Factors Beyond Hormones That Influences Women's Anxiety

Women are twice as likely as men to develop an anxiety disorder in their lifetime, and while sex hormones often take the blame, other significant factors contribute to this disparity. Integrative neurologist Romie Mushtaq, M.D., ABIHM, sheds light on three non-sex-hormone reasons women are more prone to anxiety and how to cope.

1. Chronic Stress

Chronic stress is a major contributor to anxiety in women. A 2023 survey by the American Psychological Association found that women reported higher average stress levels than men and were more likely to rate their stress levels as high. Stress not only affects how we perceive and react to situations but also impacts blood sugar levels and the risk of diabetes.

"Under chronic stress, the brain's hormonal control of glucose regulation is negatively impacted, starting with insulin resistance," says Mushtaq. This means that anxiety might be the first symptom of blood glucose level fluctuations even before a diagnosis of diabetes or prediabetes is made. Women are particularly sensitive to insulin during perimenopause and menopause, making blood sugar management crucial.

How to Cope:

• Stress Management: Practice stress-reducing techniques like mindfulness, yoga, or deep-breathing exercises.

• Blood Sugar Control: Monitor blood sugar levels and maintain a balanced diet to avoid spikes and dips that could worsen anxiety.

2. Thyroid Dysfunction

Women are five to eight times more likely to have thyroid problems than men. Thyroid hormones influence mood-related neurotransmitters (such as serotonin, dopamine, and norepinephrine), metabolic rate, and the brain's response to stress. Thus, thyroid dysfunction can contribute to or exacerbate anxiety.

"40% of thyroid disease can present with anxiety and mental health symptoms only," asserts Mushtaq. Without proper blood testing and evaluation, the root cause of the anxiety (thyroid dysfunction) may be wrongly diagnosed and treated.

How to Cope:

• Medical Evaluation: Get a comprehensive thyroid panel including tests for thyroid-stimulating hormone (TSH), free T3, free T4, and thyroid antibodies.

• Treatment: Follow medical advice for managing thyroid dysfunction, which might include medication or lifestyle adjustments.

3. Social Factors

Societal expectations and gender roles place additional pressure on women, increasing their risk of anxiety. Women are more likely to face body shaming, domestic violence, and abuse, all of which make them more vulnerable to anxiety and depression.

Life stages such as childbirth and menopause come with caregiving responsibilities, financial strain, and worry, further contributing to anxiety. These pressures, combined with hormonal changes, create a complex web of factors that impact mental health.

How to Cope:

• Support Networks: Build a strong support system of friends, family, or support groups to share the burden and find comfort.

• Professional Help: Work with a licensed therapist to unpack and process emotional triggers and learn coping strategies.

What to Do About It

"My message to all women is to remember that you are in control, even if your anxiety and busy brain are robbing you of your sense of control," says Mushtaq. Unrelenting feelings of anxiousness should not be brushed off. Seek medical attention and be your strongest advocate in the healthcare system. Recruit a trusted friend or family member to join you in medical visits if needed.

Laboratory Evaluations: Mushtaq recommends getting comprehensive blood work, including a full thyroid panel, fasting insulin levels, fasting blood glucose, hemoglobin A1c, and serum cortisol levels. These tests help identify the root cause of anxiety.

Therapy: Working with a licensed therapist can be extremely helpful in addressing potential emotional triggers of anxiety. There are various types of therapy available, and choosing the best one depends on individual needs.

The Takeaway

Numerous social, emotional, and hormonal factors contribute to women's anxiety. Discussing concerns and symptoms with a medical professional and getting comprehensive blood work done are crucial steps in identifying the contributing factors and informing an appropriate treatment plan.