The link between vasomotor symptoms (VMS) and anxiety

Commonly known as hot flashes and night sweats, vasomotor symptoms (VMS) are the most common symptoms associated with menopause.

Menopause begins exactly 12 months after a person’s final menstrual period. It marks the end of the reproductive years for a person with a female reproductive system. Menopause also refers to the months and years leading up to this day (though the more accurate term for that time is perimenopause). Approximately 75 to 80 percent of people who experience menopause experience VMS.

Hot flashes are sudden episodes of uncomfortable (and sometimes intense) warmth, typically spreading throughout the neck, face, and chest. Night sweats are hot flashes that occur during the night and disrupt sleep.

During one of these episodes, a person may experience flushing skin, sweating, and rapid heart rate. Each episode of VMS typically lasts for several minutes, and episodes are often followed by chills.

Along with warmth, flushing, sweating, rapid heart rate, and chills, another symptom associated with VMS is anxiety.

What is anxiety?

Most people have an idea of what anxiety is and what it’s like. It’s an emotional and physical response to stress that can cause a person to feel tense, nervous, restless, and wound up. In small doses, anxiety can be helpful—it can give a person the motivation or energy they need to confront a problem.

When anxiety is frequent, difficult to control, and interferes with normal functioning and day to day life, it’s something that should be discussed with a healthcare provider.

Anxiety can be a symptom of many different health conditions, including thyroid disorders, infections, nutritional deficiencies, neurological conditions, and adverse reactions to medications. For a person living with an anxiety disorder, anxiety can be the primary symptom.

As with any health condition or symptom, the first step in treatment is identifying the cause.

What is the link between VMS and anxiety?

The relationship between anxiety, VMS, and menopause is complex.

It’s known that the changes in estrogen levels during perimenopause affect how the brain works, and this increases a person’s risk of anxiety and depression.

People who report higher levels of anxiety, stress, and depressive symptoms prior to perimenopause also appear to be more likely to experience VMS, and more likely to describe VMS as being more disruptive to their lives.

Living with VMS can be difficult. Symptoms often interfere with sleep, and lack of sleep can increase anxiety. There’s also the uncertainty of when a hot flash will occur, and the possibility that one may occur at a very inconvenient time.

It should also be mentioned that VMS and anxiety can have a cyclical relationship, where VMS can be a source of anxiety and anxiety can worsen VMS.

Managing VMS and anxiety

Anyone experiencing VMS, anxiety, or both should speak to a healthcare provider about their symptoms. There are treatments available that can reduce the frequency and severity of VMS, including hormone therapy, as well as non-hormone medications. Cognitive behavioral therapy (CBT) is often used to treat anxiety disorders, and CBT has also been shown to benefit people experiencing VMS.

Making changes to routine and lifestyle are another good topic to discuss with a healthcare provider. Changes to nutrition, increasing the amount of physical activity in your life, and making time to reduce stress can all help with anxiety—and may help a person get more out of their treatment for VMS and anxiety.

Keeping a journal can help identify what triggers or contributes to anxiety and VMS. A journal is also a good place to write down questions and topics you want to cover at a healthcare appointment.