The Jigsaw of Perimenopause

One morning, as I was trail running along the edge of Winter Hill, I glanced down and felt an unfamiliar wave of unease. "Hope I don’t fall off," I thought. At the time, it seemed like a passing fear. Looking back, I now see it was the first piece of a much larger puzzle, the jigsaw of perimenopause.

The menopause, well, the perimenopause, has been just that for me: a complex, ever-evolving puzzle. Over time, I’ve started piecing it together. While I now have most of the picture, there are still gaps, pieces I’m slowly fitting into place.

Putting the Pieces Together

At first, I thought my exhaustion was work-related. I was working long hours in community care, juggling endless responsibilities. My GP diagnosed me with an underactive thyroid, and I started medication. Problem solved, right?

Then came a year of devastating loss. I lost my beloved dog, my dear friend, and my distant but still significant mother—all within 365 days. The grief was all-consuming. I coped the only way I knew how: by escaping to the trails and moors. The outdoors became my refuge, a place to process—or at least manage—my pain.

"Sometimes, all you can do is climb a hill and think of nothing."

But the tiredness lingered. The stress wouldn’t let go. I convinced myself it was because of the toxic work environment I was in, compounded by the grief. I eventually left that job, thinking I’d feel better. I didn’t.

The Turning Point

As the pandemic unfolded, life became even harder. The “doorstep rule” stripped me of my freedom to roam the trails and moors that had been my solace. Work in healthcare became relentless, with longer hours and mounting stress.

I started gaining weight—probably from stress, poor diet choices, and exhaustion. Yet the idea of perimenopause didn’t even cross my mind. After all:

a) I was only in my mid-40s, and

b) I attributed my struggles to grief, work stress, and the chaos of the pandemic.

I was forgetting things constantly, so much so that I kept a diary to stay on top of my work. I even worried I had early onset dementia. My running suffered, too. Distances I’d once covered with ease became impossible. Injuries piled up, and recovery took longer. I was too tired, too drained to even try.

My emotions were all over the place. I’d cry over nothing, lose interest in everything, and sleep for hours but still feel exhausted. My periods became unbearably heavy—weeks of bleeding, followed by only a few days' respite. At one point, I genuinely thought I was dying.

The anxiety was perhaps the worst. It was suffocating, spiraling into catastrophic thinking that kept me awake at night. Rain sounds on Spotify became my only escape.

Finally, a Diagnosis

My first conversation with a male GP didn’t go well. He dismissed the idea of perimenopause because I was "too young" and prescribed oral contraception to manage the heavy bleeding.

Months later, when my anxiety became unmanageable, a female GP prescribed me Citalopram. It helped, but it wasn’t the whole solution. By then, I’d watched Davina McCall’s program on menopause, and I started to see the bigger picture. Armed with this new understanding, I made another appointment—this time in person—with a female GP.

In June 2022, I was finally diagnosed with menopause symptoms and started HRT.

Still Piecing It Together

Now, a year later, I’m on HRT and lifting weights. I’m working on my diet and slowly reclaiming my sense of self. The jigsaw isn’t complete yet, but I’m getting there.

Reflecting back, the first piece of the puzzle wasn’t the stress, the anxiety, the weight gain, or the heavy periods. It was something much more subtle: a change in my fears.

That morning on Winter Hill, when I suddenly worried about falling, was the first sign. An irrational, creeping fear, a piece of the jigsaw I only just recognised years later.

Lessons Learned

Perimenopause is a minefield. The symptoms are vast and varied: fatigue, memory lapses, mood swings, anxiety, depression, bloating, insomnia, and more. Yet it’s often misunderstood, dismissed, or overlooked.

Through it all, I’ve been fortunate to have the unwavering support of my husband and a handful of incredible friends. They’ve helped me navigate the darkest moments and keep moving forward, one step at a time.

So, to anyone struggling: know that you’re not alone. The pieces of your puzzle will come together in time. And when they do, you’ll start to see the whole picture—and realize just how strong you are.