Finding myself in perimenopause

I thought perimenopause would announce itself with a hot flush and perhaps a slightly dramatic fan.

Mine was less considerate. It arrived as anxiety, emotions that seemed to have acquired their own loudspeaker, a changing body and the unsettling feeling that I did not quite know who I was anymore.

On paper, I was still me. I was running an award-winning marketing agency, managing a blended family of seven – eight if we include the rescue dog, which we absolutely should – answering messages, organising life and generally appearing functional. Inside, something felt off.

That is one of the strangest things about early perimenopause. You can look entirely like yourself while feeling as though somebody has quietly moved all the furniture in your brain.

The symptoms nobody had properly explained to me

Perimenopause is the time leading up to menopause, when hormone levels fluctuate and periods may start to change. The NHS lists symptoms including anxiety, low mood, mood swings, memory problems, poor concentration, sleep issues, joint pain, headaches, heart palpitations, itchy skin, hair thinning and changes in sex drive.

It can affect work, relationships, confidence and family life. It can also look very different from one woman to the next. Some women breeze through it. Some feel flattened by it. Plenty sit somewhere between the two and become exceptionally good at pretending they are fine.

For me, the emotional change was enormous. I felt more anxious and less certain of myself. Things I might once have brushed off could sit heavily. I sometimes felt lonely even when surrounded by people, because it is difficult to explain that you have lost your sense of self when you cannot identify the exact moment it went missing.

Start by believing yourself

If you feel different, do not dismiss it because you are busy, because other people have bigger problems or because a well-meaning person tells you that everybody gets tired.

Keep a simple record of what is happening. Note changes in your cycle, sleep, mood, anxiety, headaches, skin, hair and anything else that feels relevant. You do not need a colour-coded spreadsheet unless that brings you joy. A note on your phone is enough.

That record can help you spot patterns and gives you something concrete to take to a GP appointment. It also reassures you that you are not inventing a new symptom every week.

What helped me

There was not one answer. Annoying, I know. I would have preferred a single button marked “feel normal again”. Instead, I had to understand my body and rebuild parts of my life around what actually supported me.

I asked for medical help

I went onto HRT a few years ago because I needed help getting over the major bump. Before then, I had absorbed the idea that HRT was somehow a bad thing – something to avoid unless it was absolutely necessary. The more I researched it, the more I realised that much of that fear came from outdated information.

HRT does not only deal with hot flushes. It can help with sleep problems, anxiety and low mood caused by menopause and many other symptoms. Beyond symptom relief, NHS guidance says it can help protect against osteoporosis and maintain muscle strength. There is no fixed time limit either – it can be continued for as long as the benefits outweigh the individual risks, with treatment reviewed over time.

I am perfectly happy with my decision. If I knew then what I know now, I sometimes wonder whether I could have supported myself naturally through more of the early stages, but that is hindsight. For me, it has never had to be HRT or natural support. I use HRT alongside movement, food, supplements and the more woo-woo things that help keep my head in the right place. They can all sit at the same table without having an argument.

I stopped abandoning myself to keep other people comfortable

Perimenopause made certain friendships and relationships impossible to ignore. I became more aware of where I was over-giving, swallowing my feelings or keeping the peace at my own expense.

I have let go of relationships that no longer served me. That sounds beautifully serene written down. In real life it involved sadness, doubt, repeated conversations in my head and eventually the realisation that history is not the same thing as health.

Not every difficult relationship needs to be dramatically removed. Some need a boundary. Some need honesty. Some need less access to you. A few need an exit. The point is not to become ruthless; it is to stop treating your own wellbeing as the least important item in everybody else’s diary.

I leaned into my woo-woo side

I like a bit of woo woo. It helps me focus, reset and notice what is going on beneath the noise. That might mean journalling, meditation, setting intentions, pulling a tarot card or simply creating enough quiet to hear my own thoughts.

You do not need to buy crystals or start thanking the moon if that is not remotely you. The practical value is creating a pause between feeling and reacting. Mindfulness, breathing, walking, therapy or ten minutes alone with a cup of tea can serve the same purpose.

My version gives my busy brain somewhere to put itself. It has helped me keep a steadier mindset while I have worked out what I want the next part of my life to look like.

