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Yet the hormone changes of menopause impact the bodys ability to manage cortisol production, explains Midis Chief Medical Officer Kathleen Jordan, MD, and overall higher cortisol levels manifest as various symptoms, including increased anxiety. In sum, shifting hormone levels in perimenopause make it harder for mood-protective neurotransmitters to do their thing, rendering women more likely to experience stressful events more negativelyand with more anxietythan women with higher or more consistent hormone levels