Panic attacks during menopause: symptoms and treatment

During menopause, a woman's reproductive function gradually fades away. Complex transformations occur in her body, which concern not only the reproductive system. Hormonal changes are accompanied by a deterioration in the psycho-emotional state, the emergence of anxiety about one’s age and appearance.

Women often experience panic attacks during menopause, which significantly worsen their quality of life. Correctly selected treatment can weaken their manifestations and get rid of them completely.

About panic attacks in general

Medicine does not classify panic attacks as independent pathologies, but considers them a special state of the nervous system, in which anxiety and fear increase significantly.
During panic, the body experiences severe stress. Under its influence, a whole chain of reactions begins to occur, provoking the symptoms of a panic attack. In particular:

1. When there is stress in the body, adrenaline and cortisol are intensively produced. Under their influence, breathing quickens and blood vessels constrict, which leads to a rapid heartbeat and a jump in blood pressure.
2. Due to frequent breathing, carbon dioxide is removed from the body very quickly and the anxiety state increases.
3. A decrease in the amount of carbon dioxide changes the blood balance. Such changes are accompanied by dizziness and numbness of the fingers and toes. Constriction of blood vessels leads to the fact that the cells receive insufficient nutrition, and lactic acid begins to be intensively produced. When it enters the bloodstream, all manifestations of a panic attack intensify.

The attack lasts from 10 to 30 minutes, but, having survived one attack, you should be prepared for the appearance of several more.

Symptoms and treatment methods

Individual characteristics of the body often leave a personal imprint on the clinical picture, but the most common symptoms are the same:

• increased sweating;
• dizziness;
• sudden changes in blood pressure;
• respiratory spasm;
• fever or chills;
• nausea;
• chest pain;
• cardiopalmus;
• fear of madness or death.

The development of a panic attack during menopause occurs in stages. A sharp release of adrenaline provokes a spasm of blood vessels, which leads to rapid breathing and increased heart rate. Then the amount of carbon dioxide in the blood decreases and lactic acid begins to accumulate in the tissues. In women, attacks occur 5 times more often and this is understandable, since powerful hormonal changes occur in their body several times during their lives, associated with periods of growing up, pregnancy, childbirth, and the decline of reproductive function.

Additional risk factors are psychological trauma, in which fear, resentment, and hatred are constantly felt. Chronic stress leads to disruption of periods of sleep and wakefulness, makes it difficult to fall asleep, which leads to overwork and the appearance of chronic fatigue. The body is deprived of time for natural recovery and renewal. A sedentary lifestyle and bad habits weaken the heart muscle, reduce immunity, and contribute to problems in the gastrointestinal tract, cardiovascular, and endocrine systems.

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A weakened body cannot adequately respond to stress or a hormonal surge, emotional balance is disturbed, and strong emotions again provoke an attack. To get out of this circle, external intervention is necessary.

Correction with medications

When the available remedies for menopause do not cope with panic attacks, the symptoms intensify and treatment becomes an urgent need, then you should immediately consult a doctor.

Something to remember! Self-medication is dangerous, especially in the case of age-related hormonal changes.

To stabilize the condition and obtain positive dynamics, it is necessary to undergo an examination. It necessarily includes tests for the level of basic hormones, as well as a general blood and urine test, tests for coagulation, cholesterol, and sugar. You will need consultations with an endocrinologist, cardiologist, mammologist, phlebologist, and gynecologist. It is advisable to undergo an examination by an ophthalmologist to check the condition of the fundus and retina. Only after clarifying the general condition of the body, identifying hidden diseases or prerequisites for them, can treatment begin.

An integrated approach involves medication and psychological direction. During menopause, they are both important, otherwise attacks may recur and even intensify. The treatment period is at least six months.

Important to remember! Once the course has started, you cannot interrupt it without a doctor’s recommendation.

First of all, drugs are prescribed that stabilize hormonal levels during menopause. This can be full-fledged HRT or products containing phytohormones, such as Qi-Klim, Klimadinon, Klimaksan, Remens. They stabilize the condition, reduce the severity of emotional reactions, and have a mild sedative effect.

Additionally, the doctor may prescribe Seduxen, Relanium, Medazepam, Grandaxin, Tazepam. These medications relieve anxiety, relax muscles, and are used as antidepressants.

