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Perimenopause can be a challenging phase for many women, marked by mood disturbances that often manifest as anxiety and depression. While hormone replacement therapy (HRT) is a common treatment option, its potential side effects and long-term risks can make it a less desirable choice for many. Fortunately, recent research has shed light on the potential of herbal medicines in managing perimenopausal anxiety and mood swings.

The Neurochemistry of Perimenopause Anxiety

Studies have shown that estrogen plays a significant role in cognition and mood regulation by modulating serotonergic function. During perimenopause, hormonal fluctuations can lead to dysfunction in GABAergic receptors, with evidence suggesting a decline in GABA concentration in the frontal cortex. This imbalance in neurotransmitters is often at the root of perimenopausal mood disturbances.

Herbal Medicines: An Alternative Approach

In recent years, herbal medicines have gained recognition for their potential in alleviating psychological conditions, particularly their anxiolytic and sedative effects. Here are some herbal options that may help modulate neurotransmitters and effectively manage the psychological symptoms of perimenopause:


Kava is a herb that has shown promise in relieving the neuro-vegetative complaints associated with menopause, such as anxiety and sleep disturbances. Clinical evidence also suggests that kavalactones found in kava may also improve libido in women, enhancing sexual function and satisfaction due to its anxiolytic effects.


Passionflower has been the subject of several studies highlighting its anxiolytic and sedative properties. Its effects are mediated by its impact on the GABA system, including its affinity to GABA(A) and GABA(B) receptors, as well as its influence on GABA uptake in the brain. A study in menopausal women found that passionflower was effective in reducing temperamental changes and sleep dysfunction, making it a safe alternative when HRT is not recommended.

California Poppy

The endogenous alkaloids present in California Poppy exhibit sedative properties and may act as weak modulators of GABA-A receptors in the brain. Furthermore, when interacting with opioid receptors in the brain, California Poppy provides analgesic effects, offering relief from mental stress and pain while aiding sleep. Traditionally, it has been used for its calming properties and as a natural sleep aid.

Passionflower and California Poppy are often combined to create a potent remedy for managing hyperactivity and sleeplessness during perimenopause.

Take Control of Your Perimenopausal Symptoms

Perimenopause anxiety can feel crippling for many women, but with the power of nature’s remedies, you can regain control of your emotional well-being. 

Explore how herbal medicines can help you find calm and balance during this transition, by booking a free discovery consult with me

Together, I can tailor a holistic approach to support you on your journey towards reclaiming your calm and embracing this new phase of life with ease. 

Don’t wait! Take the first step towards your well-being today.


Appel, K., Rose, T., Fiebich, B., Kammler, T., Hoffmann, C., & Weiss, G. (2011). Modulation of the γ-aminobutyric acid (GABA) system by Passiflora incarnata L. Phytotherapy research : PTR, 25(6), 838–843. https://doi.org/10.1002/ptr.3352

Miroddi, M., Calapai, G., Navarra, M., Minciullo, P. L., & Gangemi, S. (2013). Passiflora incarnata L.: ethnopharmacology, clinical application, safety and evaluation of clinical trials. Journal of ethnopharmacology, 150(3), 791–804. https://doi.org/10.1016/j.jep.2013.09.047

Bartram, T. (2013).  The Encyclopedia of Herbal Medicine. Grace Publishers, London: UK

European Medicines Agency. (2015).  European herbal monograph on Echscholzia californica Cham., herba. Retrieved from https://www.ema.europa.eu/en/documents/herbal-monograph/final-european-union-herbal-monograph-eschscholzia-californica-cham-herba_en.pdf

De Leo, V., la Marca, A., Morgante, G., Lanzetta, D., Florio, P., & Petraglia, F. (2001). Evaluation of combining kava extract with hormone replacement therapy in the treatment of postmenopausal anxiety. Maturitas, 39(2), 185–188. https://doi.org/10.1016/s0378-5122(01)00197-9

Cagnacci, A., Arangino, S., Renzi, A., Zanni, A. L., Malmusi, S., & Volpe, A. (2003). Kava-Kava administration reduces anxiety in perimenopausal women. Maturitas, 44(2), 103–109. https://doi.org/10.1016/s0378-5122(02)00317-1

Epperson, C. N., Amin, Z., Ruparel, K., Gur, R., & Loughead, J. (2012). Interactive effects of estrogen and serotonin on brain activation during working memory and affective processing in menopausal women. Psychoneuroendocrinology, 37(3), 372–382. https://doi.org/10.1016/j.psyneuen.2011.07.007

Gilfarb, R. A., & Leuner, B. (2022). GABA System Modifications During Periods of Hormonal Flux Across the Female Lifespan. Frontiers in behavioral neuroscience, 16, 802530. https://doi.org/10.3389/fnbeh.2022.802530

Sarris, J., Stough, C., Teschke, R., Wahid, Z. T., Bousman, C. A., Murray, G., Savage, K. M., Mouatt, P., Ng, C., & Schweitzer, I. (2013). Kava for the treatment of generalized anxiety disorder RCT: analysis of adverse reactions, liver function, addiction, and sexual effects. Phytotherapy research : PTR, 27(11), 1723–1728. https://doi.org/10.1002/ptr.4916

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