Perimenopause, Work and Wellbeing: Why Women’s Voices Matter

Have you ever felt like your body and brain are working against you at exactly the stage of life when the world expects you to be “at your peak”? You are not imagining it – and you are not alone. Research shows that many women describe perimenopause as a time when heavy, unpredictable periods, mood changes and sleep disruption collide with busy careers, caring responsibilities and the pressure to keep going as normal.

“I really messed up at work recently…”

Not long ago, I really messed up at work. In the moment, it felt awful – my heart raced, my thoughts blurred, and I could almost feel my confidence draining away. Somehow, I pushed through to the end. The people in the room were kind; they said “well done for trying” and genuinely meant it, and their kindness stayed with me long after the meeting was over.

That experience brought something into sharp focus for me – something I know many women in midlife face: the anxiety that comes with hormonal changes and the way our brains start working differently. For me, one of the hardest parts is the uncertainty: will today be a day when I can’t retrieve the words I need? When that happens, I worry people will assume I’m less capable or less intelligent. The truth is, my brain works differently now – but I can still research, think, care deeply and solve complex problems.

Some days I wonder if it’s time to give up. Then I think about how many capable, passionate women have stepped back from work – not because they lost their skill or their drive, but because they didn’t have the support or understanding they needed. Hormone therapy has helped me, especially with memory, but even that journey is tangled in fear and confusion. The conflicting information out there is overwhelming, and insensitive remarks from healthcare professionals don’t help. I once heard a doctor suggest that HRT was only necessary for women in “high‑powered” roles – as if only certain lives were worthy of comfort or cognitive clarity.

I know I still need to show up and deliver. I always have, and I always will. But maybe it doesn’t have to be perfect. Maybe I can do it differently, with more self‑compassion – and maybe you can too.

The workplace: where symptoms are hardest to hide

Stories like this are playing out in workplaces every day. In the UK alone, there are over 4.3 million employed women aged 45–60, and most will spend at least part of their working lives going through perimenopause and menopause. Symptoms vary widely – some women have very few, while up to a third experience severe symptoms that can significantly affect quality of life.

Work is often the place where symptoms feel hardest to manage. Women commonly report poor concentration, tiredness, memory issues, low mood and reduced confidence, on top of hot flushes, sleep disturbance and heavy bleeding. Many feel embarrassed or worry about stigma, especially when their line manager is younger or male, and may be reluctant to disclose what they’re going through.

This isn’t just a “women’s issue”; it’s a workplace and economic issue too. Problematic hot flushes, for example, have been linked with a higher intention to leave the workforce, and national bodies like the British Menopause Society have highlighted that menopause can have a significant impact on women’s work and are calling for better awareness, policies and support in organisations.

What women say they need

Across current research and policy work, several needs come through clearly:

• Better education, earlier and for everyone. Perimenopausal women in one study called for comprehensive education about periods and menopause from school age, involving both girls and boys, so future generations are better prepared and stigma is reduced.

• Trained, informed professionals. Women consistently reported feeling dismissed or not taken seriously when they sought help for menstrual or perimenopausal symptoms and wanted healthcare professionals to receive dedicated training in women’s health and menopause care.

• Supportive workplace cultures and policies. Guidance for employers suggests including clear information about menopause, practical adjustments (like flexible working, access to fans or toilets, and reasonable time for appointments) and named points of contact or “menopause champions”.

At policy level, organisations such as the British Menopause Society are recommending that menopause is treated as a priority area within women’s health strategies, with better access to balanced information, treatment options and lifestyle support for women in midlife.

If you're reading this and recognising yourself, you might like to take one deliberate step this week: write down what you’re experiencing, name what you need, and share it with someone you trust at work or at home. That might mean asking for an adjustment to your working day, requesting clearer information from a healthcare professional, or starting a conversation about menopause guidance in your organisation.

Remember: you are not a problem to be fixed; you are a skilled, experienced woman navigating a major life transition while still showing up, leading, caring and solving complex problems. When women in midlife speak plainly about what is happening in their bodies and brains, and when we ask for the conditions we need to thrive, we don’t just make work more sustainable for ourselves – we quietly rewrite the script for the women who will come after us. Every story told, policy questioned, meeting request made and boundary set is a form of leadership.

So if you've ever stepped away from work, changed direction or felt your confidence slip during perimenopause, know this: your insight, your questions and your courage to name what you need are exactly what will help shape workplaces where the next generation of girls can grow into women who are believed, supported and able to stay. Your voice is part of that change, and it is needed now.

My eBook, Perimenopause and Longevity is a practical, compassionate guide for women in their 40s and 50s who want to feel better now while protecting their future healthspan. Rather than promising quick fixes, it explores how small, realistic changes in nutrition, movement, sleep, stress and connection can support your body through hormonal shifts and beyond. You’ll learn what longevity really means in midlife, why perimenopause is such a pivotal window for long-term health, and how to experiment with simple habits that fit your real life, not an idealised version of it.

Start now with Perimenopause and Longevity: Steps to Help You Live Longer and Feel Stronger, and stop waiting for things to get worse before you support your hormones, energy and long-term healthspan.