My Silent Struggle: An Untold Story of Menopause

For as long as I can remember, I have been on a journey to discover my authentic self and purposely align my actions with it. My desire to live and lead with grace, gratitude, and joy is deeply embedded in this journey. Long before this phrase became my Instagram handle, it was the mantra that helped me navigate a precipice that nearly ended my career, destroyed my marriage, and left me questioning my sanity.

At 42, I was a highly accomplished C-level executive with a great husband, an amazing 5-year-old daughter, many friends, and a beautiful home. I had worked hard for this success and assumed that, with sustained effort, it would continue. Little did I know that a precipice was near, and I would soon plummet. In the coming months, I would tumble into a cohort of women who experience early menopause, commonly defined as reaching menopause before age 45.  

The definition of menopause is as simple as the term itself ~ a pause in a woman’s menstrual cycle ~ albeit actual menopause is a permanent pause. Menopause marks the date of a woman’s last period and the end of her fertility. Menopause, while often perceived as ominous, was not my precipice. My precipice was perimenopause, the phase of a woman’s hormonal journey that precedes menopause.

For some, perimenopause symptoms are sneaky, creeping up over several years, unpleasant in most cases, but with plenty of warning. For me, these symptoms were anything but sneaky. They were a dizzying, systemic collection of intrusive psychological and somatic symptoms. Symptoms including irrational behavior, anxiety, depression, hot flashes, brain fog, and sleep issues. Not only was I rapidly stumbling toward early menopause, but the presentation of my symptoms was severe.

I could no longer manage my demanding schedule, and my performance at work suffered, as did life at home. It was unbearably lonely and frustrating, with an added number of indignities ranging from sweating profusely to tearful outbursts and embarrassing flights to the bathroom. I quickly became a medical detective searching for answers to what was happening to me. Repeatedly, I heard from the doctors I sought help from that it must be the stress of my demanding lifestyle or the onset of depression.

After leaving one appointment with a prescription for anti-depressives, I instinctively felt depression was not the correct diagnosis. Tossing the prescription, I instead self-medicated with alcohol, exacerbating my already deteriorating physical and mental health and further fueling my poor judgment. I was, according to all the experts I met, simply too young to be in perimenopause. A conclusion reinforced by the unreliable blood tests often used to diagnose this hellish hormonal nightmare I was living.

After months of suffering in silence, hoping no one would notice, the concern and exasperation of my colleagues, team, friends, and husband were visible. With no answers forthcoming, I lost confidence in my capabilities and watched my agency diminish. I surrendered to the consensus opinion that my symptoms were stress-related and resigned from my position. A desperate decision to salvage my sanity, professional reputation, and marriage. A potentially career-ending decision.

Today, nearly two decades later, perimenopause and menopause symptoms impact nearly one billion women worldwide (Hickey et al., 2024). It is a biological inevitability for almost 100% of women, often coinciding with the height of a woman's career, given that the average age of perimenopause and menopause is 47 and 51, respectively (Brown et al., 2024). A pervasive misunderstanding that menopause is a “transition” also lingers, suggesting one will pass through this “phase." In actuality, menopause is permanent, marked by the perpetual decline of estrogen. When untreated, as it often is, estrogen insufficiency contributes to a multitude of long-term hormonal deficiencies and a resulting spectrum of psychological, somatic, and urogenital symptoms, including altering the way a female brain functions (Verdonk et al., 2022).

Many months after my resignation and dozens of doctors’ visits later, it was confirmed that I had experienced early menopause and that my debilitating ailments were a result of the rapid onset of severe perimenopausal symptoms. Symptoms that don’t simply stop when your period stops. Recent research indicates that early menopause happens in approximately 12% of women globally between the ages of 40 to 45. This data also illustrates that early menopause is not a straightforward diagnosis and often takes up to five years to diagnose due to scarce data and an even scarcer understanding among the medical community (Mishra et al., 2024).

The clarity of my eventual diagnosis did not lead to immediate treatment nor a straightforward way back to the career I loved and left. It took several years to finally find what I needed to mitigate my severe symptoms in the form of hormone replacement therapy (HRT); luckily, I began HRT before suffering the onset of long-term health issues attributed to menopause like osteoporosis or cardiovascular disease. My return to the C-suite was more circuitous, though unsurprisingly, it coincided with restoring my agency and confidence once I regained my health.

Finally, in 2024, a better understanding of menopause is at the tipping point, and HRT is no longer the boogeyman it once was (Muir, 2024). However, the story of menopause at work remains largely an untold story, as mine was for nearly 20 years. Recent studies (Brewis et al., 2017; Menopause Impact on Woman at Work-2024-03-22, n.d.; Sauer et al., 2023) underscore that menopause plays a role in diminished work ability, decreased productivity, and weaker performance; absenteeism increases in perimenopause and menopause; and women in perimenopause and menopause downshift to less demanding roles, move to part-time or leave the workforce entirely. Menopause remains an individual issue today, not an organizational one or a societal one.

Isn't it all of these? Women spend one-third to one-half of their lives post-menopausal, and many are without the treatment needed to thrive (Barratt, 2019). This exacerbates the leap in societal understanding from menopause as the problem to women themselves as the problem (Verdonk et al., 2022). For organizations, it is a medical issue, sitting firmly in the domain of employee health and wellness. It is also a diversity issue for organizations; its impact on women’s ability to perform at work further limits the pool of qualified female candidates advancing to the most senior levels.

Consider this a call to action: Start talking and normalizing the menopause conversation. Include menopause training with other inclusion training programs. Provide accommodations, develop policies, and provide resource guides. Let’s stop struggling in silence. Menopause is not just a middle-aged women’s issue; it is everyone’s issue.

Bibliography

Barratt, B. (2019, October 18). She’s not “Losing her Touch”: Employers must do more to recognize the symptoms of menopause. Forbes.

Brewis, J., Beck, V., Davies, A., & Matheson, J. (2017). The effects of menopause transition on women’s economic participation in the UK.

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Brown, L., Hunter, M. S., Chen, R., Crandall, C. J., Gordon, J. L., Mishra, G. D., Rother, V., Joffe, H., & Hickey, M. (2024). Promoting good mental health over the menopause transition. In The Lancet (Vol. 403, Issue 10430, pp. 969–983). Elsevier B.V. https://doi.org/10.1016/S0140-6736(23)02801-5

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Menopause impact on woman at work-2024-03-22. (n.d.).

Mishra, G. D., Davies, M. C., Hillman, S., Chung, H.-F., Roy, S., Maclaran, K., & Hickey, M. (2024). Optimizing health after early menopause. Lancet (London, England), 403(10430), 958–968. https://doi.org/10.1016/S0140-6736(23)02800-3

Muir, K. (2024). The Financial Times Limited Trade Journal PDF GENERATED BY PROQUEST.COM. https://www.proquest.com/trade-journals/employers-must-do-more-keep-menopausal-

Sauer, J., Mehegan, L., Williams, A., Bonner-Cozad, A., Lampkin, C., & Ekman, M. (2023). THE ECONOMIC IMPACT OF MENOPAUSE: A MULTIMODE RESEARCH PROJECT. In Innovation in Aging (Vol. 7, Issue S1).

Verdonk, P., Bendien, E., & Appelman, Y. (2022). Menopause and work: A narrative literature review about menopause, work, and health. In Work (Vol. 72, Issue 2, pp. 483–496). IOS Press BV. https://doi.org/10.3233/WOR-205214

Ahmed, S. B., & Hardcastle, L. (2023). Menopause: Time for a Paradigm Shift. Mayo Clinic Proceedings. https://doi.org/10.1016/j.mayocp.2023.04.014

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