Middle aged woman waking up with anxiety

Perimenopause Anxiety in the Morning: Is It Normal?

Perimenopause anxiety in the morning is more common than you think!  Even some women who never experienced anxiety before notice this unpleasant (and debilitating) feeling in their 40’s and 50’s. For women who had it before, it can come back stronger! 

However, because morning anxiety is common, it does not mean you have to live with it. There are many things that you can do to help. 

What Are the Causes of Morning Perimenopause Anxiety?

In general, your stress hormone cortisol levels are higher in the morning to help you wake up. Before perimenopause, progesterone helps to control the spike. As your progesterone levels go down during this period in your life, there is more cortisol to overwhelm your nervous system in the morning. 

Moreover, higher cortisol levels can also show up during the night, causing a poor night sleep, which further contributes to anxiety in the morning. As it is well known, adequate sleep (6 to 8 hours) is essential for emotional health.

Last, normal stressors in life (such as taking care of older parents while taking care of your own children) can further aggravate overall anxiety. 

Now that we established that nervousness, fearful feelings, and irritability in the mornings are common, let’s see what can be done about it.

What Are Natural Ways to Treat Perimenopause Anxiety in the Morning?

  • Better sleep
  • Establishing morning routines to cope with morning anxiety
  • Eating foods that can help decrease the feeling
  • Balancing your hormones

Improving Sleep

Sleep disturbances

To help with morning anxiety, let’s start by improving how well you sleep at night. This might sound like a difficult task as perimenopausal insomnia is real! However, many lifestyle changes can help.

Even if it is not a perfect night’s sleep, any improvement will help you feel better in the morning and throughout the day.

The sleep foundation recommends the following lifestyle changes for sleep:

  • Maintain a regular bed and wake up time schedule
  • Budget time to sleep
  • Create a regular, relaxing nighttime routine
  • Create a sleep environment that is dark, quiet, comfortable and cool 
  • Use your bedroom only for relaxation and sex
  • Foster healthy pro-sleep habits throughout the day

Pro-Sleep Nutrition Habits to Consider

Limiting or avoiding caffeine

Consider minimizing coffee and other drinks high in caffeine to 1-2 cups early morning, as the effects of caffeine can linger for over 5 hours. If you are substituting coffee with tea, make sure it is low in caffeine. Also, be aware of soft drinks and energy drinks as they contain high amounts of caffeine.

Limiting alcohol can also be beneficial. 

While many use alcohol to help them sleep, it can actually worsen sleep quality. Furthermore, alcohol can contribute to a hormonal imbalance.

It is a great thing that mocktails and low alcohol drinks are so trendy! Thanks to the sober curious movement, you have many choices to help you limit or avoid alcohol.

Balancing Cortisol Levels Throughout the Night

If you wake up in the middle of the night feeling fully awake or anxious, this can mean that you had a spike in cortisol levels. Discuss with your doctor potential solutions to spike cortisol at night. However, it is good to know that there are over-the-counter (as well as prescribed) supplements that can specifically help you manage cortisol levels during the night. 

Natural Sleep Aids 

There are many natural sleep aids available. Two of the most well-known and studied sleeping aids are melatonin and valerian.  You can take melatonin 30 minutes before bedtime to help you fall asleep or in the middle of the night to help you go back to sleep.

Morning Routines to Decrease Perimenopause Anxiety

While you might not control the immediate feeling of anxiety, you can control what you do in the morning.  Establishing a routine to help you ease into the day can help to decrease the feeling. 

First, let’s talk about what not to do. This is mostly to remind you to stay away from your phone. Start the day by doing something for yourself! 

Now, let’s talk about what to do:


A morning workout does not have to be strenuous or even away from home. The goal here is to release anxiety and have good endorphins running throughout your body. Even a 20 minutes yoga routine will help. 

Of course, if you are the person that wakes up in the morning and likes to do a full workout routine, go for it! Exercising early in the morning is one of the best ways to start the day.

A warning for you: it is important not to sacrifice sleep for a full workout. You need to aim for 7 to 9 hours of sleep every night. Plan ahead, go to sleep early, to fit both into your routine. Sacrificing sleep for exercising can make anxiety worse and might even be bad for your waistline.

Wake up a Little Early

Allow yourself to take the morning at ease instead of rushing to get to work or get your family out the door. Instead, give yourself time to work out, have a cup of tea, or meditate.

Prepare the Night Before

Minimize the number of tasks you have to do in the morning. For example, have your clothes ready and easy breakfast items available. This can prevent the morning rush and help you decrease your anxiety.

Morning Routine to decrease anxiety

Eat Breakfast Foods Designed to Decrease Perimenopause Anxiety

Avocado and egg toast

Nutrition can help anxiety in many ways. First, eating a diet rich in whole grains, vegetables and fruits can provide important nutrients to combat anxiety. 

Also, eating protein-rich foods can help you make key neurotransmitters that will help you feel more relaxed. There is also the likelihood that when you eat a protein-rich breakfast, you will skip high sugar foods that can make anxiety worse. 

Moreover, there is a connection between gut health and anxiety. A healthy gut can help you feel more relaxed and sleep better, further reducing morning anxiety.

Foods to Avoid

Added Sugar

Foods high in ADDED sugar can create spikes in blood sugar followed by a quick drop-off associated with anxiety. Popular breakfast items like traditional pancakes with syrup, pastries, muffins, and other foods are best to eat only from time to time. Save it for those days when you have time for a leisurely breakfast with friends or family. 

Furthermore, excessive sugar consumption can lead to increased cravings, almost like an addictive substance, leading to anxiety when you don’t have high intakes of sugar. It is a cycle.

Last, a diet high in sugar can damage your gut health, leading to potentially more anxiety and decrease sleep quality.

Please note that foods with naturally occurring sugars like fruit are healthy for you. While they contain sugar, they are also high in fiber, which slows down the speed at which sugar is absorbed. Make sure to eat whole fruits or juices mixed with a higher vegetable to fruit ratio (use only a bit of fruit to sweeten your juice naturally). 


Caffeine is a stimulant and affects the body in a similar way that a frightening event will. Therefore, choose lower or no-caffeine alternatives such as decaffeinated tea or decaf coffee in the mornings where anxiety is severe.

Other days you can drink up to two cups of coffee or caffeinated drinks per day.

Balance your hormones

Naturally, perimenopause and menopause create a hormonal imbalance as your body adapts to the new changes. However, everything that is discussed in this post will help you balance your hormones. 

There are many natural ways and supplements to help with hormonal imbalances. However, it is important to talk with your doctor about the hormonal changes you might be experiencing.

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