It’s Not You, It’s Perimenopause
- Brainz Magazine
- May 8
- 7 min read
Written by Jo Ibbott, Executive Menopause Coach
Jo is well-known when it comes to Menopause! She is an Executive Coach specialising in Menopause and Founder of What the Fog? Facebook Community, Foglights Menopause Hub and developed the Courage Coaching Menopause Advocate Programme for organisations.
Tasha enjoyed her job and felt fulfilled in her career. She knew she was good at it, her colleagues would tell her that, the feedback was positive, and she felt confident and capable within it.
Until one day she didn’t.
Tasha started to feel overwhelmed, her anxiety was rising, she felt her brain wasn’t functioning in the way it once had, her self-confidence began to wane, and she wasn’t coping. She had no idea what was going on. She thought that perhaps this was just how things would be as she was getting older (she was 43). These symptoms impacted her choice of job, where once she’d been project managing, she was now taking on administrative roles with less responsibility. Once she was employed full-time on a permanent contract, now she was opting for part-time, shorter contracts because she didn’t have the energy and capacity for anything else.
Tasha was experiencing the beginning of perimenopause. Read on to find out what it is and what you can do to help navigate it well.
What is perimenopause & menopause?
Most women hit perimenopause, the run-up to menopause, sometime between 45 and 55, but it’s not uncommon to start having symptoms in your early 40s. About 1 in 100 start before their 40th birthday, that's called Premature Ovarian Insufficiency, or POI.
Menopause itself is defined as the point 12 months after the final menstrual period, marking the transition to post-menopause. Perimenopause, characterised by fluctuating and declining levels of oestrogen, progesterone, and testosterone, is often associated with a wider range of challenging symptoms. Hormone receptors throughout the body are affected, leading to potential physical, cognitive, and psychological changes. On average, this can last between 4-7 years. This hormonal shift constitutes a significant health event.
Menopause can also be induced surgically, through hysterectomy, or medically, through interventions like radiation therapy or chemotherapy. This is commonly termed ‘crash menopause’ due to the lack of a gradual transition. Those who experience menopause this way often describe it as ‘challenging’ and ‘brutal’.
Menopause can affect trans or non-binary people assigned female at birth if they haven’t undergone any medical interventions, such as masculinising HRT or hysterectomy. Trans men and non-binary people assigned female at birth may experience menopause if they keep their ovaries and don’t alter their hormone doses with time.¹
Why does it happen?
Perimenopause is the years leading up to menopause. Menopause is just one day - the day 12 months after the day of a woman’s last period. Following that day, a woman is considered to be post-menopausal, which doesn’t mean all symptoms disappear! It’s perimenopause that can creep up and cause the trouble.
Perimenopause begins when our ovaries begin to run out of eggs. As the eggs deplete, the levels of associated hormones, oestrogen and progesterone, begin to fluctuate and decline. Women have hormone receptors all over their bodies, which is why we can be affected by physical, cognitive, and psychological symptoms associated with the fluctuations and decline. Effectively, all the systems in our bodies that have relied on these hormones start to feel their absence, which triggers symptoms. It’s a significant health event.
How do you know if you’re perimenopausal?
It can be hard to know if you’re perimenopausal as symptoms creep up, and we all have different experiences. In the UK, the NICE Guidelines state that blood tests may be considered if you’re between 40 and 44 and experiencing symptoms. This is considered ‘early menopause’.
If you’re over 45, blood tests are generally considered to be inconclusive as hormones are fluctuating so much that it doesn’t give an accurate picture. The important thing is to understand the symptoms of perimenopause, which ones you are experiencing, and how they are impacting you. Download my free symptom tracker here to help you.
What are the symptoms?
There are many symptoms associated with perimenopause. Most people are aware of hot flushes and night sweats, but there are many other symptoms such as chills, tinnitus, joint pain, low mood, anxiety, low confidence, concentration issues, brain fog, memory lapses, low libido, headaches, palpitations, genitourinary syndrome of menopause, dry mouth, dry eyes, itchy skin, dry skin, low energy, sleep disturbances, insomnia, irritability, loss of joy and increased emotion. It’s the psychological symptoms that women report having the biggest impact, particularly at work.
I think I’m perimenopausal. What should I do next?
Talk to your GP or healthcare professional. Talk about your symptoms, how they are impacting you. Ask about HRT and lifestyle changes to support your health and wellbeing and help manage symptoms.
