By Dr. Nirusha Kumaran – GP, Functional & Longevity Medicine Specialist
Perimenopause is one of the most profound biological transitions in a woman’s life, yet for many professional women, especially those in high-pressure corporate or city environments, it remains hidden in plain sight.
Whilst there have been significant strides in workplace wellbeing, the conversation around women’s hormonal health, particularly perimenopause, is still underdeveloped. This silence is having a significant impact as research shows that 1 in 10 women in the UK leave their jobs due to unmanaged menopause-related symptoms. That figure doesn’t account for the countless others who suffer quietly, pushing through brain fog, anxiety, disrupted sleep, and declining energy, while still trying to lead teams, meet targets, and juggle responsibilities at home.
As a GP and Functional and Longevity Medicine Specialist, I’ve worked with countless women in this exact position – high-achievers who don’t realise that the physical and emotional symptoms they’re experiencing are rooted in hormonal change, and compounded by burnout or poor stress management.
What Is Perimenopause?
Perimenopause is the transition phase before menopause, typically beginning in a woman’s 40s (though it can start earlier). It can last anywhere from 4 to 10 years. It’s characterised by fluctuating oestrogen and declining progesterone levels, which can affect everything from mood and memory to metabolism, immunity, sleep, and skin health.
Many women are surprised to learn that symptoms such as:
- Anxiety or panic attacks
- Brain fog and forgetfulness
- Joint and muscle pain
- Digestive issues such bloating
- Sudden weight gain around the abdomen
- Low mood or motivation
…can all be driven by hormonal shifts during perimenopause. These symptoms are often dismissed as “just stress” or “getting older”, but they are often the first biological signals that your hormonal balance is changing.
Why This Can Impact Working Women Harder
The perimenopausal age bracket (typically 40-54) is usually a time of peak responsibility for many women. One may be managing a leadership role, raising children, caring for aging parents, navigating financial pressures, and more.
Unfortunately, the traditional healthcare system isn’t always equipped to identify or support this transition properly. Blood tests are often not routinely done after the age of 45. Many women are prescribed antidepressants or told to ‘wait it out’.
In the workplace, symptoms such as brain fog or emotional changes can be misinterpreted as underperformance or a lack of motivation, when in reality, they may be rooted in a very real physiological transition.
What Can Women Do?
From lifestyle changes, to supplements and even Hormone Replacement Therapy (HRT), there are many options that can help improve symptoms and hormonal balance in this key transitional phase. Here are some practical, evidence-based strategies that I recommend to my patients, especially those in high-stress professions:
- Get diagnosed
If you suspect you’re in perimenopause, seek specialist advice to clarify your symptoms and diagnosis. Functional hormone testing (such as urinary hormone metabolites or comprehensive blood panels) can provide insights that go beyond what the conventional clinicians may typically offer.
- Personalised Nutrition
Focus on an anti-inflammatory diet that stabilises blood sugar and supports hormone metabolism. Prioritise colourful vegetables, omega-3-rich foods (like oily fish and flaxseed), high-fibre meals, and reducing ultra-processed snacks that trigger mood dips or fatigue.
- Support Your Stress Response
Perimenopause is as much about adrenal health as it is about sex hormones. Incorporate daily stress-reducing practices, whether it’s a 10-minute walk outdoors, breathwork, or a 5-minute medication practice – this can have a profound impact on reducing stress.
- Smart Supplementation
Magnesium (for sleep and nervous system support), B vitamins (for mood and energy), omega-3 fatty acids (hormonal balance and inflammation reduction), vitamin D3 with K2 (bone and immune support), and adaptogens e.g. ashwagandha or rhodiola (stress support) can all be helpful to support symptom management under specialist guidance.
- Sleep Is a Superpower
Poor sleep is one of the most common symptoms I see, but in fact it can exacerbate everything else. Avoiding screens before bed, using blue light blocking glasses, keeping the room cool, and sticking to a regular sleep/wake time can all be helpful to improve sleep. If needed, there are also natural support supplements or HRT that can be utilised.
Hormone Replacement Therapy
Hormone Replacement Therapy (HRT), which can include regulated ‘Body Identical’ or custom-compounded ‘Bioidentical’ HRT, can offer significant symptom relief but also longevity benefits, from improving sleep and mood to protecting bone, cardiovascular and brain health.
There is not a one-size-fits-all solution and dosing should always be tailored to the individual. It is also important to consider the balance of all the sex hormones, including Oestrogen, Progesterone, Testosterone and DHEA for optimal support. For many women, starting HRT is transformative, allowing them to feel “like themselves again” and stay engaged in their careers and relationships.
What Can Employers Do
Creating menopause-aware workplaces doesn’t require huge investments, but it does require intention and action.
Some recommended strategies:
- Awareness training for managers to recognise symptoms and offer flexible responses
- Menopause-inclusive policies outlining support options such as flexible hours or work from home options
- Access to expert health guidance via wellbeing programmes or private healthcare
- A supportive culture where women feel safe speaking up about their needs
Santander UK is one example of a company that saw dramatic improvements in staff wellbeing after launching a menopause support strategy in 2019, which includes flexible working, manager training, and access to expert advice. Within a year, 75% of staff reported improved menopausal symptoms.
Final Thoughts
Perimenopause isn’t the end of one’s productivity or potential. It’s a natural transition that, when recognised and supported, can become a catalyst for renewal, clarity, and strength. It also presents a vital window to invest in one’s long-term health, supporting both healthspan and lifespan.
Whether you’re leading a team, managing a portfolio, or growing a business, you deserve personalised care and understanding that meets you where you are. By breaking the silence, embracing support, and creating menopause-inclusive workplaces, we can shift the narrative, not just for ourselves, but for the generations of women who follow.
Let’s not allow this phase of life to silence brilliance. Let’s create space for women to rise, thrive, and lead with vitality.
About the author
Dr Nirusha Kumaran is one of the UK’s leading medical experts specialising in women’s longevity and hormonal vitality. For more information, please visit: www.drkumaran.com or follow @dr_nirusha.kumaran
