What if it's Not Perimenopause, but Stress & Burnout Instead?

As women, we are often taught to expect certain changes as we approach midlife. When I started experiencing fatigue, mood swings, brain fog, and sleepless nights, I immediately assumed it was perimenopause. After all, I was in the right age bracket, and the symptoms matched what I’d heard from friends and read about online. So, I sought advice and was put on hormone replacement therapy (HRT) to help ease the transition.

But instead of feeling better, something didn't quite add up. My symptoms persisted, sometimes even worsening. I ended up in hospital with clinical burnout in February this year after 18 months of HRT and that’s when I started questioning: What if it wasn’t perimenopause at all?

Stress and Burnout – The Silent Imposters

Perimenopause and menopause are very real and valid stages of life that come with hormonal shifts, but they are not the only explanation for symptoms like exhaustion, irritability, and even anxiety. What I eventually discovered—and what many women may not realise—is that stress and burnout can mimic these same symptoms.

In today’s world, juggling career demands, family responsibilities, social pressures, and our own high expectations leaves little room for rest. We are expected to "have it all," but at what cost? It took me time to see that I wasn’t just dealing with a natural hormonal shift—I was burned out.

My Experience: Misdiagnosing Burnout as Perimenopause

Initially, I was sure it was perimenopause. The lack of energy, the difficulty concentrating, feeling ‘not myself’—it all fit. I went through various medical appointments, and eventually, I was prescribed HRT. I hoped the treatment would help me regain my balance, but as time went on, I started to question whether hormones were the real issue. I wasn’t finding the relief I expected, and worse, I felt I was battling an invisible enemy.

It wasn’t until my body screamed at me to stop by putting me in hospital that I took a step back and considered my lifestyle that the truth hit me: I wasn’t simply entering a new phase of life—I was overwhelmed by chronic stress and had a head on collision with burnout. The high levels of cortisol, the fight-or-flight response I seemed to be constantly in, a disregulated nervous system, were playing havoc with my body. I needed more than HRT; I needed a plan to address the root cause.

How to Tell the Difference Between Perimenopause and Burnout

It's not always easy to distinguish between the two because the symptoms overlap. Here’s a closer look at what to consider:

- Fatigue: While perimenopause can bring about fatigue, stress and burnout cause a deep, bone-weary tiredness that doesn’t go away with rest. You might be physically present but emotionally checked out.

- Mood Swings: Hormones do play a role in mood changes, but if you’re feeling persistently anxious, irritable, or on edge without any significant hormone fluctuations, stress may be the culprit.

- Brain Fog: Both perimenopause and burnout can cloud your thinking, but in burnout, it’s often coupled with a sense of hopelessness or dread.

- Sleep Issues: Whether it’s night sweats from hormone changes or sleepless nights due to racing thoughts, both stress and perimenopause can disturb sleep. But ask yourself if your sleeplessness could be tied to unresolved stressors in your life or your brain constantly running at over 100mph.

What Helped Me Break Free from Burnout

Once I realised stress and burnout were the real issues, I took action to prioritise my wellbeing. I stopped work. I began to set boundaries for myself. I carved out time for self-care and embraced mindfulness practices to help calm my overactive mind. I redesigned my future life.

Therapy was also instrumental in helping me work through my exhaustion. Slowly but surely, I regained my energy and sense of purpose. It became clear that treating burnout, not just perimenopause, was the key to feeling like myself again.

The Importance of Listening to Your Body

This World Menopause Day, I want to encourage every woman to listen closely to her body. If you’re experiencing symptoms commonly associated with perimenopause, by all means, explore the medical avenues available to you. But also ask yourself: could it be stress or burnout? It’s essential to dig deeper to avoid misdiagnosis and ensure you get the right kind of help. I look around me now with a whole new lens - I see many women looking like & experiencing exactly what I did.

As women, we are complex and multifaceted, and so are our bodies. Whether it’s perimenopause, stress, or both, don’t hesitate to ask more questions and seek the support you need. But HRT won’t fix the burnout issues if they are there, it’s essential you change your lifestyle. When I shifted my focus to managing burnout, everything changed. So, if you’re feeling off, remember: it’s not always about hormones. Sometimes, it’s your body asking you to pause, breathe, and take care of the stress you’ve been carrying for too long.

Here’s to a happy, healthy, stress-free menopause! Happy World Menopause Day!