• A recent survey of more than 700 Australian women found that almost half had considered retiring or taking a break from work when their menopause symptoms were severe.
  • Research shows that mindfulness can reduce the severity of hot flushes.
  • Overcome brain fog by taking notes, which has the bonus of making you look super professional. 
  • If you're having a hot flush in the office, calm your breathing and recognise many women have been through this before.

As a real estate agent running her own business, Janice Maple was unfailingly organised, sharp and driven. So, when, at 47, her attention span started perimenopause could be to slip and disorganisation took hold, she was understandably rattled. Her concerns only increased as her interest in work plummeted. “I thought I was having a midlife crisis and I was showing early signs of dementia,” she recalls. “Where I used to be very steady and predictable, I became erratic and disorganised. I was stressed about it as I wasn’t really sure what was going on.”

Janice eventually decided her lack of focus and disinterest in work must be a sign she needed to find a deeper purpose, so she sold her business and began searching for more meaning. “I don’t think I was coping with the changes, the feeling of being disorganised and erratic, which made me question what I was doing,” she explains. “Did I really need this stress in my life? Was this really what I wanted to do? Why was I doing it in the first place? What was I trying to prove and to whom?.”

It wasn’t until a couple of years down the track that the penny dropped for Janice, now 50, when she was talking with friends about menopause. “I realised that I was probably experiencing perimenopause, but I had no idea,” she says. “There’s no education about it. I thought menopause was just when you stop menstruating – I didn’t realise there were all these other hormonal imbalance symptoms.”

Caught in the fog

Issues like poor concentration and forgetfulness aren’t the first symptoms that spring to mind when you think of menopause, which may be why this life transition tends to trip up women just as they’re hitting their career stride.

“Many women don’t even realise [brain fog] can be a sign of perimenopause – they think, ‘Oh, I’m getting dementia and need a brain scan,’” says Thea O’Connor, a workplace wellbeing consultant who runs an online program, The Change, for professional women going through menopause. It’s a really common concern, she says, and can be especially worrying for women who don’t know that brain fog is a temporary symptom.

One reason for the brain drain? Blame those fluctuating hormones, says GP Dr Ginni Mansberg, a member of the Australasian Menopause Society and author of The M Word: How to Thrive in Menopause. “We’re pretty sure that oestrogen is a brain enhancer,” she explains. “Oestrogen is up and down like a yo-yo during perimenopause and really low after menopause.” The effects of this hormone roller-coaster can vary. So while some women may only notice a small dip in concentration, others will really struggle cognitively.

Poor sleep, linked to low levels of progesterone, could also be what’s affecting your mental performance. “When you ask working women, of all the symptoms, which one has the biggest negative impact on work, fatigue is number one,” says O’Connor. “That can be a knock-on effect of things such as night sweats, insomnia or anxiety.” Two years into her menopause journey, events manager Taline Haroyan, 53, says she can deal with the night sweats and hot flushes – it’s the mental fog that bothers her the most. “I feel stupid and that I can’t catch up on my thoughts,” she says. “I’m forgetting a lot – I have to think twice. I hate it. I’ve stepped back a little and I’m trying not to take too much on because I don’t trust myself. I felt like I was missing deadlines, and recalling important information was an effort.”

Going from feeling sharp and in control to forgetful and foggy can really erode a woman’s confidence, says O’Connor. “You start to doubt yourself, and the problem with that is it becomes a vicious loop, because anxiety impairs cognition even further. So you’re worried about having brain fog and that just makes things worse,” she says. “You have to be really alert to your self-talk during this life stage and remember you’re more than your symptoms and that your skills are still there.”

Time out

Beyond the brain fog and fatigue, perimenopause’s mood swings and intense hot flushes can really dial up the pressure – the last thing you need for a calm and productive day at work.“We know from studies that if you have stresses in your life anyway, this period will exacerbate it,” says Dr Mansberg. Psychologist Jacqui Manning agrees.“It’s frequently raised as a contributor to feelings of anxiety and/or depression [in my practice] and the effects can be misunderstood,” she says.

No wonder, then, that some women are choosing to step back or opt out of the workplace altogether. This year, a survey of more than 700 Australian women by employee benefits platform Circle In and the Victorian Women’s Trust found that almost half had considered retiring or taking a break from work when their menopause symptoms were severe – of those, 28 per cent went through with it.

When Janice decided to sell her business, she aimed to keep working, but on her own terms. “I desired more freedom and flexibility to do the things I wanted to do,” she explains. “I also wanted to give more to my community. I started working independently as a real estate agent, which allowed me to work when I was motivated and focused, at a more relaxed pace. I also set up a community for women called Kindred Women Together.”

