Know the Causes & Symptoms of Panic Attacks in Women

Researchers have identified 3 notable causes of panic attacks and other signs of anxiety in women: serotonin deficiency, low vitamin B6 levels, and low iron levels.

anxiety panic attack symptoms in women

Causes of anxiety in women can be attributed to serotonin levels.

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It has long been known that women are twice as likely as men to suffer from generalized anxiety disorder or panic disorder. What has not been understood, however, is exactly why. But medical research is beginning to uncover the explanations for this gender-based paradox, giving us as clearer picture of how to address signs of anxiety in women.

For starters, let’s take a look at symptoms.

Anxiety Attack Symptoms in Women

  • Excessive worry
  • Sudden overwhelming fear
  • Palpitations
  • Feeling nervous
  • Trembling
  • Shortness of breath
  • Sense of choking
  • A detached feeling
  • Fear of dying
  • Feeling powerless
  • Numbness or tingling in the limbs or entire body
  • Chills or sweating
  • A sense of impending doom or feeling like something bad is going to happen
  • Dizziness
  • Nausea
  • Chest pain
  • Difficulty concentrating on things that are worries

Why Women Are More Prone to Panic Attacks and Anxiety

Serotonin is a neurotransmitter that acts as a messenger to transmit signals within the brain. Low serotonin levels are well-recognized by the medical community as a primary cause of panic attacks, depression and other signs of anxiety in women. And, women are much more likely to suffer from serotonin deficiency than men. But why?

Low serotonin levels in women likely are the result of their more sensitive and intense responses to stress  as well as their higher rates of thyroid problems.[2] There is also some evidence that female hormones interact with serotonin to cause anxiety symptoms to occur or worsen during the premenstrual time, during the postpartum period, and around the time of menopause.

Not coincidentally, these are all periods when sex hormones are in flux. Men, on the other hand, generally experience a steady level of sex hormones until middle age, when the decline is gradual.

Serotonin and Panic Attacks

Research published in the medical journal Biological Psychiatry, provides intriguing insight as to why women seem to be affected so much more intensely than men to serotonin deficiency.

To study the effects of serotonin deficiency on the brain, the researchers depleted serotonin levels in both men and women. They found that men with decreased serotonin levels become more impulsive but did not experience mood changes in response to the induced chemical changes. Women, on the other hand, experienced responses commonly associated with depression such as worsening of their mood and becoming more cautious (anxious). The researchers also discovered that the mood-lowering effect in women was influenced by a variation in a gene called the “serotonin transporter gene”.[3]

In short, the study results indicate that men and women use serotonin differently. That is, in general, women are highly susceptible to decreases in this neurotransmitter and demonstrate multiple symptoms. When men, however, experience a decrease in serotonin, it often does not translate to depression and anxiety.

Although serotonin is manufactured and performs its primary functions in the brain, approximately 90 percent of the body’s serotonin supply is found in the digestive tract and in blood platelets. Therefore, serotonin affects multiple systems, including the nervous, cardiovascular, and digestive systems.

This explains why many women who suffer from serotonin deficiency experience multiple symptoms simultaneously:  stress and anxiety, depression, nervousness, panic attacks, altered sleep patterns, food cravings, weight gain and upset stomach. This further clarifies why depression and signs of anxiety in women have been linked to an increased incidence of diabetes, heart attack, and stroke.[4,5]

Signs of a Panic Attack Caused By Vitamin B6 and Iron Deficiency

Another study linked vitamin and mineral deficiencies to panic attacks in women and other signs of anxiety in women. Since vitamin B6 and iron play important roles as cofactors for the synthesis of serotonin, the researchers tested to see whether or not low levels of the nutrients played a role in the incidence of panic attacks.

Study participants were divided into two groups: one group included patients who had been to the emergency room due to panic attacks or hyperventilation attacks while the other group did not have a history of panic attacks. The researchers tested the blood levels of both groups to see whether a deficiency in B vitamins or iron could contribute to the attacks. The results indicated that low blood levels of these two specific nutrients were indeed related to panic attacks.[6]



[1] Anxiety and Depression Association of America.

[2] Merck Manual on Depressive Disorders.

[3] Biological Psychiatry, 2007, Vol. 62, Issue: 6, Pages: 593-599.

[4] American Heart Association.

[5] American Journal of Public Health, April 9, 2013.

[6] Acta Med Okayama. 2013;67(2):99-104.

This article was originally published in 2013 and has been updated.

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Jami Cooley, RN, CNWC

Jami Cooley is a Certified Nutrition and Wellness Consultant as well as a Registered Nurse, but her interest in integrative medicine grew out of her experience in conventional medicine. Cooley … Read More

View all posts by Jami Cooley, RN, CNWC

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