I moved without turning it into punishment

Walking and yoga have both helped me. Movement supports sleep, mood, strength and long-term health, but I also value the immediate effect of changing the scenery.

A walk will not solve every problem. It will, however, get you away from the laundry pile, loosen a tense body and occasionally stop you sending a message that would have required its own crisis-management plan.

Start where you are. Ten minutes counts. Gentle yoga counts. Strength work counts. Dancing in the kitchen while waiting for the air fryer counts more than the fitness industry would like to admit.

I paid attention to the basics

I try to eat in a way that gives me steady energy, include protein in my meals, drink enough water and protect my sleep. None of that is exciting, but neither is trying to conduct a client meeting after four hours of broken sleep and half a coffee.

I also review supplements and skincare rather than assuming every symptom is something I must simply endure. I take Arella Collagen and Pause as part of my wider routine, alongside HRT. I believe in natural products and in paying attention to what genuinely helps my body – it does not have to be one route or the other.

I stopped expecting my body to behave exactly as it used to

The weight gain has been one of the most frustrating parts for me, especially how stubbornly it hangs around. I can walk for miles, eat well, cut out sugar and alcohol, and the scales can still behave as though none of it happened.

Menopause can change where the body stores fat, while sleep, stress, ageing and changes in muscle mass can all add to the picture. Knowing that has not magically made my jeans looser, but it has helped me stop treating every change in my body as a personal failure.

I also found that foods I had eaten for years no longer seemed to agree with me. My intolerances changed, and the bloating and digestive discomfort made me feel even less at home in a body I was already trying to understand.

If your digestion, bloating or reactions to food have changed too, it may be worth talking to somebody who can help you look at the whole picture. I had food intolerance testing to help me identify patterns and give me a more structured starting point, rather than removing foods at random and hoping for the best.

Once I stopped eating the foods that no longer agreed with me, I began to lose weight gradually. I am not going to pretend I did not wish it would happen a little faster, but this was the only change that seemed to shift it for me. Over time, avoiding my quite extensive list of no-nos has become much easier – although I cannot say I was thrilled when I first saw how long it was!

Finding the right help

I knew I needed help, but at first I did not feel as though I was getting the answers or support I needed from the doctors I saw. I did not want prescription medication for anxiety or low mood because, for me at that point, it felt like putting a sticky plaster over something I believed was being driven by hormonal change.

That was a decision about my own body, not a judgement on anybody who takes medication – for somebody else it may be exactly the support they need. On my darkest days, I questioned whether I belonged here at all. That is difficult to write, but it is true, and it shows how far away from myself I had become.

A quick but important note: if that feeling is familiar to you right now, please talk to somebody today. You can call Samaritans free on 116 123. If you think you may act on those thoughts, call 999 or go to A&E.

The NHS wait for specialist menopause support was around 18 months at the time, so I went to a fabulous private consultant locally who had been recommended to me. It was the best £200 I spent. I finally felt listened to, understood and able to make a decision based on what was actually happening to me.

Menopause is talked about far more openly now, and I have noticed much more support becoming available through GP practices. I recently saw a fantastic nurse for my HRT health check. She was incredibly knowledgeable, had been through a difficult menopause herself and understood the difference between reading a symptom list and living it.

Private care is not within everybody’s budget, and it should not have to be the only way to feel heard. Whatever route you choose and can afford, help is out there – you may just need to dig a little deeper to find the person who listens properly and helps you explore the options that feel right for you.

You have not disappeared

If you are in the early stages and feel unlike yourself, I want you to know this: you have not disappeared. You may be changing, and some of that change may eventually be useful.

I have worked on myself a lot. I understand my body better, I am clearer about my boundaries, and I care far less about performing a version of myself that keeps everybody else happy. Life is too short to give quite so much of a stuff about what people think.

I still have busy days, anxious moments and times when the house, work and my hormones appear to have formed a small committee against me. The difference is that I recognise myself now. I know what helps, I ask for support sooner and I no longer assume I must navigate everything quietly.

Perimenopause can shake your identity. It can also be the point at which you stop living entirely by other people’s expectations and begin choosing what actually fits.

Useful sources: NHS menopause and perimenopause symptoms · NHS HRT benefits and risks · NHS guidance on how long to take HRT