I’ve had anxiety on and off for years and was already taking medication to manage it. But about six years ago, something changed. My anxiety became much worse and more unpredictable. I constantly felt on edge—heart racing, and an almost constant nervousness, even around friends.
I blamed my stressful job. What else could it be? I had no particular worries. I tried everything to manage it - exercise, therapy, adjusting my medication - but nothing helped. This went on for another two or three years, and I was miserable and exhausted.
Eventually, I saw a different doctor who told me I was in perimenopause. Peri-what?! I had never even heard of it, never mind realised it could cause things like anxiety. I thought menopause happened much later (I was 46) and was just hot flushes and periods stopping - not this.
So many of us go through this - blaming ourselves, feeling lost - without realising our hormones could be the cause. And because we don’t talk about it enough, we’re left to figure it out alone.
The hidden mental toll of menopause
Looking back, I now realise my anxiety wasn’t the only thing changing. But at the time, I just assumed everything was due to stress.
Sleep problems. I’d be exhausted by 8pm but then wide awake at 2am for absolutely no reason.
Zero motivation. I lost interest in everything and didn’t even want to see friends.
Confidence crisis. I was second-guessing myself at work, overthinking emails, and wondering if I could keep doing my job.
At the time I didn’t see the pattern. But now? Classic perimenopause.
Why is this happening?
Here’s what I wish I had known sooner: hormones don’t just regulate periods - they affect mood, memory, and mental health. So when they start fluctuating, it can feel like we’re going crazy.
Oestrogen supports brain function, memory, and mood. As it drops, we might experience brain fog, forgetfulness, and mood swings.
Progesterone is a calming hormone that balances stress. When levels decrease, anxiety and irritability can creep in.
Testosterone affects confidence and motivation. As it declines, so does our drive and self-assurance.
It’s a bit like someone rewiring your brain without bothering to tell you!
How it affects our lives
For many of us, this side of menopause is the hardest. But because we don’t associate menopause with mental health, these struggles are often not spoken about.
We can go from feeling confident and in control to feeling completely overwhelmed.
At Work – Struggling to focus, forgetting things easily, or doubting our abilities. Brain fog can make it feel like our mind suddenly freezes mid-sentence.
In Relationships – Becoming more irritable, reacting emotionally to things that wouldn’t normally bother us, or withdrawing from loved ones.
In Daily Life – Finding even small decisions overwhelming, feeling emotionally drained, or losing joy in things we used to love.
Because menopause is still so misunderstood, many of us don’t realise what’s happening. Instead of recognising it as hormonal changes, we blame stress, ageing, or just 'not being ourselves lately.' But these struggles aren’t just in our heads - there’s a real biological reason behind them.
What can help?
The good news? We don’t have to just “put up with it” like our grandmothers and mothers most likely did. There are ways to manage the mental and emotional symptoms - and small changes can make a big difference.
Lifestyle Tweaks – What we eat, how we move, and how we rest all impact hormones. Reducing caffeine and alcohol, adding protein and healthy fats, and prioritising movement support brain health and mood.
Managing Stress Differently – Perimenopause makes us more sensitive to stress. Techniques like breathwork, meditation, yoga, or simply taking short breaks can help regulate the nervous system.
Prioritising Sleep – Sleep disruptions are common, but small changes - like reducing screens before bed and creating a consistent wind-down routine - can improve rest and reduce brain fog.
Talking About It – Whether with friends, a menopause coach, or a doctor, opening up can be a huge relief. So many of us go through this, yet we often feel like we’re struggling alone.
Exploring Medical Support – If symptoms are significantly affecting daily life, options like HRT, supplements, or cognitive behavioural therapy (CBT) can be life-changing. There’s no one-size-fits-all approach, but support is out there.
Understanding what’s happening and knowing there are solutions can help us take back control.
Final Thoughts: We Are Not Alone
Menopause can feel like it’s taking pieces of us away - our confidence, our clarity, our sense of self. But this isn’t the end of who we are. It’s a transition, not a decline.
If you’ve been struggling with anxiety, brain fog, or feeling like you don’t recognise yourself, please know this: you’re not imagining it, you’re not alone, and you don’t have to suffer in silence. There is support, there are solutions, and most importantly, there is a way forward.
The more we talk about this, the easier it becomes for all women to get the help we deserve.
// Helen Wales, Menopause Coach
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