Need to take into account! If a woman has a driving license and is often behind the wheel, she must inform the doctor about this.

Some sedative drugs have a mild hypnotic effect and inhibit reactions, which is unacceptable when driving a vehicle in person. In this case, the treatment must be adjusted.

Psychological techniques

Psychological correction of the emotional state gives good results. Since panic attacks most often occur spontaneously or under stress during menopause, it is worth listening to the recommendations of psychotherapists and mastering several self-regulation exercises. If your mental state causes anxiety and it is difficult to cope with the situation on your own, then you need to contact a specialist who practices neurolinguistic programming, Gestalt therapy or cognitive behavioral therapy. During the session, the doctor finds out the reasons, together with the patient the problem, considers ways to solve it, conducts various types of training aimed at mastering the technique of finding calm in stressful situations.

What are the differences between attacks during menopause?

Panic attacks during menopause have exactly the same mechanism of occurrence as in other cases. But with its onset, the risk of their occurrence increases significantly. Many ladies experienced attacks for the first time during perimenopause, and before that they did not have such conditions.

The appearance of attacks is provoked by a decrease in the level of estrogen - the main female sex hormones. They affect not only the organs of the genitourinary system, but also control the functioning of the nervous system.

The climacteric period is divided into the following main stages:

1. Premenopause - the ovaries begin to produce less estrogen and progesterone, and the hypothalamus stimulates their hormonal activity. The stage is characterized by hormonal imbalance.
2. Menopause is the last independent menstrual cycle after which menstruation has not occurred for 12 months. The hypothalamus adapts to the changed hormonal levels.
3. Postmenopause lasts until the end of a woman’s life. The level of sex hormones is low, and the hypothalamus has reduced sensitivity to them.

Thus, at each stage certain transformations occur in the body. If they occur gradually, then the nervous system has time to adapt to hormonal changes and functions without failures.

With a rapid transition from one stage to another, hormonal imbalance develops rapidly, and problems arise in the functioning of the central nervous system, as indicated by panic attacks. Menopause and attacks have similar symptoms, but there are manifestations that are characteristic only of one condition.

An attack is indicated by a feeling of restlessness, anxiety for no apparent reason, and intense fear that overshadows all other thoughts.

Danger of attacks

Panic attacks that occur during menopause necessarily require treatment. They won't go away on their own. It is necessary to contact a gynecologist and be sure to inform him about the attacks that are bothering you, as well as the symptoms that accompany them. By normalizing hormonal levels, you will be able to get rid of.

When hormonal therapy does not eliminate the attacks, sedatives, tranquilizers and antidepressants are additionally prescribed. If left untreated, the intense fear that occurs during an attack can go beyond natural boundaries, and the woman will develop a phobia. Without the professional help of a psychologist, it will not be possible to cope with a phobia.

Provoking factors

During menopause, panic attacks are provoked by factors that have a negative impact on a woman’s nervous system:

• frequent stressful situations leading to emotional overload;
• restraining negative emotions and aggressiveness related to manifestations of hormonal changes;
• lack of proper rest due to sleep problems;
• excessive alcohol consumption and cigarette smoking;
• great physical stress on the body.

If a woman of reproductive age has already had panic attacks, then with the onset of menopause the likelihood of their occurrence is very high.

Ladies with the following diseases and conditions are at risk:

• there are pathologies in the functioning of the adrenal glands;
• diseases of the cardiovascular system;
• any thyroid dysfunction;
• the body is predisposed to allergies;
• migraine;
• emphysema.

Panic attacks may indicate the development of depression, various phobias and schizophrenic disorders. They also occur in post-traumatic disorders that arise after complex injuries received during natural disasters or dangerous circumstances.

Panic attacks during menopause

Prevalence

According to the Women's Health Initiative (WHI), about a fifth of menopausal women say they have had one of two types of panic attacks in the past 6 months. Full-blown panic attacks were observed in 9.8% of women, and another 8.1% had so-called incomplete panic attacks. Compared to women in the 50 to 59 year old group, older women were significantly less likely to report sudden panic attacks.

Women with lower incomes are 2.7 times more likely to report full-blown panic attacks than those with higher incomes. There was no significant association between marital status and 6-month prevalence of panic attacks.

