Let’s get one thing straight from the get-go: perimenopause is not a gentle glide into menopause for everyone. For me, it was more like a hormonal car crash I didn’t see coming – complete with severe depression, mystery heart palpitations, feeling five degrees hotter all the time and a period that lasted so long it should’ve paid rent. So, in the spirit of sisterhood and saving other women from the horror movie that was my experience, here’s what I wish I’d known before perimenopause knocked me sideways.

1. Perimenopause can start way earlier than you think

I was 45, feeling fabulous and running my own media company, ShellShocked Media. Life was humming along... until it wasn’t. Hot flushes crept in. Anxiety tightened my chest like a corset. Then came the heavy bleeding – and I mean CSI crime scene amounts of blood in the bed sheets. I had no idea what was going on.  You see, I’d never even heard the word perimenopause. I thought menopause was something that happened to grey-haired ladies in their sixties. No one had mentioned that peri sneaks in during your forties, or even earlier, and can hang around like an unwanted guest for up to a decade. Yes, ten years!

2. Your mental health might take a nosedive – and it’s not your fault

I expected hot flushes eventually. What I didn’t expect was crying in my car feeling like a failure after doing a perfectly good segment on Today Extra. My confidence was shot, and my negative self-talk was at banshee level. Unfortunately, it’s hard to see how hard you are being on yourself when it’s all in your own head. It’s isolating and scary. The soul-crushing depression made me think I should quit the journalism career I’d spent decades building. The shame I felt meant I didn’t even tell my closest friends. I was known for being bubbly and confident, so I felt like a fraud in my own skin. I also didn’t have the tools to cope because I’m one of the lucky people who’s had excellent mental health my whole life. But peri depression nearly broke me. Please take peri mental health very seriously.

3. Doctors can be bloody useless if they’re not menopause-savvy

The first doctor I saw told me my hormone levels were “normal” and maybe I should try some relaxation exercises or take up a new hobby. A hobby. I needed a lifeline, not knitting needles. Too many GPs have had next to no formal training in menopause. I learned that the hard way. Eventually, I found a menopause doctor who looked at me crying in her office and said, “This is perimenopause. And I can help you.” That one sentence gave me hope. I’ve since campaigned in Parliament to get compulsory education for GPs.

4. HRT/MHT is not the devil – it can be a damn miracle

Thanks to a couple of scientists, who grossly misinterpreted the data in an American study back in 2002 (the Women’s Health Initiative), Hormone Replacement Therapy now also known as MHT got a bad rap for supposedly causing breast cancer. The average age of women in that study was 63 and they used a synthetic HRT/MHT that’s not used anymore. So many red flags. But modern, body-identical HRT/MHT has been a game changer for me. Now it’s not a silver bullet and you still have to use it as a tool to improve your health. I had to try four different types until I found my Prince HRT, and I’m never letting it go. It helps me sleep, stopped my heart palpitations, protects my bones, helps my brain and stops me from crying daily! Basically, it gave me my life back. If I could shout this from the rooftops I would. But I also understand not everyone can or wants to take HRT. I’m all for choice. Just make sure you make a choice that is evidence based not fear based.

5. Lifestyle changes are non-negotiable

Lifestyle changes are non-negotiable in perimenopause because your body is no longer running on the same hormonal autopilot it once did. You can’t out-yoga a hormone crash or out-caffeinate a sleepless night forever. What you eat, how you move, how you manage stress and how much sleep you get all directly impact how brutal or bearable your symptoms will be. It’s not about perfection – it’s about making consistent choices that support your shifting body. Think of it as upgrading your operating system. You wouldn’t ignore warning signs on your car dashboard, so why ignore the ones your body’s flashing at you? 

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