Eighteen Months Ago, I Was Convinced
Eighteen months ago, I was lying in bed at 3am, drenched, with itchy ears and a mood that could’ve curdled milk. Night sweats. Irritability. A libido that had apparently moved overseas without leaving a forwarding address. Every single item on the perimenopause checklist, present and accounted for, reporting for duty at the most unsociable hour available.
I’d quietly decided I was perimenopausal. I’d started mentally rehearsing the GP appointment. I was preparing to narrate my life like a cautionary tale about hormones, ready to make peace with the idea that my forties were simply going to feel like this. Drenched. Foggy. Cranky. Slightly unrecognisable to myself.
Then, almost by accident, I changed my diet. I reduced the foods I knew were triggering inflammation in my body. Within weeks, every single symptom packed up and left. Not eased. Not improved. Left. Eighteen months of feeling like a functioning human, no night sweats, no itchy ears, libido back from her sabbatical with a tan. I’d filed the whole episode away as solved and moved on with my life.
And Then This Week Happened
This week, I woke up at 3am drenched again. Itchy ears. Same flat, foggy, what’s even the point of anything mood. Every symptom from eighteen months ago, back in formation, like they’d been waiting in the wings the whole time. For about thirty seconds I had the dramatic thought, oh god, here we go, this time it really is perimenopause.
But here’s the thing, this week didn’t happen in a vacuum. The weekend before, I’d been through a brutal stretch of anxiety. The kind that lives in your chest and refuses to negotiate. And anxiety, in my body, sets off inflammation like a fire alarm. By the time the night sweats arrived, I was already mid flare. My body was loudly inflamed from the inside out, and right on cue, every symptom I’d once labelled perimenopause came marching back in formation.
That’s when the penny dropped, because of course it dropped at 3.47am. I hadn’t suddenly become perimenopausal overnight. My body had become inflamed again. The symptoms were identical to eighteen months ago because the cause was identical. Which meant, possibly, hopefully, infuriatingly, that what I’d been calling perimenopause was never perimenopause at all. It was inflammation, wearing a costume my body knew how to recognise and that the brochures had taught me to misread.
What We Already Know About Women’s Bodies
Let’s lay this out, because none of it’s conspiracy territory. Women’s medicine is catastrophically under researched. Women have been excluded from clinical trials for decades. Symptoms in women’s bodies get dismissed, downgraded, or rerouted into whichever vague diagnosis is currently fashionable, which for women over thirty five is almost always something hormonal. Tired? Perimenopause. Foggy? Perimenopause. Itchy? Perimenopause. Cranky? Definitely, and have you considered HRT, babe.
We also know the West has a deeply toxic relationship with ageing, particularly ageing women. We pathologise it. We market to it. We treat midlife like a slow leak rather than a season with its own power. Perimenopause has become a category so elastic it can absorb almost any symptom a woman over thirty eight presents with, which is enormously convenient for everyone except the woman in question.
Other cultures don’t experience perimenopause the way we do. The symptoms we treat as universal and inevitable aren’t actually universal or inevitable. Which means something in our environment, our food, our stress, our lifestyles, is amplifying what could otherwise be a much gentler transition. And we’re not asking that question with any real seriousness, because asking it would require dismantling an entire industry that depends on midlife women feeling broken.
So What If It’s Just Inflammation
Here’s the question I can’t stop turning over. What if a meaningful chunk of what gets labelled perimenopause is actually inflammation with the wrong name tag. What if you’re not perimenopausal. What if you’re eating too much junk, drinking too much wine, and existing in a constant low grade flare that your body’s trying desperately to alert you to, and your GP’s handing you a hormone panel for it.
I’m not saying perimenopause isn’t real. It absolutely is. I’m not telling anyone to ignore their symptoms or skip their GP. I’m saying that I’ve lived this loop twice now, in my own body, and the pattern is too clean to ignore. When my body’s inflamed, the symptoms arrive. When my body’s calm, the symptoms leave. That’s not a hormonal cycle. That’s cause and effect, dressed up in a much scarier outfit.
What if the protocol we should be trying first, before we accept midlife as a sentence, is the unsexy one. A cleaner diet. Gentle movement, not punishing fitness. Sleep that’s actually restorative. And, the most powerful one of all, removing the toxic people whose names alone send your nervous system into a spike. What if that’s the actual answer, and we’ve been sold a much more expensive, much less effective version of it dressed up in nice packaging.
Before You Accept the Diagnosis, Babe
If you’re reading this at 3am, drenched, itchy, foggy, furious, and convinced your body’s breaking, I want you to pause before you accept the brochure. You might be perimenopausal. You also might not. You might be inflamed, exhausted, under fed in the ways that actually matter, and over exposed to people and food and stress that your body’s been quietly begging you to reconsider.
Before you book the hormone panel, before you start grieving the version of you that felt good, try the boring stuff first. Look at what you’re eating. Look at how you’re moving. Look at how you’re sleeping. Look hard at the people whose names make your shoulders climb toward your ears. That last one’s the one we want to skip, and it’s usually the one doing the most damage. Your nervous system isn’t subtle. It knows who’s safe and who isn’t.
You don’t have to accept suffering as the price of being a woman in her forties. You don’t have to dress up your own decline as inevitable just because the marketing’s glossy and the language is everywhere. Listen to your body before you medicalise it. Be curious before you panic. The answer might be a hormone protocol and that’s completely valid. The answer might also be a quieter life, a cleaner plate, and a much shorter list of people who get access to you. Try the soft answer first. You deserve to find out which one it actually is.

We Need to Stop Clapping for Basic Decency – Chaos, Crumbs and Clarity
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