Suzanne’s perimenopause symptoms were debilitating from the start, having affected her life, family and career drastically. But as she would soon find out, the roadblocks to treatment and support were built up high, leaving herself and countless other women to advocate for themselves to health professionals. Here’s how she did it.

The Aussie mum experienced a host of symptoms at the onset of perimenopause, at the time unaware of the cause. 8 years on, she says she’s still navigating the ins-and-outs of this stage and has had to manage discomfort and pain along the way. Let's take a look at some of the most common signs and symptoms of perimenopause across the board:

Evidently, we see a whopping 75% of women deal with joint pain; a debilitating symptom which Suzanne knows all too well.

“Body aches and joint pain kicking off with a frozen shoulder for many months despite leading a physically active lifestyle, severe itching on arms like ants crawling always at night resulting in bruising and scratch marks,” she says of the symptoms she’s experienced.

“Years of insomnia resulting in feelings of being hung over each day, hot flushes rivalling any 50-degree day in the middle of winter – soaked sheets/bedding, and honestly the most debilitating brain fog – this one was the killer and remains so. Unable to string a sentence together, significant memory issues – names, numbers, and the ability to recall what I had completed 5 mins ago let alone a week, a month, or a year ago. I would be presenting or leading a discussion at work and forget mid-sentence a word or what I was even talking about.”

Suzanne’s definitely not alone here; brain fog is one of the less represented symptoms of menopause and perimenopause, but it’s certainly not uncommon – on the contrary. Researchers have found that during menopause, memory function changes, and brain fog is a common result of this. The signs of this confusing and distressing symptom include:

• Difficulty concentrating
• Difficulty multitasking or switching activities
• Difficulty remembering things like words or numbers
• More frequently losing or misplacing things
• Forgetting intentions
• Forgetting commitments
• Easily distracted

Research shows that a range of cognitive issues arise during menopause and perimenopause – and they’re far more common that what we’re led to believe. From issues with working memory and processing speed to things like verbal memory, many women are suffering with little support or awareness of these signs. Suzanne says it was the brain fog and issues with mental and cognitive clarity that resulted in a devastating career loss and distressing concerns for her health.

“My commercial skills had left the building and this was a key part of my role,” she says. “This one alone, in conjunction with lack of sleep was the final nail in my career where I held a senior role and was unable to complete the most basic tasks or function as a human – so bad, and continues to be an issue, I thought I had a brain tumour or the start of dementia.”

Like many women, Suzanne wasn’t just dealing with physical symptoms, she also came up against some challenging emotional and mental health changes too. She says her anxiety in particular took a major blow.

“I have always had a baseline depression and anxiety yet peri and fluctuating hormones introduces a whole new complex dynamic – the escalation in both experiences has been next level and felt like an out of body experience for the most part,” she says.

“Anxiety which truly debilitates and significantly impacts all those around you – you know this is not normal, you know this isn’t who you are, but cannot explain it, cannot do anything about it, you cannot breathe. Overlay this with bouts of intense rage which you cannot explain, they come on suddenly and are so overwhelming your mind starts to go to places it shouldn’t – at times, the situation feels dire.”

And she’s not alone. While anxiety tends to take less of the focus when it comes to education and media representation of menopause and perimenopause, it affects masses of women. A 2020 study found that 58% of perimenopausal women struggled with anxiety. One of the major contributors to anxiety includes the consequences of other menopausal symptoms like sleep disturbances or disorders, which are believed to affect a whopping 50% of menopausal people. It's been found that these sleep issues can cause anxiety, along with anxiety in turn leading to sleep issues. The fluctuating hormones during menopause are to blame for these distressing changes, in particular it’s believed that the estrogen and progesterone imbalances hold much of the blame, with research finding that these changes to estrogen levels could be to blame for a host of mental health symptoms. Signs that you’re dealing with anxiety include:

• Feelings of restlessness or edginess
• Feeling tired or fatigued
• Having a hard time concentrating
• Unexplained pains like headaches or stomach aches
• Excessive worry
• Difficulty getting to sleep
• An increased heart rate
• Excess sweating

She says while dietary and exercise changes helped, it’s the lack of education around treatments that meant she was still dealing with worsening perimenopause symptoms.

“My anxiety I also felt could be addressed and improved through diet and exercise,” she says. “This is when I took some extended time off work and engaged a PT to get me started. In parallel, I jumped onto the IQS site, downloaded the cookbooks, and began excluding processed and packaged foods, and quitting sugar.

“I lost 25kgs and felt an enormous improvement – I also took turmeric, magnesium and B6 + hormonal supplements to help aid physical and mental symptoms.”

