Perimenopause and Anxiety — What’s Really Happening in Your Brain

“Anxiety is a signal, not your identity.”

When anxiety arrives during perimenopause, it often feels abrupt like your brain and body are betraying you out of the blue. It’s not a personal failing. It’s your system recalibrating.

Perimenopause is a profound midlife transition. After puberty, it’s one of the most significant hormonal and neurological shifts a woman passes through. During this time, your levels of oestrogen, a hormone that supports emotional balance, neural resilience, and even energy, start to fluctuate in unpredictable patterns. That ripple effect reaches deep into your brain, mood, and how you manage stress.

Imagine oestrogen as the quiet conductor in a concert hall of brain chemistry. Two main players in that orchestra are serotonin and GABA:

• Serotonin helps stabilise mood, regulate sleep, and keep irritability in check.

• GABA (gamma-aminobutyric acid) is like the body’s internal tranquilliser, it slows racing thoughts, calms neural excitability.

When oestrogen dips or surges, these systems can falter. What was once a steady beat can wobble. The result? Restlessness, intrusive thoughts, heightened fear, sensations you may not expect if you've had years of emotional stability.

Professor Jayashri Kulkarni, from Monash University’s HER Centre and the Monash Alfred Psychiatry Research Centre (MAPrc), has published extensively on how hormonal shifts rewire emotional processing in the female brain. Her work demonstrates that perimenopausal anxiety is biological, not just psychological.

Meanwhile, Jean Hailes for Women’s Health underscores that oestrogen does more than regulate reproduction it plays a role in memory, focus, stress resilience, and mood balance. When it fluctuates, sensitivity to cortisol and adrenaline increases, making small stressors feel magnified.

Anxiety in midlife often arrives alongside sleep disturbance, low energy, or foggy thinking. While uncomfortable, these symptoms can be reframed as communication — not crisis. Your body isn’t breaking down; it’s requesting recalibration.

Dr Kelly Teagle, founder of WellFemme Telehealth Clinic, notes that the perimenopausal body is “renegotiating its relationship with hormones.” This process can magnify emotional responses, making once-manageable stress feel overwhelming. But, as psychologist Dr Jo Lukins (James Cook University) explains, learning to interpret these sensations with curiosity, not judgment, is key to restoring emotional equilibrium.

Research by The Australasian Menopause Society and Jean Hailes Foundation shows that magnesium, B-vitamins, and omega-3s can stabilise neurotransmitter activity in women experiencing hormonal flux.

And most importantly, rest. As Dr Carmel Harrington, sleep scientist and author of The Sleep Diet, notes: restorative sleep is the foundation of emotional balance and hormone repair.

Anxiety in these years often doesn’t show up alone. It tends to travel with poor sleep, fuzzy thinking, or exhaustion. These are not signs of failure. They’re cues, the body’s way of asking for recalibration.

Dr Kelly Teagle of the WellFemme Telehealth Clinic describes perimenopause as a period where your body is “renegotiating its relationship with hormones.” That renegotiation can heighten emotional responses, making life feel more intense.

Dr Jo Lukins (Psychologist, James Cook University) encourages us to shift from judgment to curiosity: when anxiety or tension arises, pause and ask, “What is my body needing right now?” Rather than resisting, this stance allows you to respond slowly and gently instead of reacting.

Aloriae helps you to start your midlife recalibration with small intentional actions. Begin with gentle acknowledgement: anxiety is a signal, not an identity. Support your neurochemistry through nourishment and rhythm, the two anchors of Aloriae’s Foundations.

How to start:

• Move daily to release adrenaline and rebalance cortisol. Think walking, slow swimming, or yoga.

• Nourish with magnesium-rich leafy greens, omega-3s from Australian salmon or flaxseed, and complex carbohydrates like quinoa or brown rice.

• Breathe before bed: three slow, steady breaths, each exhale longer than the inhale. This simple pattern lowers cortisol and activates GABA receptors, helping the nervous system exhale too.

• Supplement wisely under guidance from your GP or naturopath.

Perimenopausal anxiety reminds us that change is not chaos, it’s communication. This season asks for understanding, not urgency, steadiness, not suppression. As hormones shift, so does the rhythm of the mind, inviting a slower, more attuned way of living. When we respond with care through nourishment, rest, and self-kindness we create the stability that biology alone cannot. In this way, recalibration becomes more than a phase; it becomes a practice of listening deeply to what the body already knows.

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Science Snapshot — References

Australasian Menopause Society (2023) Clinical guidelines on menopause, mood and hormone therapy. Available at: https://www.jeanhailes.org.au/uploads/15_Research/Menopause-and-Australian-Women-FINAL_V2_TGD.pdf

Australian Psychological Society (2022) Managing anxiety in adults: Evidence-based resources and mindfulness frameworks. Available at: https://psychology.org.au/for-the-public/Psychology-topics/Anxiety.

Harrington, C. (2021) The Sleep Diet: The Science of Sleep, Hormones and Health. Sydney: Sleep for Health. Available at: https://www.sleepforhealth.net.au

Jean Hailes for Women’s Health (2023) Menopause and Mind Health: Understanding Mood, Memory and Hormones. Melbourne: Jean Hailes for Women’s Health. Available at: https://www.jeanhailes.org.au/resources/menopause-and-mind-health

Jean Hailes for Women’s Health (2023) The Impact of Symptoms Attributed to Menopause by Australian Women: National Women’s Health Survey Report 2023. Melbourne: Jean Hailes for Women’s Health. Available at: https://www.jeanhailes.org.au/resources/the-impact-of-symptoms-attributed-to-menopause-by-australian-women

Kulkarni, J. (2024) Profile: Professor Jayashri Kulkarni – HER Centre Australia, Monash Alfred Psychiatry Research Centre (MAPrc). Monash University. Available at: https://research.monash.edu/en/persons/jayashri-kulkarni

University of Queensland (2022) Neuroplasticity and GABA Research in Midlife Women. Brisbane: UQ School of Biomedical Sciences. Available at: https://biomedical-sciences.uq.edu.au

Flinders University (2022) Lifestyle Interventions and Anxiety Regulation During Perimenopause. Adelaide: Flinders Health and Medical Research Institute. Available at: https://www.flinders.edu.au/health-medical-research