I hit perimenopause at 48 in the middle of a demanding office job, and the hardest part was not the flushes. It was sitting in a meeting with sweat running down my back while someone asked me a question, and trying to look completely normal. Nobody at work was talking about it, and I certainly was not going to be the first.

I am not a doctor, and everything below is general information drawn from my own experience of working through this. What helped me most was understanding that the changes were real and manageable, not a character flaw I had to hide.

What it actually feels like at work

  • Hot flushes that arrive mid-meeting, with a flush spreading up your neck and chest
  • Night sweats that wreck your sleep, so you arrive already tired
  • Concentration that slips in the afternoon in a way it never used to
  • Mood that moves faster than the situation warrants, which is disorienting when you are normally steady
  • Memory lapses — walking into a room and forgetting why, losing a word mid-sentence

The sleep piece affected my work more than the flushes did. A broken night made me short-tempered in the morning meeting and slow on problems I usually solved quickly, and for a while I read that as something going wrong with me rather than a symptom with a cause.

The adjustments I actually made

None of these are dramatic, and together they made the difference. I started with the ones I could control myself, before deciding whether to say anything at work.

Should you tell anyone at work

This is a personal decision and I will not pretend it is easy. What I did was tell one manager I trusted, in plain language, in a short conversation: this is happening, it affects my sleep and sometimes my focus, I am managing it, and here is what helps. That was all. It took the fear out of being caught out, and it meant that when I asked for a small adjustment it was not a surprise. You do not owe your employer a medical history, but you may find, as I did, that one honest sentence removes a great deal of the strain of hiding.

The appointment I finally made

For two years I treated this as something to endure privately. What changed things was a straightforward appointment where I described the sleep and the flushes honestly, and asked what my options were. The conversation was far more useful than I feared — there are treatments and adjustments, and which of them suit you depends on your own health and history, so it is a discussion to have with your doctor rather than a decision to copy from someone else.

What I would say to someone reading this at 46 and putting it off: it is not a private weakness, it is a stage, and it is a lot more manageable once you stop managing it alone and silently.

The flushes were uncomfortable. The hiding was exhausting. Once I stopped hiding it, the job got easier again.

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Questions readers ask

Is it worth seeing a doctor for menopause symptoms?
Yes, particularly if symptoms are affecting your sleep, work or mood. There are options for managing symptoms, and which ones suit you depends on your own health history, so it is a conversation to have with your doctor rather than a decision to make from what worked for someone else.
Do I have to tell my employer?
No. It is your choice. Some people find one short, factual conversation with a trusted manager removes the strain of hiding it, and makes a small adjustment easier to ask for. Others prefer to manage privately. Both are reasonable.

Where to check this yourself