Losing my edge - perimenopause after cancer

I thought I was losing my edge. I didn't know perimenopause had anything to do with it.

There's a particular kind of meeting where you know, before it starts, that you'll be the one who holds the room. You know your material, you know the people, and you've done this a hundred times before.

And then one day, you don't quite hold it. There's a hesitation that wasn't there before, a word that escapes you at the wrong moment, a tiredness that follows you in, not from the morning but from somewhere deeper, somewhere sleep hasn't been able to reach for months.

On the commute home you ask yourself a question you've never seriously entertained before: is this just me now?

If that moment feels familiar, this post is for you.

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What I thought was happening to me

For most of my adult life, my work was central to who I was, not just what I did. Twenty+ years in corporate transformation had given me something I trusted completely: my capability, my drive, my ability to walk into complexity and find a way through it.

So when those things began to quietly slip, I noticed, and I was frightened.

The fatigue came first: a bone-deep exhaustion that no amount of sleep seemed to shift, followed by weight that arrived without invitation and refused to leave despite everything I tried. There were hot flushes that ambushed me at inopportune moments, night sweats that meant I was rarely properly rested, and a loss of libido that I kept to myself.

But the thing that disturbed me most wasn't any of those physical changes. It was the loss of confidence and the low mood, and the confusion about my own drive and ambition, the very things I had built my identity around. I felt like I was becoming less capable, less sharp, less myself, and I couldn't explain it.

I had a ready explanation, of course. I had been through breast cancer treatment, and I knew that tamoxifen, the medication I was taking to reduce the risk of recurrence, could have an impact on how I felt. So I told myself I would get through it, that I would come back to myself, that this was temporary.

I also told myself something else, something I suspect many women recognise: I couldn't complain. I was lucky to be alive. I had treatment, and I had people around me, so to voice how bad I felt, how lost and diminished, seemed ungrateful. I kept going. I adapted. I compensated quietly and waited to feel like myself again.

I waited a long time.

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Why this happens, and why it matters

What I didn't know then, and what most women aren't told clearly enough or early enough, is that what I was experiencing had a name. I was in perimenopause, accelerated by my cancer treatment. But the symptoms I was living with, particularly the cognitive ones, the loss of confidence, the low mood, the feeling of not quite being able to reach the version of myself I recognised, are not unique to women who have been through cancer. They are common, documented features of perimenopause itself.

A 2019 UK study of 1,000 women found that it takes an average of 14 months for women to connect their symptoms to perimenopause. That's fourteen months of living with something significant without a framework to understand it, fourteen months of plausible alternative explanations, stress, burnout, a difficult year, getting older, filling the gap that accurate information should have filled.

The consequences of that gap are not trivial. Research published in the Journal of Affective Disorders in 2024, drawing on data from over 9,000 women across multiple countries, found that perimenopausal women are around 40% more likely to experience depressive symptoms and receive a diagnosis of depression than premenopausal women. A separate study published in BMJ Women's Health found that thousands of women are diagnosed with anxiety or depression before the underlying hormonal picture is ever recognised. The mood, the low confidence and the cognitive fog are being treated as the problem, when they are often a signal of something else entirely.

This matters because the story a woman tells herself about what's happening shapes everything that follows. If she believes she is becoming less capable, she will begin to act like it, withdrawing, second-guessing, and quietly shrinking in the places where she used to expand. If she believes she is failing to cope, she will add that to the invisible weight she's already carrying.

And if, like me, she has a reason to feel she shouldn't complain, she will carry it alone.

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What changes when you have a name for it

When I finally understood what was happening to me, my circumstances didn't change overnight. The fatigue didn't immediately lift, and the confidence didn't flood back in an instant.

But the story changed, and that mattered more than I had expected.

I wasn't losing my edge, and I wasn't becoming less capable, less driven, or less myself. My body was navigating a significant hormonal transition, one that affects cognition, mood, energy and identity, largely without support, while I kept going at full speed and told myself I had no right to struggle.

That reframe is not a small thing. It is, in many ways, the beginning of everything that came after.

Because when you understand what is actually happening, not as a flaw, not as a failure, and not as the beginning of a long decline, you can respond to it differently. You can stop compensating in silence and start seeking the support that was always available to you.

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You don't have to figure this out alone

If any of this has felt familiar, the fatigue you've explained away, the confidence that's gone quieter than it used to be, the sense that you're not quite yourself in the places that matter most, that recognition is worth paying attention to.

Not because something is wrong with you, but because something is happening, and you deserve to understand it.

Perimenopause is not a problem to be solved or a crisis to be managed. It is a transition, one that, when met with the right support, can become something more than something to get through.

If you'd like to explore what that support might look like, I offer a free enquiry call. It's a calm, no-pressure conversation about what's happening for you, and whether this work feels like the right fit.