As a hormone therapist, Suzanne speaks daily with women who have noticed that menopause is increasingly impacting their sleep, mood, energy levels, and overall daily functioning. In this section, she shares anonymised stories from her practice to offer recognition and to shed light on the factors that may contribute.
I distinctly remember when Sara reached out to me for an initial consultation. She explained that she had been feeling adrift for quite some time and was struggling with hot flushes and night sweats. Her mood was under strain, and it was starting to affect those around her. She made it clear that she couldn’t continue like this any longer.
At our first appointment, she arrived in a rush. She had been caught in traffic after leaving a meeting early to ensure she was on time. I could instantly sense how tense she was. She was still visibly on edge. It wasn’t until she had removed her coat, silenced her phone, and settled down with a warm cup of tea that her story began to unfold.
For about three years, she had noticed changes taking place. The hot flushes were becoming more severe, her nights increasingly restless, and during the day, she felt less sharp. This was far from ideal, particularly as, in her role as an estate agent, she needed to stay on top of her game and maintain a clear perspective. She confided that she was making more and more mistakes, which was uncharacteristic for someone who was used to having everything under control. In the past, she seemed to thrive under pressure. She carried significant responsibility and was the person others depended on. Now, however, she sometimes found herself longing to retreat under her duvet and avoid everything altogether. This left her feeling insecure and anxious. She no longer recognised herself.
At one point, with tears in her eyes, she expressed that she felt as though those wretched hormones were ruining her life.
What often strikes me about women like Sara is that they persevere for an incredibly long time. Only when it becomes genuinely impossible do they allow themselves the space to reflect on what their body has been trying to convey all along.
During the conversation, it became increasingly evident that Sara's symptoms were not isolated. Menopause can impact various aspects of life, including temperature regulation, sleep, mood, and concentration. At the same time, I noticed something else about her: for years, she had lived at a relentless pace, under significant pressure, with little time for recovery, and a tendency to keep pushing forward. In such circumstances, menopausal symptoms can become more pronounced. The different layers of her situation were clearly interconnected.
Her medical history might also have played a role. She shared that she had endured a difficult childhood and an intense relationship in the past. Such experiences do not always fade into the background. In some women, we observe that old tensions or survival patterns become more apparent during menopause, particularly when the body has less capacity to cope with everything.
It also became clear how challenging she found it to be kind to herself. Taking rest quickly felt like failure to her. Setting boundaries felt like selfishness. While her body seemed to be calling for a slowdown, her mind kept urging her to press on. It was only when she gradually began to understand that her symptoms were not merely a sign of weakness but perhaps also a signal of overexertion that she started to find some space to view her situation differently.
In daily life, several factors appeared to impede her recovery. She led a hectic lifestyle, had few opportunities for rest, and often neglected her eating habits. She mentioned that she frequently arrived home late and resorted to eating something quick and convenient because she simply lacked the energy to prepare a proper meal. Quick meals were often more practical than cooking fresh food. While this is understandable in a busy life, it can contribute to feeling physically less stable. Disturbed nights caused by night sweats could also impact her energy levels, mood, and ability to concentrate during the day.
In Sara’s case, I also observed that her high expectations of herself played a significant role. She was accustomed to taking on a lot and had long felt the need to remain strong above all else. Consequently, she managed to maintain appearances for a time, even though her symptoms were already having a considerable internal impact. It is often the case that women minimise or rationalise their symptoms for an extended period, particularly if they are used to coping with a heavy load. This can result in them seeking help only at a more advanced stage.
Menopausal symptoms often have multiple dimensions. It is not solely about hormones, but also about how an individual lives, recovers, manages stress, and navigates boundaries.
Sara's guidance did not involve a single solution but rather a series of steps tailored to her symptoms and lifestyle. Initially, the emphasis was placed on attention and awareness. We took the time to reflect on what occurs in the body during menopause and which factors could worsen the symptoms. Simply gaining this understanding provided her with greater clarity and a sense of control.
Additionally, we reviewed her foundation together. Gradually, she began to adjust her eating habits, focusing more on regularity and incorporating foods that were easier to sustain in her daily routine. This approach was not based on the idea that everything needed to change all at once but rather on identifying what could support her body at that particular moment. With practical adjustments, she found this more manageable than she had initially anticipated. There was also an emphasis on integrating more rest and recovery into her life. We explored how she could learn to recognise early signs of overexertion and discussed small, feasible adjustments she could make.
We also considered ways to support her nervous system and selected herbs that were appropriate for her situation.
The change did not occur in a straightforward manner. That is rarely realistic. However, Sara gradually observed that she was gaining greater control over her symptoms and her daily life. Her nights became more peaceful, she felt less hurried, and she was quicker to recognise when she was once again placing excessive demands on herself. Occasionally, she still reverted to old habits, but the difference was that she noticed them sooner and had a clearer idea of what could help her to make adjustments.
Perhaps even more significantly, her perspective on herself shifted. She no longer felt the need to fight as much against what she was feeling. This brought her a greater sense of calm. Not because everything was suddenly resolved, but because she had developed a better understanding of what was happening and could respond to it in a different way. At a subsequent appointment, she shared that she was feeling more at ease with herself again and was grateful for having taken this step.
What I consistently gather from stories like these is that menopausal symptoms are rarely experienced in isolation from the rest of life. Hot flushes, poor sleep, irritability, or mental unrest may be linked to hormonal changes, but they can also be associated with prolonged stress, insufficient recovery, and patterns where someone continually pushes themselves too hard. This doesn’t imply that everything is within our control. However, it can be beneficial to take symptoms seriously and consider more broadly what might be influencing them.
Many women are accustomed to simply carrying on. Because of this, it can sometimes take a considerable amount of time before there’s an opportunity to truly listen to what their body is trying to communicate. In such instances, it can be useful to initially focus on factors you can influence yourself, such as nutrition and lifestyle, sleep, and recovery. If symptoms persist or you’re unable to address them on your own, consulting a specialist can help to explore what’s happening and identify the kind of support that might be appropriate.
The type of support that is helpful varies from woman to woman. This is precisely why it’s important not to focus solely on individual symptoms but also to take into account someone’s context, stress levels, and what is practical within their daily life.
Every transition is unique. That is why I believe it is important not to focus solely on the symptom, but to consider the woman as a whole and what she requires during this phase.
This case study demonstrates how menopausal symptoms can differ significantly depending on an individual’s lifestyle, stress levels, and recovery. The approach is always tailored, as not every woman requires the same type of support. If you would like someone to evaluate your situation, an initial consultation can help determine what is suitable.
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This article is based on the practical experiences of a specialist. To protect the patient’s privacy, the name and identifiable details have been altered. The information in this article is intended for educational purposes and does not substitute personalised medical advice.
