managing to keep job with high responsibilities during peri /meno

[Marasme]

how do 40+ women in high responsibility jobs do it?

What i used to do "easily", almost as second nature, now i struggle massively with - i need handholding (which i don t get, because noone "knows"), constant reassurance, I doubt everything i ve done previously.

I manage a team of 15 people, and have a fairly public role, with daily speaking engagements. I need to make decisions all day every day, yet i am struggling to decide on whether i ve been mistaking super basic things (e.g. right for left) all week (i have not, but i question everything, my brain is playing tricks on me, i m an anxious mess).

every so often, the anxiety becomes terror. Just pure fear - rarely rational, but that does not matter - my brain will find something debilitatingly scary for me to obsess about.

i eat well, sleep well enough since i quit wine, weight is ok, periods regular yet super heavy. I m 45, and GP was not convinced last time i visited and gave me some sertraline which is still in the box, and told me to go PT because of burnout. I am not denying that work is "hard" - 60hr week, constant travelling - but i used to NOT be scared of misplacing my passport or forgetting to get the right visa (now i am - i obsess about anything and await disaster).

If you have a job like this - how do you resist the urge to quit everyday? it feels like a game of Faking It, and i feel it can only go on for so long until disaster happens, or i quit to avoid it coming down to this.

HRT! Even if you’re still having periods. It was the crippling anxiety about work that gave me the final push to go to the GP. Since I started I’ve not looked back and the warning sign I needed to increase my dose a bit was when the self doubt started creeping in.

I’m the same age and a teacher. I stepped down from my middle management role last year and went from 5 to 4 days for similar reasons. I’ve spent today researching other jobs as the fear of failing the children sitting GCSEs and A levels has been crippling for the last 48 hours (back to school tomorrow). I’ve been teaching for 20 years, middle manager for 7 of those and now I feel I can barely cope with ‘just’ classroom teaching a subject I know inside out. No advice, just sympathy.

I stepped back for a year while trying to get this plus a few other life things sorted. Was in a similar role to the one you describe and was getting fed up of sorting everyone else out and not having enough time for my own challenges. Will see how I feel in 6 months but am hoping I can step back up.

I may be being naive, and you have my every sympathy. It is tough. And the only reason I did what I did was a wake up call with a friend at end of life, which made me reconsider why I was putting myself through it.

thanks both for your replies.

ultimately i can t easily stop working - i m the main earner. But i could "do less" - turn down the promotions, the accolades, the responsibilities. Leave the floor to not only younger women (i m all for this) but also to all my very aggressive, confident, go-getting male colleagues, who are getting from strength to strength.

It just feels like i m only really realising now WHY so many women who were older than me stepped away, gradually, from our line of work - some because of their health, because of caring needs, because of being too enraged with the sexism and the discrimination, and maybe also the anxiety.

I am going to go back to the GP and argue my case again, use the nice guidelines etc - deep down, i m scared that HRT will not solve this new way of being / feeling, and that this is the new me: smaller, scared, joyless, and not very good company.

Or some people just do not have these menopause side effects
I feel like there is so much talk of it that people are starting to assume there is a post menopusal stereotype that every woman fits

quite possibly - noone speaks about it at work so i would not know. It feels like a bit of a taboo topic, i only know of the fee who i am more friendly with, who speak / spoke about their experience.

I've myself never openly discussed how i feel with people i work with.

I don't have menopause side effects particularly, so holding down a job is fine from that perspective.

When I do find my anxiety getting out of control - which hasn't happened in about 8 years - I go to my GP, and take the medications that we between us decide are most likely to help. In my case Prozac helps, but it's Sertraline and HRT for my sister.

I also talk to a counselor once a month, and she really really helps with some of the work-related anxieties I do get. I have seen her more often in the past.

I have hrt, don't have the anxiety, but I do forget words, confuse dates, lose things, have poor sleep. I work part time, but it's a huge struggle.

@Marasme you may not like this but here goes

What do you have described is what I was like in my 20s. I had a lot of medications including tranquilisers.

They saved my career. I initially tried cycling on and off them, but then eventually I stuck to them because I couldn't do any job without them.

I also remember a colleague in her 30s so a bit older than me at the time, giving the most fabulous presentation when she had been on the phone to me crying, all weekend, with her anxiety.

I asked her how she did it and she said "lorazepam".

I also have raging insomnia, but I've had that since I was 13.

From what I can tell, HRT can be abmassive hassle to get right - so why not try the sertraline first? I did get some side-effects but nothing massive. Nothing that stopped me going to work. Didn't take that particular one though.

everything is not peri at this age. It might be, but it might not be.

my brain switched on again within two days of anti-depressants at that age. I was clinically depressed. There was nothing wrong with my life - apart from long hours.

i don't mind at all @EmeraldRoulette

i was quite pleased with myself calling the GP (i ve not managed until now - another thing that worries me) and got given a phone appointment today even when i was happy for non emergency.

GP told me i m too young for any HRT, that my bloods were fine 4 yrs ago and that if i don t want to use the sertraline, i can get online CBT via self referral and more propranolol - she also strongly suggested i should get time off work rather than anything else. I also got told off for getting an emergency app (that i did not ask for).

She sounded so pissed off that i did not try talking about the point(lessness) of bloods for peri, or NICE guidelines or anything else. Who knows... maybe she s having a shit day/week/year too.

i m not sure i ll manage to go back. It took all my energy for today, and i m left feeling absolutely shit and a drain on the system. Conclusion - i m not giving up yet on work, but not getting warm feelings that it s going to work out...

I am your age and HRT has saved me. I am going for a new role and would not have been able to have done it as I was feeling: awake at 4am with my mind pounding with anxiety, crying after my morning shower, on the way to work and before I fell asleep. Still get a bit of brain fog and my 3.30-6 energy dip but miles better.

