Anxiety Disorders Among Women: A Female Lifespan Approach

Abstract

Anxiety symptoms may present differently between women and men, and at different points in the female lifespan. The female lifespan includes distinct epochs of hormonal function, including puberty, the premenstruum, in some women pregnancy or postpartum, and the menopausal transition. These stages give rise to important treatment considerations when treating anxiety in women. When making assessments, the clinician should consider reproductive events and hormonal status, as well as sex differences in anxiety presentation. This review is structured to: 1) Define major epochs of the female lifespan, 2) Provide a brief summary of the major anxiety disorders, with a focus on prevalence and presentation in the context of sex differences and at points in the female lifespan, 3) Describe potential biopsychosocial underpinnings of anxiety disorders among women, 4) Provide guidelines for assessment and differential diagnosis, and 5) Describe treatment options with attention to reproductive events such as pregnancy.

Keywords: menopause; ovarian hormones; perinatal; postpartum; premenstrual; puberty.

FIGURE 1.

Anxiety Disorders Across the Female Lifespan^{a a} The female lifespan includes distinct hormonal and psychosocial epochs, including puberty, the premenstruum, pregnancy or postpartum, and the menopausal transition. These stages give rise to important assessment and treatment considerations. The clinician should consider reproductive events, hormonal status, and potential sex differences in anxiety presentation.