When her symptoms started to intensify, Suzanne decided it was time to start investigating – but it was not her doctor who got her on the right track, it was an online forum.

“I jumped onto a facebook group and asked some questions where I was then led to Menopause and Peri Menopause Support Group Australia,” she said. “This group was lifechanging.”

It was this support group that led the Aussie mother to finally getting the help she needed.

“The scientific and clinical evidence-based discussions led by admins (importantly acknowledging they’re not HCP’s) together with hundreds of individual shared experiences normalised my own. I then had the confidence to speak to my GP about it, who initially preferred I experience it naturally, yet I presented with an informed request for MHT (Menopause Hormone Therapy) which I was provided a script for.

“And so, my clinical therapeutic journey began… and it was life changing to say the least.”

Suzanne’s not the only one who has had to take this path – she’s one of many women forced to build their own case and advocate for their health in absence of support from the medical industry. The 53-year-old says she struggled with the expectation for women to simply grin and bear their health issues – in fact, a whole host of conditions affecting women are seen as taboo, from menstruation to menopause. One study found that the feelings of shame stemming from the taboo nature of menopause resulted in 29% of women having lost self-confidence. The study also found that 63% of women had negative work experiences due to their symptoms.

Suzanne shares her experience with the expectations of women and taboos centred around menopause.

“As this life stage has become deprioritised and an expectation of just ‘sucking it up’ has gained momentum, there has been little need to talk about it… and women have suffered in silence and/or gone underground with their treatments, she says. “Views are polarising, and continue to be and given this, it’s all too hard. Taboo conversations are fuelled by many different barriers; personal and professional conflicting views, health trends, and a serious and incomplete view of the all-encompassing and complex symptoms and age groups.

“The taboo nature of menopause and peri generated a feeling of isolation, and created an enduring negative perception of ongoing care, support and acceptance.”

After finally being heard by health professionals, Suzanne underwent a number of treatments for her symptoms.

“I started on bio identical estrogen patches low dose + progesterone, and once established, felt the overriding anxiety start to dissipate. Breakthrough symptoms occurred and I upped my estrogen to a higher dose which again worked wonders – all while continuing to maintain a healthy diet and exercise,” she says.

After experiencing some adverse reactions to the patches, Suzanne tried out gels along with the progesterone, only to come up against an allergy that left her, yet again, struggling with escalating perimenopause symptoms.

“I was then referred to a specialist gynae/endocrinologist who has acknowledged and understood my severe symptoms and has since put me on chemical menopause via a nasal spray with add back hormones – both estrogen and progesterone. While I’m still working through this treatment regime, managing peri and all of its aspects remains a work in progress as for me, there has been no perfect solve albeit, I have experienced significant life improvements on MHT

“Additionally, MHT provides ongoing life protection against brain, heart, and bone health – integral to aging well.”

Suzanne says much needs to change in our society – from the medical to educational spheres, we’re worlds behind where we should be, with many women left to suffer in silence.

“Education is critical – we have been mis informed for many years by healthcare professionals based on dated and incorrect clinical studies regarding the use of Menopause Hormone Therapy,” she says. “This I believe, and unsubstantiated, has led to a deprioritisation of perimenopause and menopause at large. The sheer lack of understanding around symptoms, the complexity of individual experiences ranging from non-existent to mild, to severe and debilitating (sadly I’m in this category) has led to significant and unnecessary distress to many generations of women… who would have previously been carted off to the farm and dismissed.

“So much emphasis and learning, and rightly so, is placed on our teenagers having a solid understanding of their bodies, why does this stop for perimenopause and menopause?”

It’s because of this lack of education and support that Suzanne is driven to make a change in society, from the school room to the medical spheres. This is her message to fellow women everywhere – and for people everywhere who need to hear it.

“I Unknowingly lost many years of my life and my career, and many women find themselves in this situation retrospectively this being largely fuels by a lack of basic personal awareness, lack of community and workplace understanding, and very limited medical and professional acknowledgment, clinical therapeutic accessibility and understanding,” she says. “Women find themselves in situations of prejudice, ignorance, and to some degree being gaslit by those who should be most supportive. It’s for these reasons I am passionate about driving awareness for all.”

“The conversation needs to be normalised, medical acknowledgement and infrastructure together with care plans need to be informed and formed, and most importantly women need to feel heard without fear of being dismissed ‘oh she’s hormonal’, ‘she’s having a flush’, ‘she’s lost the plot’, while puberty is well understood, perimenopause and menopause have a long way to go in this space.”