Hormones and Anxiety: When Your Nervous System Isn’t the Only Player
- 1 day ago
- 4 min read
Anxiety is often framed as purely psychological — something happening in your thoughts, your stress levels, or your coping skills. But in clinical practice, anxiety is frequently physiologic first.
Hormones shape how sensitive your nervous system is, how resilient you feel under stress, how well you sleep, and even how your brain interprets signals from your body.
If you’ve ever felt like your anxiety worsens at certain times of your cycle, after poor sleep, during burnout, or seemingly out of nowhere — your endocrine system may be part of the story.
Understanding this doesn’t minimize the emotional experience. It explains it.
🧠 The Hormone–Nervous System Connection
Hormones act as biochemical messengers that influence neurotransmitters like serotonin, GABA, dopamine, and norepinephrine — the very systems that regulate mood and stress response.
When hormones are balanced, the nervous system tends to feel more buffered.
When they’re fluctuating or depleted, the same stressors can feel much louder.
This is why anxiety can feel intensely physical — racing heart, chest tightness, restlessness, insomnia, or a sense of internal agitation.
🌙 Progesterone: Your Natural Calming Hormone
Progesterone has a direct calming effect on the brain because it enhances GABA signaling — the primary inhibitory neurotransmitter responsible for relaxation and sleep.
When progesterone is low or drops quickly, patients often notice:
Increased anxiety or irritability
Poor sleep
Feeling “wired but tired”
Heightened stress sensitivity
This is commonly seen in the luteal phase before menstruation, during perimenopause, or with chronic stress.
🔥 Cortisol: The Stress Amplifier
Cortisol is essential for survival, but when it stays elevated or becomes dysregulated, it can create a constant state of alertness.
Signs cortisol may be contributing to anxiety include:
Feeling tired but unable to relax
Early morning waking
Feeling overstimulated easily
Afternoon crashes with evening second wind
Physical tension
Over time, cortisol dysregulation can also lower resilience, making everyday stress feel overwhelming.
🌸 Estrogen: The Mood Modulator
Estrogen influences serotonin production and receptor sensitivity.
Both low estrogen and rapid estrogen fluctuations can contribute to anxiety symptoms, including:
Mood instability
Panic-like symptoms
Brain fog
Emotional sensitivity
This is why anxiety may worsen around ovulation, before menstruation, postpartum, or during perimenopause.
🦋 Thyroid Hormones: The Metabolic Regulators
Thyroid function plays a major role in nervous system tone.
When thyroid hormones are too high, patients may experience:
Racing thoughts
Palpitations
Restlessness
Heat intolerance
Tremor
When thyroid function is low, anxiety can still occur — often alongside fatigue, low mood, and cognitive slowing.
🌿 Blood Sugar and Insulin: The Overlooked Piece
Blood sugar swings can trigger adrenaline release, which feels identical to anxiety in the body.
Symptoms may include:
Sudden nervousness or shakiness
Irritability when hungry
Cravings
Mid-afternoon crashes
Feeling better after eating but crashing soon after
Stabilizing blood sugar is often one of the quickest ways to reduce baseline anxiety symptoms.
⚖️ Why Anxiety Isn’t “Just Stress”
Many patients have been told their labs are normal or that they simply need stress management. While nervous system support is important, it’s only one piece.
If the underlying physiology is off — hormones, sleep, inflammation, nutrient status, metabolic function — the nervous system remains more reactive no matter how much mindfulness you practice.
True resilience comes from addressing both biology and lifestyle.
🩺 A More Complete Approach
A root-cause approach to anxiety looks at patterns rather than just symptoms.
This may include evaluating:
Hormone patterns across the cycle
Sleep quality and circadian rhythm
Stress physiology
Thyroid function
Blood sugar stability
Nutrient status
Lifestyle and environmental causes
When these systems are supported, patients often notice their baseline anxiety decreases naturally — not because they’re forcing calm, but because their physiology feels safer.
🤍 The Takeaway
Anxiety is real, and it’s not a personal failure.
For many people, it’s a signal from the body — not just the mind — that something needs support.
When we understand the hormonal and physiologic contributors, we can move from simply managing symptoms to restoring resilience.
FAQ
Can hormones really cause anxiety even if my labs are normal?
Yes. Standard reference ranges don’t always capture functional imbalances or fluctuations across the cycle. Symptoms often appear before labs fall outside the range.
Why does my anxiety worsen before my period?
This is commonly related to the drop in progesterone and shifting estrogen levels during the luteal phase, which can increase nervous system sensitivity.
Can stress alone cause hormone imbalance?
Chronic stress can significantly affect cortisol patterns, which in turn influence progesterone, thyroid function, and blood sugar regulation.
How do I know if my anxiety is hormonal?
Clues include cyclical patterns, worsening with poor sleep, feeling physically “wired,” or anxiety accompanied by fatigue, PMS symptoms, or metabolic changes.
Does supporting hormones replace therapy?
No — hormone support and mental health support work best together. Addressing both provides the most sustainable improvement.
Dr. Kseniya Zvereva (ND) is a licensed naturopathic doctor in Washington, California, and Minnesota and founder of Xenia Integrative. She specializes in hormone imbalance, fatigue, gut dysfunction, pain, and stress-related conditions using personalized, evidence-informed naturopathic medicine.
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