I work with a lot of women in their 40s and 50s. You might think that age is irrelevant, and in some ways it is, but after my own experience with the perimenopause, I’m always alert to it as part of the life experience of my clients. When a woman says to me they don’t seem to have the same energy as they used to, or their mood is low, or their sleep is poor, or their memory seems faulty, or their joints ache, I ask about the menopause.

I gave precisely zero thought to the menopause until I started having hot flushes. I can’t remember why now but I made a conscious decision to be open about it, rather than trying to pretend it wasn’t happening. Someone recommended a holistic therapist, and a bucket load of very expensive homeopathic remedies saw off the flushes for a while. But then they came back. I’m of the age where I remember news stories about the dangers of HRT, so I did a lot of research before deciding to talk to my doctor. It turns out that most of the research that led to the scare stories was done on a very particular demographic, and did not represent either the risks or the benefits to someone like me, in my mid-40s, in reasonably good health, with no other hormone-related issues such as breast or ovarian cancer.

For a good two or three years, HRT did me proud. And then my energy and drive fell off a cliff. I was tired - bone tired - all the time, had absolutely no enthusiasm for my business, found it a real struggle to deliver coaching while also working on business development to ensure a flow of future clients. My memory got so bad I began to think I might have young onset dementia. Several times a day, I would ask myself if life was really worth it. Women aged 45 to 55 have the highest female suicide rate and I’ve heard some terrible stories about how close some people have come to taking their own lives. I completely get it.

My GP, unfortunately, did not respond well to this situation. I was told she could only prescribe HRT to alleviate hot flushes, not any of the 40+ other symptoms of the perimenopause. I have no idea whether this is actually what the NICE guidelines say, I didn’t have the energy to check. I also had to fend off suggestions that I needed anti-depressants. If you read enough about the menopause, you know this is a common suggestion, even though there is plenty of evidence they are unnecessary if you can sort out the hormones.

It turns out oestrogen, in particular, is an absolutely vital part of the way our whole body functions. There is hardly a physiological process that doesn’t depend on oestrogen. Hence the number and range of perimenopausal symptoms. Looking back, I realise I had been experiencing many of the symptoms associated with perimenopause for some years - but I had absolutely no idea. No one had ever talked to me about it, not even older women at work who must have been going through it right in front of my eyes. How did they do it?

Finally, I decided my quality of life, and that of my long-suffering partner, was worth more to me than a few quid in the bank, so I went private. I cried every time I thought about going to a specialist who might take me seriously and might even be able to help. In the event, the person I chose was not a cosy counselling sort, so I didn’t get to cry in her office. She’s a no-nonsense, straight-talking, entrepreneurial woman who asked a load of questions, then switched my HRT to a different brand and prescribed testosterone cream. My GP had never even mentioned testosterone cream.

There is only one testosterone cream IN THE WHOLE WORLD that is designed, tested, and licensed for women. Testosterone is seen as a male hormone, so it’s designed and built for men, not women. The cream I use has to be imported from Australia and is only available in a small number of clinics in the UK under a special MHRA (Medicines & Healthcare products Regulatory Agency) licence. Luckily, my chosen specialist is one of them. Other specialists use male-licensed testosterone and carefully monitor the effects in order to get the dose right. Not ideal, but better than nothing.

I can’t tell you how life-changing HRT, including testosterone, has been for me. It’s not perfect, I still don’t always sleep well, my skin is dry, my joints creak a bit and I have definitely lost muscle strength (although if I got my act together and did some decent strength-building exercise I could probably alleviate that). But I have recovered the energy, drive and enthusiasm for life that I thought had gone forever.

HRT is not for everyone. Some people don’t get on with it, and some medical conditions preclude its use. If so, there are other options. If you have a clued-up GP, count yourself lucky. If not, get yourself a private specialist. It’s not a luxury, it’s a literal life-saver.

My clients often think that their perimenopause (and sometimes their health in general) is not a topic for coaching, especially if their company is paying. My view is that your hormonal and general health is an absolutely critical part of your ability to do your job. And there is still a shocking level of ignorance about the perimenopause, which is why I feel it’s an obligation, almost a mission, to bring up the topic with my women clients of a certain age.

There are many people out there now campaigning to raise menopause awareness, among them Davina McCall, Penny Lancaster, and the incomparable Diane Danzebrink who had a conference-room of people in tears when she described her own menopause experience.

I should say that I think there are some upsides to the menopause. No periods, for one. And I find I give much less of a sh*t now about minding my opinions in public or embracing my more militant self and I am much less of a people pleaser than I used to be - I’m sure this is linked to reduced oxytocin levels in the body post-menopause. Quite possibly that means a lot of people are not pleased with me - and that’s not my problem any more.

I’m not an expert, I’m writing this article based on my own experiences and research, but if you’d like to talk about your perimenopause symptoms, or your confidence, authority and impact at work, do please get in touch.

Places to go for more information and support:

British Menopause Society has vast reservoirs of research and information, and you can search for specialists (private and NHS) near you: https://thebms.org.uk/

Menopause Support (Diane Danzebrink): https://menopausesupport.co.uk/

Davina McCall’s Channel 4 documentary: https://www.channel4.com/programmes/davina-mccall-sex-mind-and-the-menopause

Louise Newson the menopause doctor: https://www.drlouisenewson.co.uk/

Anne Henderson (my hero!): https://gynae-expert.co.uk/

Menopause Cafe: https://www.menopausecafe.net/

The Menopause Charity: https://www.themenopausecharity.org/

Menopause and Me: https://www.menopauseandme.co.uk/