After speaking with friends who had similar experiences, Janice now believes that questioning the meaning of life is a psychological symptom of perimenopause. The transition certainly has a tendency to prompt women to reassess their purpose and direction, notes O’Connor. “It’s not called ‘the change’ for nothing!” she says. “The healthy side of that is it really does force you to stop and take stock and ask yourself,‘What needs to change? Am I on track? Does this still feel purposeful? And what have I been putting up with that I no longer need to?’”

On the flip side, she adds, not recognising that perimenopause is at play can lead to knee-jerk reactions. “I’ve heard stories of women who gave up their job because the symptoms became too much, didn’t realise it was perimenopause, went off and got treatment... and now they’re feeling really good and want to get back in, but they’re worried what their CV is looking like having left under those circumstances,” says O’Connor.

Janice doesn’t regret her decision to sell up, but says loosening up her schedule didn’t resolve her scatterbrain issues the way she’d expected.“My symptoms got worse,” she admits. “After leaving the full-on, results-driven workplace, I realised I still needed routine in my life. Three years later, I find that I achieve more when I have a plan of what I want to get done in that day or week.”

Moving forward

If menopause symptoms are negatively affecting you at work – and, according to Circle In, 83 per cent of women say that’s the case – it’s important to know there are solutions. “The first thing is to stop putting up with it and go to a health practitioner,” says O’Connor. “Women often suffer for too long in silence.”

There are really good treatments available, says Dr Mansberg, including hormone replacement therapy (HRT), which, she says, is 98 per cent effective for hot flushes and may improve other symptoms such as anxiety, insomnia, brain fog and body aches. But if that’s not for you, there are plenty of other options, she adds. If you’re struggling with mood, “We’d suggest you do all the things we would [recommend] normally, such as getting enough sleep, having a healthy diet, doing exercise and seeing a psychologist,” Dr Mansberg points out. Some natural supplements, such as ginkgo biloba or St John’s wort, may improve anxiety and sharpen cognition, but it’s important to check with your GP before taking them, especially if you’re on other medication.

One of the most helpful tools to have in your perimenopause kit is mindfulness. “Research shows it can reduce the severity of hot flushes,” O’Connor explains. “Normally, you might be saying, ‘This is so embarrassing, everyone’s looking at me,’ but if you learn to breathe and say, ‘Just one hot flush at a time, many women have been through this before,’ it can help.” Meanwhile, Dr Mansberg suggests physiotherapy to combat muscle aches and pains, which research suggests are even more common than hot flushes.

After trying a natural menopause supplement with little success, Taline has decided to just go with her body’s flow. She’s installed a mini fan on her desk to counter hot flushes and has developed some tricks to work around the mental fog. “I’m more accepting of it now,” she says. “If I need to write things down or put sticky notes everywhere, I will! I’ve been conscious to be more careful, make lists and put things in my calendar so I don’t forget.” 

Arming yourself with practical strategies such as these can help you feel more in control, says O’Connor. “Rather than live in dread of that moment you forget something or have a hot flush, it’s about planning. With just a bit of preparation beforehand, you can go, ‘Okay, I’m equipped now, I know what I’m going to do.’”

A smart workaround for brain fog is to employ tactics that serve you while making you look extra dedicated to the job. “Let’s say you’re having a conversation with someone,” explains O’Connor. “You can say something like, ‘I’m just going to jot down the key points here because this is a really important conversation,’ and then at the end you feed back and say, ‘Have I got the main points here?’ It looks like you’re being a super- professional communicator, but you’re also taking your time to write things down.”

Take time to remind yourself of your unique skills and attributes to counter any confidence wobbles, adds O’Connor. “One of the questions I ask women is, ‘What’s something you’ve done recently you feel proud of ? And what qualities did you bring?’ You might’ve brought a sense of care or humour or new insight. It’s so important to notice it, connect with it and value it in yourself.”

If you feel ready to throw it all in, press pause before making the decision, urges Manning, who suggests talking with your manager about flexible working arrangements you can try first. “They might include working from home more or taking some time out – you won’t know if you don’t ask,” she says. Reaching out to a friend who’s ahead of you in their menopause journey to get some perspective, or making small changes to your day, such as taking lunch away from your desk and getting outside regularly, may be enough to reduce your stress and anxiety, she adds.

Ultimately, awareness and acceptance of this life transition may be key to getting back to your happy place at work. For both Taline and Janice, understanding that hormones are contributing to their mental fog issues – and that other women are on the same journey – has been a huge relief. “The fact that I’m not alone, [discovering] that it’s a thing that happens to everyone – that, in itself, has saved me,” says Taline.

“I’m still going through it, but I’m not scared to talk about it with my friends and look at ways to improve my situation,” adds Janice. “We discuss the pros and cons and what menopause gives us: a chance to reset and learn more about ourselves.”

© Prevention Australia
Tags:  menopause