I was 46 when I noticed something was… off. It wasn’t the classic hot flush. It was brain fog. The kind where I’d walk into a room and forget why. Or lose my train of thought mid-sentence.
I blamed stress, long days, parenting. Menopause wasn’t on my radar, I still had regular periods. But as I learned from my conversation with Dr Annie Middleton, a GP and menopause expert, I was already deep in perimenopause, and I didn’t even know it.
What Is Perimenopause?
“Perimenopause is the hormonal storm that can last up to 10 years before your period stops,” Dr Middleton explained on our podcast.
That’s right. The “menopause” we often talk about is actually just one day, 12 months after your last period. Everything before that? That’s the part no one talks about and it’s where most of the real symptoms show up.
Symptoms No One Warned Me About
Perimenopause is caused by fluctuating estrogen, and estrogen receptors are everywhere brain, skin, bones, even your bladder. “That’s why the symptoms are so widespread,” Dr Middleton said. “Mood changes, brain fog, anxiety, sleep disruption, they all stem from hormonal changes.”
For me, it was brain fog and sleep. For others, it’s irritability, vaginal dryness, or memory lapses. Everyone’s experience is different, and that’s part of why it’s often missed or misdiagnosed.
“But I Still Get My Period…”
Exactly. That’s what I thought too. Dr Annie debunked that myth quickly:
“You can absolutely still be having your periods and be perimenopausal. In fact, for some women, the bleeding gets heavier before it stops.”
So if you’re 40+ and feeling “not quite right,” don’t wait for your period to disappear before seeking help. That’s like waiting for a storm to end before grabbing an umbrella.
You’re Not Alone (Even If It Feels That Way)
One of the most powerful things Dr Annie said was this:
“Women shouldn’t suffer in silence. If symptoms are affecting your life, even mildly, that’s enough reason to talk to your GP.”
And it’s true. The shame and silence around menopause are relics of past generations. We’re allowed to ask questions. We’re allowed to advocate for our health.
My Advice? Get Curious
If you’re reading this and nodding along, start tracking your symptoms. Write them down. Talk to someone. And most importantly, don’t brush it off as “just stress.”
This podcast conversation changed the way I think about my body, my hormones, and my future. I hope it does the same for you.
Listen Now
This episode with Dr Annie Middleton is a must-hear for every woman over 35 and the people who love them.
– Written by Hala Ali
The Visionary with Hala Ali Podcast 