It’s Menopause Awareness Month, but how aware are we, really? Despite being a universal experience for half the population, menopause remains one of the least talked about and most misunderstood transitions in a woman’s life. So let’s stop skirting around it. Let’s talk about the worst part. The stage where the symptoms peak, the confusion is high, and support is often missing: perimenopause.
Perimenopause: The Eye of the Storm
Many people assume that menopause is one single moment … your periods stop, and that’s it. But the most intense and challenging phase is actually perimenopause, the years leading up to menopause. This is when your hormones begin to fluctuate wildly, sometimes years before your final period. Estrogen levels can spike and crash unpredictably, causing physical and mental symptoms that can feel completely overwhelming.
And the kicker? Most women don’t even realise what’s happening to them.
A 2022 study found that nearly two-thirds of women didn’t recognise their symptoms as menopause-related. That means millions are suffering without a name for what they’re going through.
What Does the Worst Stage Feel Like?
Perimenopause symptoms can feel like your body is turning against you. Here’s what many women experience during this intense phase:
- Hot flushes and night sweats that interrupt sleep and daily life
- Mood swings and anxiety that appear out of nowhere
- Brain fog so thick it’s hard to focus or remember simple things
- Insomnia, often paired with overwhelming fatigue
- Joint pain, weight gain, hair thinning, and skin changes
- Loss of confidence and a sense of not recognising yourself
Some even experience heart palpitations, dizziness, or changes in libido. And these aren’t just physical inconveniences, they impact careers, relationships, and mental health.
Why It’s So Hard to Get Help
One of the most frustrating parts of this stage is the lack of proper medical support. Most GPs receive little to no training in menopause care. That means symptoms are often misdiagnosed as stress, depression, or simply “getting older.” For those experiencing early menopause (before age 45), the challenge is even greater. Unless you push for hormone testing, many doctors won’t consider menopause as a possibility …especially if you’re still having periods.
Mental Health: The Silent Struggle
The mental health impact of perimenopause is massive — and massively overlooked. Women report feeling:
- Like they’re “going mad”
- Unable to cope at work
- Detached from who they used to be
These feelings are not in your head — they’re rooted in hormonal changes. And yet, many women are offered antidepressants instead of hormone therapy or support.
Why Things Are Finally (Slowly) Changing
Thanks to high-profile voices like Davina McCall and Dr. Naomi Potter, menopause is finally getting some attention. Social media, podcasts, and documentaries have cracked open the conversation. Workplaces are beginning to introduce menopause policies. And more women are demanding answers and care.
But change is slow. And too many women are still suffering in silence.
What You Can Do Right Now
If you’re in the thick of it, here’s how to take back some control:
- Track your symptoms — use a menopause app or symptom diary to spot patterns
- Speak to your GP — request a doctor who specialises in women’s health if possible
- Ask about HRT (Hormone Replacement Therapy) — it’s not for everyone, but it can be life-changing
- Find community — look for Menopause Cafés or online support groups
- Educate yourself — knowledge is power, especially when navigating a system that might not fully support you
The Bottom Line
The worst stage of menopause — perimenopause — can feel like chaos. But you’re not alone, and you’re not imagining it. With the right support, education, and medical care, this transition doesn’t have to be terrifying or isolating.
This increased visibility is leading to changes in the workplace, where employers are offering more support for menopausal women, and in healthcare, where there’s growing pressure for improved training and resources for medical professionals.
