Yes, estrogen can help panic attacks, particularly those linked to menopause, because it influences mood-regulating neurotransmitters like serotonin and GABA; declining estrogen levels can trigger panic, while estrogen replacement therapy (ERT) or hormone replacement therapy (HRT) may help stabilize hormones, reduce anxiety, and improve mood, though individual results vary and it's not for everyone.
Benzodiazepines most commonly used to treat anxiety disorders are clonazepam (Rivotril)*, alprazolam (Xanax) and lorazepam (Ativan). Also used are bromazepam (Lectopam), oxazepam (Serax), chlordiazepoxide (once marketed as Librium), clorazepate (Tranxene) and diazepam (Valium).
The drop in serotonin that accompanies the declining estrogen levels during menopause may result in panic attacks and other mood changes. In contrast, progesterone has a calming effect on the brain and works similarly to benzodiazepines, a class of medications with anti-anxiety and sedative effects.
While the researchers determined that estrogen-based hormone therapy does not consistently reduce anxiety symptoms among midlife women, modest benefits were noted in perimenopausal or early postmenopausal women, particularly among those who were symptomatic and within a few years of their final menstrual period.
How to handle a panic attack
Practice Meditation. Meditation is great at reestablishing the mind-body connection, slowing down the chaos of a panic attack through intentional breath and focus. It helps reduce cortisol levels, improves sleep quality, and helps keep the mind from wandering.
Multiple attacks of different intensities may occur over several hours, which might feel as if one panic attack is rolling into the next, like waves. At first, panic attacks usually seem to come 'out of the blue,' but over time a person may come to expect them in certain situations.
Estrogen is positively associated with serotonin, so increased estrogen means increased serotonin production as well. Additionally, this increase in estrogen can suppress cortisol (the stress hormone) and adrenaline (a hormone central to your fight-or-flight response).
Timeline for HRT Effectiveness on Anxiety
However, for others, it might take a longer period, potentially several months, to observe any significant improvements. Generally, a typical timeframe within which many women start to notice changes in their anxiety levels due to HRT is approximately one to three months.
The researchers looked at the anxiety-reducing effects of oxytocin, a neurotransmitter sometimes called the “love hormone” for its ability to reduce stress and promote pro-social behaviors such as trust, empathy, and openness to social risk.
Thyroid hormones play a significant role in anxiety. Thyroid-stimulating hormone (TSH) levels directly correlate with the severity of panic attacks (which are a type of anxiety disorder). Common symptoms of thyroid imbalance can include: Nervousness.
Mood swings are another effect of low estrogen. You may feel sad, anxious, or frustrated. Shifting hormone levels and night sweats may disrupt your sleep. This can cause fatigue, which may make mood swings worse.
Studies show that CBT can be very effective in managing anxiety during hormonal changes—from PMS-related fears to worries during perimenopause—since it reprograms how the brain interprets physical sensations.
Triggers for panic attacks can include overbreathing, long periods of stress, activities that lead to intense physical reactions (for example exercise, excessive coffee drinking) and physical changes occurring after illness or a sudden change of environment.
These sedatives are central nervous system depressants. Benzodiazepines approved by the FDA for the treatment of panic disorder include alprazolam (Xanax) and clonazepam (Klonopin). Benzodiazepines are generally used only on a short-term basis because they can be habit-forming, causing mental or physical dependence.
Supplement options
Although further studies are needed, vitamin D deficiency has been linked to anxiety and depression. Supplements may help manage symptoms of stress and anxiety in those who are deficient. Vitamin B complex supplements may also help lower stress and anxiety levels.
HRT can take up to 3 months to work fully to improve your symptoms. Common side effects include headaches, breast tenderness and vaginal bleeding, but these usually improve in the first few months of treatment. If you feel that the HRT you're taking is not helping your symptoms, talk to a doctor.
However, HRT can improve anxiety symptoms because it helps balance hormones that play a part in mood regulation. Oestrogen has a significant impact on serotonin, a neurotransmitter known as the 'feel-good' chemical in the brain.
Estrogen is widely used in the treatment of perimenopausal depression in women, either directly or indirectly. Phytoestrogens such as genistein have been suggested as alternatives to estrogen therapy due to their potential antidepressant and anxiolytic effects in both animal and human studies [140–142].
Some of estrogen's effects include: Increasing the mood-altering chemical serotonin and the number of serotonin receptors in the brain. Modifying the production and the effects of endorphins, the "feel-good" chemicals in the brain. Protecting nerves from damage and possibly stimulating nerve growth.
Low estrogen can cause many physical and emotional changes. If you're experiencing some of the following symptoms, it could be a sign that your hormonal levels need attention: Mood swings: Feeling more irritable, anxious, or even depressed than usual?
Progesterone, in most women helps to induce a feeling of calm, by stimulating neurotransmitter GABA. These hormones fluctuate in perimenopause, they have an affect upon the brain and can leave women feeling their moods are out of control.
Talk to Yourself
Telling yourself, “This will pass,” “I can get through this,” “I'm not dying,” or “I'm not having a heart attack” can help you get through these uncomfortable moments. Another way to be prepared for a possible panic attack is to write down helpful statements, such as, “You're OK.
A silent panic attack is an intense episode of anxiety without obvious external signs. Unlike typical panic attacks, these don't involve visible physical reactions like hyperventilation or shaking. People experiencing a quiet panic attack might appear calm on the outside.
Panic attacks often include physical symptoms that might feel like a heart attack, such as trembling or tingling in the body or a rapid heart rate. Panic attacks can occur at any time, sometimes even during sleep.