Menopause and Panic Attacks

Panic attacks may increase as the production of estrogen and progesterone goes down. Estrogen helps inhibit the production of the stress hormone cortisol.  As estrogen decreases cortisol production may increase, leading to a rise in both blood sugar and blood pressure.   These changes may lead to feelings of anxiety.  Estrogen is also a neuromodulator that positively impacts serotonin, a neurotransmitter associated with feelings of wellbeing.  As estrogen decreases serotonin may as well, leading to feelings of panic or anxiety.  Progesterone   is important in the production of GABA (gamma-aminobutyric acid), a neurotransmitter responsible for feelings of calm and relaxation.

SYMPTOMS OF A PANIC ATTACK (lasting up to 40 minutes) INCLUDE:

Distressed breathing or hyperventilation Gastrointestinal or abdominal Distress Rapid heartbeat or chest pain Tremors


Dry mouth or chocking Tingling fingers/toes


sweating Feelings of dread, fear, nervousness, anxiety or apprehension
Feeling like you are dying or going crazy


Potential stressors: rapid emotional cycling due to swift shifts in hormones, negative or pessimistic thinking, drinking alcoholic or caffeinated beverages, and vasomotor symptoms like sweating.  Not to be overlooked are life style changes (spouse leaves/dies, parents get older, children leave home), lack of sleep, or shallow breathing.

Possible treatments : psychotherapy, healthy diet, natural remedies and sleep as well as medication. Remember that addressing hormone fluctuations is important. When possible stimulate the production of sex hormones naturally.

Non-pharmacological treatments: mindfulness techniques, meditation, massage, exercise, yoga, good sleep hygiene, deep breathing exercises, stay hydrated (dry mouth may be mistaken for a symptom of panic and accidently trigger an attack).

Herbal treatments include Linden flower, St. John’s wort, Ginseng and Macafem.

Medications: short term use of sedative like medications (Klonopin, Atovan and Xanax)  may bring more immediate relief of symptoms (8). Doctors often prescribe a class of antidepressant called SSRI's or selective serotonin reuptake inhibitor (Prozac, Zoloft, Celexa, Paxil or Lexapro).  Be aware that some people react to these drugs with intensified symptoms of anxiety and panic. Keep in mind that the SSRI’s and sedatives may increase the users’ likelihood of developing dementia.

To balance sex hormones naturally: consume vitamins B, D and E, as well as cysteine, curcumin, resveratrol, and fish oil, gamma linoleic acid (GLA) selenium and green tea.  Herbs to take: passiflora and valerian root are used by some.  Dietary you may try incorporating soy which has a substance called genistein in it.  This mimics estrogen. You may want to eat the following foods containing phytoestrogens:

Legumes like soy, alfalfa, black, pinto and lima beans and chick peas or garbanzo beans

Nuts and seeds: pistachio, chestnuts and walnuts, flax, sesame, and sunflower

Vegetables: cauliflower and broccoli, garlic, collards, green beans, olives & olive oil, winter squash.

Fruits: dried apricots, peaches, oranges, dried dates, cranberries and dried prunes.

Herbs: licorice, ginseng, oregano, macafem and sage

Whole grains and flaxseed

Red wine has some phytoestrogens as does V8 and green tea.


References & Sources:

1   Women to women website, run by Dr. Marcelle Pick, OB-GYN, NP.  Webpage:  Am I in menopause. Accessed at:

2 A vogel website.  Webpage:  menopause health hub, panic attacks and menopause. Accessed at:       

3   Website: 34 menopause symptoms.  Webpage: panic disorder.  Accessed:                          

4   Dr. Hyman’s website. Webpage: How do I naturally balance female sex hormones?   Accessed:       

5   Academic review: testing popular claims against peer reviewed science. 6.1 –many foods contain                 phytoestrogens. Accessed:                disruptors/

6   Breast cancer fund website.  Webpage:  Phytoestrogens, plant estrogens.  Accessed:       

7 website: mental health daily. Webpage: 20 foods high in estrogen (phytoestrogen).  Accessed:         

8 Web Md website.  Webpage: Anxiety and   panic disorders health centres.  Accessed:       

9 Aging brain care website. Anticholinergic cognitive burden scale.   Accessed:       

The information on this site is for educational and informational purposes only.  It is not to take the place of medical advice or treatment.   Seek out a qualified health care provider if you have questions or need help.  Dr. Grant is not responsible for any possible health consequences of anyone who follows or reads the information in this content.  Everyone, but especially those taking medication (over the counter or prescription) should talk with a physician before undertaking any changes to their lifestyle or diet (including taking supplements).