Kristina Chetcuti, a registered health coach (UKIHCA) specialising in behaviour change and lifestyle medicine (ELMO), answers your lifestyle dilemmas.
Q.: If you’d asked me to describe myself five years ago, I’d have said confident, assertive, diplomatic and capable of sleeping standing up if need be. Since turning 45, I’ve become sleepless, crippled by anxiety, can’t suffer fools and utterly lacking in confidence. Who is this woman?! I don’t even recognise myself!
A.: Please, please, don’t for a minute think you’re on your own or that you’re not going to get through this. You’re not, and you will.
I’d just like you to take a step back for a moment and look at how you’ve arrived at midlife. You’re probably juggling a demanding career, caring responsibilities and ageing parents, not to mention, as an expat, maintaining personal relationships in two different countries.
Everything, everywhere, all at once
On top of all that, you’ve been bombarded with society’s cultural messaging about women and ageing. From adverts to films, magazines and social media, the message is blunt: a woman’s value lies in her youth, appearance and fertility.
On top of that, you look in the mirror and start noticing wrinkles or grey hairs sprouting from everywhere. It’s hardly surprising if you begin to feel threatened by the idea that you’re past your prime, with invisibility waiting just around the corner.
On top of that, out of nowhere, an impostor syndrome to kick in. You’re constantly thinking: “I’m so stupid; everyone else is so clever / so successful / so much more capable than me.” This is supposed to be the stage of life when you have everything under control, and yet, somehow, you feel as though you’re being crushed.
On top of that, there’s the double standard. In men, salt-and-pepper hair and wrinkles are considered sexy, the sort of thing to swoon over (think George Clooney et al.). Female role models who age visibly and remain celebrated are much harder to come by.
And finally, on top of all this, we’re led to believe that menopause consists largely of a woman suddenly getting very hot. We have these images ingrained in us: a woman standing in the supermarket, fanning herself with her shopping list while simultaneously stripping off layers. The hot flush has become the mascot of menopause. In our minds, no hot flush, no menopause.
Sadly, we are clueless.
Credit: Pexels
Last year, researchers analysed responses from about 65,000 women across 140 countries for a digital study of menopause (I was one of them!). The MenoScale study looked at women in perimenopause and post-menopause, whether taking HRT or not.
The analysis found that psychological and cognitive symptoms, namely anxiety, brain fog, memory problems, low mood and irritability, were central to the menopausal experience, regardless of menopausal stage or HRT use. Low interest in sex also featured prominently.
Hot flushes and night sweats, usually cast as the leading ladies of menopause, were not the most prevalent symptoms, as also shown by other studies.
This is because hormonal fluctuations during perimenopause and beyond can affect far more than our body temperature: changing oestrogen levels impact the brain systems which control mood, stress responses and sleep.
This may help explain why some women suddenly find themselves wrestling with anxiety.
Catastrophising
But you are not alone. Only last week, BBC broadcaster Anita Rani posted an unusually personal video on Instagram while out running in the park, revealing that she had suddenly burst into tears. The video stuck a chord with thousands of viewers.
She then wrote about the experience in The Times of London: “I’m not an anxious person… it’s how I’ve been brought up, confidence comes easy to me – yet suddenly I have started catastrophising and worrying constantly. It felt like the world was ending.”
We’re simply not informed enough about menopause. A 2026 Belgian survey found that nearly 30% of Belgian women aged 40 to 60 did not recognise their symptoms as related to menopause. Almost half of those experiencing physical or mental symptoms said they discussed them with nobody.
Credit: Pexels
It’s only relatively recently that researchers have started paying serious attention to this stage of women’s lives. We seem to be the first generation of women talking about it openly.
I’m still not sure whether previous generations simply got on with it or whether their experience was different. Did they have healthier environments, less pressure, less social media? Or were they struggling just as much, but kept it all inside?
Somehow, we still imagine menopause striking in our late 50s or 60s, but perimenopause can begin in our late 30s. And many of us don’t even know what to look out for.
So, familiarising ourselves with the symptoms means can helps us make sense of what’s happening, rather than feeling that our bodies have suddenly turned against us.
How can you help yourself?
1. Acknowledge that what worked before might not work now
You’re going through a biological transition, and you may need to adapt to it. The food you used to eat might no longer suit you as well. The exercise you used to do might need rethinking. And the emotional resources you’ve always relied on may not feel as accessible as they once did.
Please don’t think of this as a personal failing. Talk to your GP or a menopause specialist about what you’re experiencing and what might help.
2. Look at what you eat
Keep in mind that multiple studies have shown that a healthier and more plant-based diet decreases the impact of the symptoms – again, something which can be discussed with a healthcare professional
3. Prioritise sleep
Sleep problems and anxiety can become a vicious cycle. What helps will vary from person to person.
It might be something as minimal as a hot bath before bedtime or something more structured such as cognitive behavioural therapy (CBT) for insomnia.
4. Don’t try to tough it out alone
You shouldn’t have to endure this transition in silence. Do not withdraw or feel embarrassed about what’s happening. Rally your friends, tell your partner what you’re going through, and let people in.
If you’re in a relationship, Burning Up, Frozen Out is a useful book to read together. Understanding what’s happening can make it easier for both of you to navigate the changes.
5. Finally, be kind to yourself
I watched this TEDx talk by psychologist Kristin Neff on self-compassion, and it made me cry. It also made me realise how harsh we women can be with ourselves.
We expect ourselves to keep everything going, to cope, to perform, to be there for everyone else. And when we struggle, we can be our own worst critics.
You’re going through a major transition. You deserve the same understanding you would offer someone else.