Who is at risk of panic?

The risk of panic disorder is associated with certain features in a woman’s life.

• Smoking (unlike alcohol and coffee) is closely associated with full-blown panic.
• Adverse life events can trigger panic attacks. Those who experienced 5 or more traumatic events in the next six months were 6.9 times more likely to experience panic attacks.
• Lung disease may be a risk factor. Women with a history of asthma are more likely to experience panic.
• A connection has also been found between full-blown panic and a history of cardiovascular disease, angina, and chest pain. And also overweight.
• The strongest association with panic attacks exists in women who suffer from migraine with aura. They were 6 times more likely to report complete panic than women without headaches.

A third of women with panic attacks also experience depression.

The study suggests that the occurrence of panic attacks in older women is relatively common. Among women with high anxiety, conditions associated with menopause (or menopause) (tachycardia, choking, hot flashes, drenching sweats) or chronic illness may increase panic attacks.

Other predisposing factors for menopause may include life stresses (eg, retirement and widowhood).

The prevalence of panic attacks is higher in the younger age group of menopausal women.

Even one panic attack is enough to disrupt a woman's daily life and create fear and anticipation of subsequent attacks. Fortunately, both the psychological and physical causes of panic disorder can be treated. In general, it is recommended that any treatment be accompanied by counseling or “talk therapy.” Continue reading to learn more about approaches to treating panic disorder.

How does the condition manifest?

Doctors conditionally divide the symptoms of an attack into 2 components: physical, which the patient feels with her body, and mental, which is recorded by consciousness. During an attack, mental symptoms predominate, which are also pronounced.

Mental symptoms

Symptoms of the mental group include:

1. There is a feeling of impending danger that does not actually exist. At the moment of an attack, the expectation of negativity begins to dominate over other thoughts in a woman’s mind. Therefore, it is simply impossible to explain that she is not in danger.
2. The fear of death takes over. It develops over a period of time: several days, a week or a month. Then the feeling of fear subsides a little, but the problem remains. A woman is afraid of contracting a dangerous disease or other health-related phobias appear.

During menopause, fear can be so great that a woman wants to run away somewhere, or it completely fetters her.

Experiencing a feeling of fear, a woman faces the following disorders:

• there is a lump in the throat;
• perceives with distortion what he sees or hears in reality;
• it seems to her that she is looking at herself from the outside and cannot control her actions;
• begins to be afraid of going crazy.
• a pre-fainting state appears, a feeling of lightheadedness, loss of connection with reality.

If during the attack the described disorders did not manifest themselves clearly, then recurrence of attacks should be expected. After a panic attack with intense symptoms, attacks occur infrequently.

Physical symptoms of a panic attack

The following physical symptoms of an attack are identified, which occur due to the release of adrenaline into the blood:

1. The heart begins to beat faster and it seems as if it will jump out of the chest.
2. Changes in vascular tone provoke a fever attack.
3. Breathing becomes very rapid. Thus, oxygen deficiency due to narrowed blood vessels is compensated.
4. Dry mouth appears and sweat profusely occurs due to disturbances in the functioning of the autonomic nervous system.
5. Chills begin with severe trembling.
6. Weakness appears, accompanied by dizziness.
7. The palms of the hands and soles of the feet become cold.
8. There is a painful sensation in the chest on the left side.
9. Diarrhea or vomiting may occur.

Many of the symptoms listed are related to menopausal symptoms, and therefore women often do not mistake them for panic attacks. In particular, nocturnal attacks of heat, called hot flashes, are considered a hallmark of menopause.

Unusual or atypical manifestations

Non-standard manifestations of attacks, which are also called atypical, include dysfunction of an organ in the absence of diseases.

In particular:

• the woman begins to hear or see worse;
• voice disappears;
• some problems with speech appear, up to the inability to speak;
• the gait takes on an unnatural appearance.

Non-standard manifestations are quite rare. They usually appear in crowded places. At home, a woman does not encounter them. During an atypical attack, the lady experiences virtually no fear, but only emotional stress. Doctors classify such attacks as hysterical neuroses.