Frankly, your gp, like mine, needs better education around menopause.
I too have a “big” job, lots of responsibility, lots of staff, lots of decisions are mine. Without sounding like a total twat, I’ve done it successfully for years. Until I didn’t. It was a bit like the boiled frog analogy, because it all crept up quite slowly. Weird anxiety, brain fog, forgetting words, occasional rage (oh, the rage!) obsessional worrying about things that were frankly irrational and almost being “braced for impact” for something I didn’t understand. Went to the the GP twice, was fobbed off once and once given sertraline. That gave me the most horrific paranoia, I binned it after a few weeks. Also had CBT which did nothing.
In the end I saw a private menopause specialist GP. She was brilliant, took an hour to listen to me and prescribed HRT. Game changer. It’s been 3 months and that constant feeling of “fight or flight” has subsided, I can think again, the rage has disappeared, libido reappeared and life feels “normal” and totally manageable again.
No side effects for me either.
Cost £300 I think for the appointment then another £200 ish for the meds. After that, you can move your prescription to your gp and just pay normal prescription charges. If you can afford it op, I highly recommend giving it a go.

I am so sorry you are going through this. I am also in a “big job” and last summer accepted I needed HRT. My GP also fobbed me off so I went privately and the lovely gynae was so helpful. It’s been a game changer and work feels so much more manageable. I saw Dr Alison Wright who was lovely.

Do you have access to private medical? A private GP appointment or specialist menopause appointment might be a good place to go through all your symptoms with the time to do it.

I'm older but have been on HRT for 3 years but the last year the anxiety and insomnia have been awful. I've been offered anti-D's before and declined but my GP took the time to explain that citalopram can reduce night sweats and reduce night anxiety and it's been brilliant. Such a relief!

I saw a BUPA menopause specialist at 43, and it was fab. I feel much better now, am on the right medication and she also got me blood tests that identified I had very low iron (and other things). I had tried my GP and that was a waste of time. This service was actually brilliant. I’m under 45 https://www.bupa.co.uk/health/payg/menopause-plan

I don’t recognise myself. That’s the top and bottom of it OP, like you.

Big job here too, spinning multiple plates, have to be on it, get things right, accurate dates/times/people/places. Travel lots, time bound multiple projects.

Dont sleep, paranoid. But the most debilitating thing is the imposter syndrome which is my constant companion.
It makes me needy, unsure, mistrust my decision and interactions.

This is not me, all new to me and it can quite frankly fuck off.
Heavy gushing painful periods can fuck off too.

HRT did improve things for me. I ran out and am suffering a very very low mood, sweating profusely and feel awful.

HRT is your friend. It works!

Sorry you’re going through this op. I think it’s something very successful women don’t talk about because they see it as a sign of weakness.

I had a terrible time in my 40’s. Very similar, big job and also young children. Put it down to exhaustion. Nearly ended up on antidepressants. Eventually I was prescribed HRT which helped. I also have to be very careful with my diet, no alcohol exercise every day (weights, modest cardio), 8-9h sleep. If any of those things slip I struggle. It’s bloody hard work though, much harder than it used to be.

Ask the receptionist which GP in the practice has an interest in women's health/menopause; go and see them, even if it's a longer wait.

OP, I’m 50 in a similar role. HRT inc testosterone is game changing. I also have coil and no more heavy periods - please go back and see a different GP

Your gp is a dick. You are not too young at all. I felt exactly like you do, struggling in a fast paced job that needs quick decisions. HRT gave me my brain back, only way I can describe it but I’m back to my ‘old self’. Is going private an option for you or changing doctors?

As others posters have said already, you need to try HRT by seeing a private menopause GP/specialist. Or go back to your NHS GP and put your foot down.

Like others on here, I too have a ‘big job’ (stressful, high pressure role in banking) that I’m damn good at. But as I reached my mid-40s, something changed. I hid it but behind my mask I was crumbling. I was suddenly anxious, forgetful, emotional, tearful all the time. I felt like a bumbling idiot. And even more irritable than usual (who knew that was even possible?!). I was also getting constant injuries in the gym (despite being a qualified fitness instructor so I wasn’t doing anything ‘stupid’) and it was actually a female sports specialist doctor who said it sounded like peri. To cut a long story short, I eventually tried HRT (Oestrogel and Utrogestan) and OMG the difference was obvious within a few days! No more anxiety, no more tears and fewer memory issues. If I reduce my Oestrogel, the symptoms are back within days so it is absolutely HRT that is helping.

Most successful women going through peri don’t openly talk about it at work. In a still somewhat sexist world, the last thing we want to do is send up a flare that we’re also getting old as well as being female. Because unfortunately we will be judged. So it isn’t work the risk. Especially when we’re already dealing with so much. I talk to trusted female friends and we support each other. But at work I keep my (usually big) mouth zipped as I don’t want to draw attention to what I’m going through.

Is the 3.30-6 energy dip a peri thing? I get it, but thought it was just me!

I feel the same OP. Unfortunately HRT hasn’t worked for me (dose can’t be adjusted in my case) but I hope you find something that works.

I’m experiencing similar and feel my job is at risk due to some bad luck & decisions to ‘step back’.

Not tried HRT yet as first wanted to try dietary changes (have longstanding bad habits!) but likely to do so soon.

have always exercised, for mental health reasons, tried loads of different things, and until this it helped me loads, now it’s harder.

Agree with other posters that your GP sounds poor.

I seek info & support from outside work: reputable information sources, friends, family, MN! & private healthcare consultations if you can afford it.

Same here: 50, job with lots of responsibilities, self-doubting my decisions… I’ve tried HRT but stopped so need to try again a lower dose… fingers crossed it works this time