attack, you still have some control. When the body’s autonomous fight-or-flight response takes over, this is referred to as a panic attack. Physical symptoms are frequently more severe than anxiety symptoms.
  • Anxiety attacks can build up over time. Panic attacks usually strike without warning. Panic attacks frequently cause anxiety about having another attack. This can have an effect on behavior, causing people to avoid places or situations that could trigger a panic attack.


Panic Attacks: What Causes Them?

Unexpected panic attacks have no obvious external triggers and occur unexpectedly. Expected panic attacks and anxiety, on the other hand, can be triggered by specific, common triggers such as:


  • A stressful work situation or school,
  • Driving, and or flying,
  • Social situations,
  • There are a lot to choose from, but some of the most common include:
    • Claustrophobia: Fear of being in constricted, confined spaces.
    • Aerophobia: Fear of flying.
    • Arachnophobia: Fear of spiders.
    • Driving phobia: Fear of driving a car.
    • Emetophobia: Fear of vomiting.
    • Erythrophobia: Fear of blushing.
    • Hypochondria: Fear of becoming ill.
  • Things that serve as reminders or memories of traumatic past experiences,
  • Chronic health problems such as heart disease, diabetes, irritable bowel syndrome, or asthma, pain,
  • High levels of caffeine,
  • Medication and supplements, and withdrawal from drugs or alcohol.

Risk Factors

Anxiety and panic attacks share risk factors, such as having experienced some type of trauma as a child or an adult, such as a death, divorce, or another type of loss. Other less obvious risk factors include chronic stress (at work or school) and family or financial conflict. Dealing with chronic health conditions, whether for yourself or a loved one, can be extremely stressful. Drugs and alcohol only add to the stress and increase the likelihood of an attack. If you have a close family member who suffers from anxiety or panic disorder, or if you suffer from depression, your chances of having panic attacks are increased. To be clear, people who suffer from anxiety are more likely to have panic attacks, but having anxiety does not guarantee that you will have a panic attack.

Controlling Panic Attacks


Regardless of the cause of the panic attack, the treatment will be the same regardless of age or gender.

  1. The first step is to learn to control your breathing. A common symptom of a panic attack is hyperventilation. Take a few slow, deep breaths. When you notice your breath quickening, concentrate on each inhale and exhale. As you inhale, feel your stomach fill with air. As you exhale, count down from four. Rep until your breathing slows down.
  2. Some prescriptions, such as antidepressants, anti-anxiety medications, and benzodiazepines, can help manage panic attacks and provide relief in as little as 15 minutes.
  3. Because the decrease in hormones associated with menopause can result in panic attacks, hormone replacement therapy (HRT) may help to prevent attacks in the future.


Many of the psychological symptoms we notice as we age are directly related to hormonal changes that occur during menopause. The simplest way to reduce anxiety and panic attacks is to manage the physical symptoms, which can help alleviate some psychological symptoms. Hormone surges, for example, can cause night sweats and insomnia, as well as fatigue and anxiety. Hormone surges, for example, that wake you up at night can cause night sweats and insomnia, leaving you tired, anxious, and vulnerable the next day. Hormone replacement therapy (HRT) has been demonstrated to be the most effective method of reducing hot flashes and night sweats.

Know that you are not traveling alone. Menopause anxiety is a very common and often difficult symptom to deal with during menopause. Overwhelmed, sad, and anxious do not have to be your new normal. There are effective ways to restore your hormones to youthful levels while also reducing anxiety and panic.