Join us in What the Fog? Facebook Community. A community space to ask your questions, find support, and learn from others' experiences.
Do your research. There are some great books out now that will help you understand what is happening, why, and what you can do to help yourself. Some excellent recommendations are “The Definitive Guide to Perimenopause & Menopause” by Dr Louise Newson, “Everything You Want to Know About Menopause (but were afraid to ask)” by Kate Muir, “The New Menopause” by Dr Mary Claire Haver, and “The Menopause Brain” by Dr Lisa Mosconi.
Talk to your partner, explain what’s happening, and help them understand too.
Don’t assume anything! Your experience won’t necessarily be the same as your mum’s or your best friend's. Knowing and noticing your experience is key.
Create space for self-care. This time of life offers us a wonderful opportunity to reflect, reassess, and make changes if needed. Listen to your body and adjust accordingly. Now is the time to invest in your health and wellbeing, not just to help manage symptoms but for future health too.
Perimenopause and work
Tasha’s story highlights the subtle and insidious impact menopause symptoms can have on women’s work and careers. We know that she’s not alone either, 1:10 women leave the workforce due to symptoms, according to research by the Fawcett Society.²
Workplaces are suffering too, as they are losing skilled, talented, experienced women and having to re-recruit and replace, all of which is costly.
Tasha thought it was her, she thought she was becoming less capable of coping with the demands of her job and her confidence was suffering as a result.
When I met Tasha, she said to me that perhaps if there had been an awareness poster on the back of the toilet door at work when she was having her daily meltdowns, explaining the symptoms, she might have realised it was perimenopause and not her, and she might not have left her job.
If the symptoms are impacting you and your work, here are my top tips for dealing with it:
Talk to your GP or healthcare professional about HRT - many women report feeling ‘them’ again once they start taking it and get the right regimen and dose.
Talk to someone you trust at work. Explain what’s happening, the impact it’s having on you psychologically, physically, and practically.
Under UK Health & Safety Law workplaces have a duty of care to ensure symptoms are not exacerbated by the workplace environment. Ask for adjustments such as flexible working, a fan, a more comfortable uniform, and access to toilets that you need.
Check your Employee Assistance Programme if you have one, to see if Menopause Care is offered.
Seek external support, a menopause coach or counsellor. They will help you make sense of what’s going on and how you can move forward well. You can book a 1:1 with me here.
If your workplace refuses to listen or make supportive adjustments, you may have a case under the Equality Act 2010 (UK) for a discrimination claim. ACAS guidelines state:
“Whilst the menopause is not a specific protected characteristic under the Equality Act 2010. If an employee or worker is put at a disadvantage and treated less favourably because of their menopause symptoms, this could be discrimination if related to a protected characteristic, for example:
age
disability
gender reassignment
sex"³
Tasha is doing well now, she has the right support from her GP and an understanding of the things she needs to be doing to keep well in the face of this hormonal decline. She now knows, with hindsight, that it wasn’t her; it was perimenopause.
Knowledge is power
Much of the problem of perimenopause and menopause is that there’s no definitive starting point, symptoms can creep up, and we are not well prepared for it. By the time we’ve noticed it, for some, like Tasha, the impact has had big consequences, whether that be emotionally, financially, or physically.
Getting prepared for perimenopause, increasing your understanding of the impact of hormonal fluctuations and decline, will help you when it does happen.
If you’re in the midst of it, seek the help you need, prioritise yourself, and don’t suffer in silence. There are things you can do that will make the transition more positive and set you up for good future health, too.
Knowledge is power, but only if you do something with it!
Why not book a 1:1 with me today and begin the process of navigating perimenopause and menopause with knowledge and confidence?
Read more from Jo Ibbott
Jo Ibbott, Executive Menopause Coach
Jo Ibbott is a leading expert on perimenopause and menopause, particularly its impact on women and the workplace. Experiencing the often-dismissed symptoms of mid-life hormonal shifts firsthand (low mood, anxiety, irritability, loss of confidence, and sleep disturbances), Jo trained as an Executive Menopause Coach. Her mission is to ensure no woman is undermined by menopause. To that end, she equips organisations with understanding and solutions, and has created a range of coaching and educational resources, alongside the What the Fog? Facebook Community, to empower women with knowledge and confidence.
The Definitive Guide to the Perimenopause & Menopause by Dr Louise Newson, p248
https://www.acas.org.uk/menopause-at-work/menopause-and-the-law
