HRT, Menopause Advice, Post Menopause
13 Mar 2025
The Silent Struggle of Women in Midlife. For many women, their 40s and 50s come with a cascade of mysterious health symptoms fatigue, anxiety, joint pain, brain fog, weight gain, and irregular periods. Yet, when they seek medical help, they’re often told:
"It’s just stress."
"You’re depressed, here’s an antidepressant."
"It’s normal aging—nothing to worry about."
But what if these symptoms are actually hormonal shifts linked to perimenopause and menopause?
The truth is, many women in midlife are misdiagnosed or dismissed, leading to years of unnecessary suffering. This blog explores:
Commonly overlooked conditions during perimenopause Why women’s symptoms are often misunderstood How to advocate for better healthcare.
If you’ve felt unheard or misdiagnosed, you’re not alone—but with the right knowledge, you can take control of your health and life.
Why Women in Midlife Are Often Misdiagnosed
The Medical System Wasn’t Designed for Perimenopause
Historically, women’s health research has been underfunded, and medical training often lacks education on perimenopause and menopause.
Many doctors are trained to recognise menopause only when periods stop completely, but perimenopause can last 5-10 years before that. Symptoms of hormonal changes mimic other conditions (like depression, thyroid disease, or autoimmune disorders), leading to misdiagnosis.
The Fix: Find a menopause specialist or doctor trained in hormonal health.
Women’s Symptoms Are Often Dismissed as “Psychological”
Did you know? Women are more likely than men to be prescribed antidepressants for unexplained symptoms—when the root cause is actually hormonal.
Mood swings, anxiety, and brain fog are common symptoms of perimenopause due to fluctuating oestrogen and progesterone. Instead of investigating hormone levels, many women are told they have anxiety, depression, or burnout.
The Fix: If your symptoms started in your 40s or 50s, ask your doctor: “Could this be perimenopause?” “Can we discuss hormone testing or HRT options?”
Commonly Overlooked Conditions in Perimenopause
Many women are misdiagnosed with other conditions when perimenopause is the culprit.
Thyroid Disorders vs. Perimenopause
Symptoms that Overlap: Fatigue, brain fog, weight changes, hair thinning Mood swings, anxiety, depression Irregular periods
What’s Happening?
Declining oestrogen impacts thyroid function, making perimenopausal women more likely to develop hypothyroidism.
Thyroid disorders are often overlooked or not tested properly.
What to Ask Your Doctor: “Can we check full thyroid function (TSH, Free T3, Free T4, thyroid antibodies)?”
Depression & Anxiety vs. Hormonal Changes
Symptoms that Overlap: Low mood, loss of motivation, increased anxiety Irritability, anger, panic attacks
What’s Happening?
Oestrogen and progesterone affect serotonin and dopamine (brain chemicals that regulate mood).
Fluctuations in perimenopause can mimic depression or anxiety.
Antidepressants may help some women but don’t address the root hormonal cause.
What to Ask Your Doctor: “Could my mood symptoms be related to hormonal fluctuations?” “Can we discuss HRT as an option instead of (or alongside) antidepressants?”
Fibromyalgia vs. Menopausal Joint Pain
Symptoms that Overlap: Muscle and joint pain Fatigue and sleep disturbances Brain fog
What’s Happening?
Oestrogen supports joint lubrication and muscle recovery—low oestrogen increases pain sensitivity.
Many women with menopausal joint pain are misdiagnosed with fibromyalgia.
What to Ask Your Doctor: “Could my joint pain be hormone-related?” “Are there lifestyle or HRT options to help?”
IBS (irritable bowel syndrome) vs. Oestrogen-Related Gut Issues
Symptoms that Overlap: Bloating, constipation, diarrhoea Food intolerances Unpredictable digestion
What’s Happening?
Oestrogen and progesterone influence gut motility and microbiome health.
Low oestrogen affects gut bacteria, leading to bloating and IBS-like symptoms.
What to Ask Your Doctor: “Could my digestive symptoms be linked to perimenopause?” “Would probiotics or dietary changes help?”
How to Work with Your Doctor for Better Care
If you suspect perimenopause but aren’t getting the help you need, here’s how to advocate for yourself:
Track Your Symptoms
Keep a journal of: Changes in mood, sleep, energy, digestion Irregular periods or new symptoms Any triggers (stress, diet, sleep changes)
Why? Having clear records makes it easier to discuss concerns with your doctor.
Ask for the Right Tests
Many doctors only check basic hormone levels, but in perimenopause, hormones fluctuate daily, making single tests unreliable.
Recommended Tests for Midlife Women: Comprehensive Hormone Panel – Oestrogen, Progesterone, Testosterone, FSH, LH –these maybe difficult to get on the NHS. Thyroid Function – TSH, Free T3, Free T4, Thyroid Antibodies Vitamin Deficiencies – Vitamin D, B12, Iron, Magnesium
Explore Treatment Options (Beyond Antidepressants)
If your doctor immediately prescribes antidepressants or dismisses your symptoms, ask about:
HRT (Hormone Replacement Therapy): Proven to relieve perimenopausal symptoms and protect long-term health Lifestyle changes: Strength training, diet adjustments, stress reduction Supplements: Magnesium, Omega-3s, adaptogens (like ashwagandha)
Pro Tip: Find a BMS (British Menopause Society) Specialist or menopause-literate doctor who understands hormonal health.
You Deserve the Right Diagnosis & Care
Misdiagnosis in midlife is common—but it’s NOT normal. Your symptoms are real, and they deserve attention.
If your doctor isn’t listening, seek a second opinion. Knowledge is power—track your symptoms, ask the right questions, and advocate for better care. Perimenopause is a natural transition, but you don’t have to suffer—there are treatments that work!
Act Today: If you suspect perimenopause but feel unheard, book an appointment with a menopause specialist—because your health matters.