First aid for panic

When an attack begins during menopause, a woman can independently reduce her symptoms by following these tips:

1. To stabilize breathing, you should start breathing into a paper bag, and if you don’t have one at hand, then into your palms clasped together. The essence of the exercise is to prevent outside air from entering the bag. A woman will be able to quickly change the concentration of carbon dioxide in the blood and the manifestations of panic will decrease.
2. You need to perform a breathing exercise 15 times, accompanied by counting. You need to breathe with your stomach, not your chest. Inhale for 3 counts, smoothly inflating your stomach. We hold our breath for 2 counts, and exhale for 5 counts, drawing in our stomach.
3. You need to try to distract yourself. You should start counting some objects, reading words backwards, or performing simple mathematical operations.
4. It is recommended to wear an elastic band on your wrist, which you can pull back when you feel an attack approaching. If it’s not there, then you need to pinch yourself.
5. To relieve a rapid heartbeat, you should forcefully start coughing.

If severe chest pain occurs, take an aspirin tablet and call an ambulance.

Prevention

The following preventive measures will help prevent panic attacks during menopause:

1. Normalize your daily routine to eliminate excessive stress. You should set aside 8 hours for sleep and go to bed before midnight.
2. Try to avoid stress and nervous irritation.
3. Quit smoking and reduce alcohol consumption to a minimum.
4. Increase your consumption of vegetables, fruits and berries, and reduce the amount of fatty foods.
5. Drink at least 1.5 liters of clean water per day.

It is important to increase your stress resistance. Yoga or breathing exercises help with this.

Treatment of panic attacks

The maximum effect is achieved by comprehensive treatment of panic attacks, including medication and the use of non-drug methods.

The latter include breathing exercises, therapeutic and relaxing massage, and folk remedies. In some cases, you will need the help of a psychologist or psychotherapist.

Women are prescribed medications with phytoestrogens or hormone replacement therapy to reduce the intensity of all menopausal symptoms, including panic attacks. If the patient has pronounced symptoms of a panic attack, and treatment with hormones has not significantly reduced them, then sedatives, tranquilizers and antidepressants are additionally prescribed.

It is strictly forbidden to select medications on your own. Only a doctor should prescribe medications, their dosage, regimen and duration of treatment after a medical examination, ultrasound and other studies, as well as blood tests for hormones.

After all, all drugs have a number of contraindications. If they are not taken into account, then the progression of the lady’s existing diseases can be provoked.

Pathology therapy

Treatment for a panic attack should be comprehensive. To normalize hormonal levels, a woman is prescribed hormone replacement therapy. Medicines must be taken strictly in prescribed doses so as not to provoke a deterioration in health.

If serious mental problems arise, it is recommended to consult a psychotherapist. However, such help is required only for those who had panic attacks before menopause. Most women are able to eliminate a panic attack on their own with simple tips:

• in case of breathing problems, you need to learn to breathe in your hands: firstly, it distracts from the main problem, and secondly, it helps to normalize breathing;
• It is better to perform breathing acts by counting;
• to distract from the state of panic, anxiety is driven away by switching to other ideas: you can count trees, cars passing by only a certain color, etc.;
• for some patients, a rubber band can be a salvation, with which you can lightly hit yourself on the wrist to relieve an attack and distract from negative thoughts;
• if you experience chest pain caused by cardiac problems, you can cough a little;
• If a panic attack occurs in women suffering from asthma or epilepsy, qualified help may be needed; you need to warn someone you know about this.

Panic attacks are an unpleasant phenomenon that must be treated. Such attacks do not go away on their own; the attending physician must know about their occurrence in order, if necessary, to schedule a consultation with another specialist and adjust the patient’s treatment.

Interesting and educational video on this topic:

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Traditional methods of treatment

In folk medicine there are many recipes that help get rid of panic attacks.

The most popular include the following:

1. Every morning prepare an infusion of 2 tbsp. lie dry peppermint and 1 liter of boiling water. When the infusion has cooled, strain. Drink a glass of infusion when you feel an approaching attack, and also when going to bed.
2. Twice a day, half an hour before meals, drink a mixture of 40 ml of freshly squeezed red beet juice and the same amount of honey.

Treatment is carried out for 2 weeks, then a break is taken for a similar period and, if necessary, the course is repeated.