How to Manage Perimenopausal Anxiety with Supplements

Understanding Estrogen Dominance (Part 2): The Good, Bad and Ugly of Estrogen Metabolites

You might be surprised at the number of women who mention anxiety as their most challenging symptom perimenopause. And interestingly, this is completely new for many of them. 

Perimenopausal women suddenly feel unable to cope with situations that were never a problem before. Unrelenting anxiety can be frightening and undermine confidence. And many women assume they are slowly going crazy! The feeling of constant worry, tension, irritability or loss of focus can be debilitating, especially if it results in scary things like panic attacks or heart palpitations. Note: frequent episodes of heart rhythm irregularities should be checked out to make sure there’s nothing serious going on.

The good news with anxiety is that there is often a hormonal imbalance that can be corrected. Low estrogen or progesterone levels may be the culprit. Both of these hormones have significant effects in the brain. The bad news is that you or your doctor may not recognize what’s going on and you may be dismissed with “it’s all in your head” or come away with unnecessary prescriptions for anti-depressants or anti-anxiety meds that are only Band-Aids and do nothing to solve the underlying problem.

Fortunately, there are non-pharmaceutical approaches that can be helpful. Because we are all different, responses may vary. Here are options to consider.


Ashwagandha is an adaptogenic herb that is often used as a natural remedy for anxiety because it helps to stabilize the body’s response to stress. In addition to stabilizing cortisol, it protects the brain from degeneration and improves anxiety symptoms by destroying free radicals that cause damage to the brain and body. Ashwagandha helps to improve focus, reduce fatigue and fight anxiety without the side effects of most anti-anxiety medications.

Kava Root

Kava is used to improve mood, ease anxiety and boost sociability. It works by stimulating dopamine receptor. A randomized controlled trial conducted in Australia found that kava can be considered a first-line therapy for generalized anxiety disorder. Take kava under the guidance of your health care provider, as it can interact with certain medications like benzodiazepines (Xanax, Ativan) or prescription sleeping pills (Ambien, Lunesta, etc). Also, do not consume alcohol if you are using kava and be aware of the most common side effects, including headache, drowsiness and diarrhea. There are reports of liver damage with kava, so it’s wise to get baseline and periodic liver functions tests while taking kava.

5-HTP (5-hydroxytryptophan) 

Supplementing with 5-HTP, which is synthesized from tryptophan (an essential amino acid that acts as a mood regulator), can help to treat a number of issues that are associated with anxiety, including insomnia, moodiness and headaches. 5-HTP increases serotonin, a calming neurotransmitter that transmits signals between the nerve cells and alters brain functions that regulate your mood and sleep patterns. The most common side effects are nausea, vomiting and diarrhea. Do not take 5-HTP with any prescription anti-anxiety or antidepressant medications.

GABA (Gamma aminobutyric acid)

GABA is an inhibitory neurotransmitter that can cause a sedative effect, help regulate nerve cells and calm anxiety. Anti-anxiety drugs, like Xanax and Valium, work to increase the amount of GABA in the brain. There are GABA supplements available in your local health food or vitamin store. Or, another option is to use valerian root, which naturally increases your brain’s GABA level and helps to calm anxiety. Be aware that valerian has a very strong odor!


Magnesium plays many important roles in the body, and magnesium deficiency is one of the leading deficiencies in adults. So if you’re struggling with anxiety, you may want to try taking a magnesium supplement. Magnesium is relaxing and helps GABA function. Look for magnesium glycinate or threonate. These are forms that the body absorbs better. However, be aware that too much magnesium can cause diarrhea, so be careful with the dose.

B vitamins

B vitamins help to combat stress and stabilize your mood. Vitamin B6, in particular, serves as a natural remedy for anxiety because it works to boost mood, balance blood sugar levels and maintain a healthy nervous system. Vitamin B12 is also important for fighting chronic stress, mood disorders and depression. It helps to improve your concentration, improve energy levels and allow your nervous system to function properly.

Essential Oils

In addition to supplements, some essential oils can be very useful for managing anxiety. Lavender oil is relaxing and has been shown to reduce anxiety as effectively as benzodiazepines when used in an oral capsule (Lavela WS-125).

Using lavender oil topically or inhaling lavender can help to induce calmness and relieve symptoms of anxiety like nervousness, headaches and muscle pain. Put 3 drops of lavender oil in your palm and rub it onto your neck, wrists and temples. You can also diffuse lavender oil at home or at work, inhale it directly from the bottle for immediate relief, and add 5–10 drops to warm bath water to fight anxiety naturally.

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Roman chamomile essential oil is used to calm nerves and reduce anxiety because of its mild sedative and relaxation-promoting properties. Inhaling roman chamomile works as an emotional trigger because the fragrance travels directly to the brain to help fight anxiety symptoms. Diffuse 5 drops of Roman chamomile oil at home or at work, inhale it directly from the bottle or apply it topically to the neck, chest and wrists. Roman chamomile is also gentle enough for children to use as a natural remedy for anxiety.

The real “fix” here is to determine underlying hormone imbalances and take appropriate action to regulate these. If you’re not sure, where to start, let’s talk. There’s no need to suffer through perimenopause!

Dr. Anna Garrett is a menopause expert and Doctor of Pharmacy. She helps women who are struggling with symptoms of perimenopause and menopause find natural hormone balancing solutions so they can rock their mojo through midlife and beyond. Her clients would tell you that her real gift is helping them reclaim parts of themselves they thought were gone forever.

Find out more about working with her at or click the button below to start your journey to hormone harmony today!

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