Nervous system check: stress, arousal and the small hours
The autonomic nervous system governs the physical side of alertness — heart rate, breathing, digestion, temperature. In perimenopause, erratic progesterone disrupts the GABA system that normally damps arousal, and broken sleep raises reactivity further. This check measures how much of your life is spent in that heightened state. It is not a diagnosis, and several symptoms it asks about have specific medical causes worth excluding first.
Nervous system dysregulation is a popular phrase that does not correspond to a medical diagnosis. What is real underneath it is well described: the autonomic nervous system has an arousal branch and a calming branch, and several things in the menopause transition tilt the balance towards arousal.
Progesterone's metabolite allopregnanolone acts on the GABA-A receptor, the brain's main inhibitory system and the same receptor targeted by benzodiazepines. When progesterone becomes erratic, that calming input becomes erratic too. Sleep deprivation raises reactivity measurably on top of it.
Before reading anything into a high score: palpitations, breathlessness and tremor all have specific medical causes that need excluding, and the bands below say so.
Read more on this
Perimenopause anxiety: new, worse, or nothing like you before
Menopause heart palpitations: common, frightening, usually benign — and always worth checking
Menopause insomnia: why sleep breaks in the transition
Sources
- NICE NG23 — Menopause: diagnosis and management
- The Menopause Society — patient education
- NHS — Anxiety, fear and panic