If you remember the smell of a Cabbage Patch Doll’s head… chances are you are not in your twenties anymore.
That is not a crisis. It is a transition.
Perimenopause often sneaks up quietly. It starts with subtle shifts. Sleep changes, mood fluctuations, brain fog, irregular cycles, long before the word “menopause” even feels relevant.
There is a woman in a boardroom who suddenly cannot retrieve a word she has used for twenty years.
She pauses. The silence stretches half a second longer than she would like.
No one else notices. She does.
Later that evening, she lies awake at 3:17 a.m., replaying the moment. She thinks it is stress. She thinks it is ageing. She wonders if she is losing her edge.What she does not yet know is that her brain is recalibrating.
Menopause is often spoken about as if it arrives at the same time, in the same way, for every woman.
For many Black women and women of colour, that assumption does real harm. Early and surgical menopause are not rare outliers, they are lived realities shaped by stress, health inequalities and systems that were never designed with our bodies in mind.
Many women carry symptoms they have learned to minimise. Brain fog. Exhaustion. Anxiety. Sleep disruption. Emotional flatness. Health research is clear. Prolonged exposure to stress hormones like cortisol affects memory, immunity, cardiovascular health and emotional regulation. These are not imagined experiences, they are biological responses.
During transitions such as perimenopause and menopause, this impact intensifies. When stress has been normalised for years, symptoms are often misattributed to ageing, weakness or lack of resilience.
The truth is simpler and harder. The body is signalling that survival mode has gone on too long.
If menopause has made you question your confidence, your clarity or your place in the room, pause for a moment. Nothing is “wrong” with you.
By 2030, over 1.2 billion women worldwide will be in menopause or post-menopause. Yet many of us are still navigating this transition in silence, apologising for symptoms, pushing through exhaustion and quietly adjusting our lives to cope.
One in ten women will leave their job because of menopause. Not because they lack ambition. Not because they are disengaged. But because the workplace was never designed to hold them at this stage of life.
That single statistic should stop every employer, leader and policymaker in their tracks. Menopause is not a niche wellbeing issue. It is a workforce stability issue, a leadership pipeline issue and increasingly, an equity issue.
Menopause is often discussed as a universal biological transition. In practice, it is anything but universal. Who is believed, who is treated early and who gains access to specialist care is shaped as much by systems, culture and confidence as it is by hormones.
Across health systems, menopause inequity does not show up loudly. It appears quietly, in delayed diagnoses, inconsistent prescribing, postcode lotteries and women being told to “wait it out” when evidence says otherwise. These gaps matter most for women whose voices have historically been marginalised.
Recent policy and clinical developments have brought these inequities into sharper focus.
In England, menopause has now been confirmed as a priority condition within the forthcoming NHS Online Hospital, enabling women to be referred digitally for specialist menopause care via the NHS App. This shift has the potential to reduce regional disparities, long waiting times and barriers faced by…
If menopause has made you question your memory, your mood or your confidence, the problem is not you, it is that no one explained what was happening inside your brain.
For many women, perimenopause does not arrive quietly. It announces itself through forgotten words, emotional surges, disrupted sleep and a creeping fear “Why does my brain not feel like mine anymore?”
In most workplaces, changes in confidence or performance are attributed to shifting roles, organisational pressure or workload. We are reminded that the most significant disruptors are usually the ones no one is examining.
Menopause is not a personal weakness. It is a biological transition with workplace consequences. The problem is not the symptoms. It is the silence around them.
Before women begin questioning their capability, one essential reflection is missing “Is my confidence changing because of competence or because of chemistry?”
Did you know that millions of women are living with perimenopause without realising it?
Research shows that more than half of women cannot identify the early signs of hormonal transition and this lack of awareness has far-reaching effects, from workplace performance to relationships and mental health.
In professional settings, symptoms such as insomnia, brain fog and mood swings can quietly erode confidence and focus, often mistaken for burnout or stress.
At home, fatigue and hormonal shifts can strain emotional connection and intimacy, while the mental health impact, including anxiety, depression and low motivation, often goes unseen or dismissed.
Black feminist scholar Bell Hooks reminds us, “Honesty and openness is always the foundation of insightful dialogue.” Menopause policy must embody that truth.
Policymakers can no longer rely on one-size-fits-all workplace protections. Psychological research on stereotype threat, pioneered by Dr. Claude Steele, shows that when women of colour sense bias or dismissal, stress hormones rise and cognitive performance drops.
Add the midlife surge of hormonal fluctuation and the effect is compounded. Higher anxiety, disrupted sleep and impaired decision-making.
A truly responsive legislative agenda would integrate this science into practice. That means funding intersectional mental-health programs, requiring culturally competent clinical training and creating corporate guidelines that address the psychological as well as physical demands of menopause.
Proud Sista!
Proud Sista!
Proud Sista!
Proud Sista!
Proud Sista!
