Your Coping Strategies Didn't Fail. Your Hormones Changed the Rules.

If you're a woman in your 40s or 50s wondering why the life hacks that worked for 20 years suddenly... don't — pull up a chair.

I need to tell you something that would have saved me a lot of suffering if someone had told me sooner.

You're not losing your mind. You're not getting lazy. You haven't suddenly become incompetent at life.

Your hormones changed the game. Nobody told you the rules were different now. And you've been beating yourself up for losing a game you didn't know had changed.

What Nobody Tells You

We hear about hot flushes. We make jokes about "senior moments." We vaguely know menopause is coming and it involves... something. Mood swings? Night sweats? Eventually no more periods?

What we don't hear — what I wish someone had told me — is that perimenopause can absolutely dismantle the scaffolding you've spent your entire adult life building.

All those systems you created to keep yourself functioning? They stop working.

The coping strategies that got you through two decades? They collapse.

The mental clarity you took for granted? Poof.

And because nobody warned you this was coming, you assume the problem is you. Obviously. What else would you think?

So you're trying harder than you've ever tried. Falling further behind than you've ever been. Forgetting things you've never forgotten. Overwhelmed by tasks that used to be automatic. Exhausted in a way that sleep doesn't touch.

You try harder. New planners. New apps. New productivity systems. New supplements. New diets. You watch videos about morning routines. You buy yet another journal.

Nothing works.

I know. I KNOW.

Here's What's Actually Going On

Estrogen isn't just a reproductive hormone. (I didn't know this either, and I'm a psychologist. Nobody teaches us this stuff properly.)

Estrogen is deeply involved in brain function. It helps produce and regulate dopamine, serotonin, and norepinephrine — the neurotransmitters that control focus, working memory, mood, motivation, energy, and executive function. You know, the ability to plan, organise, prioritise, start things, finish things. The stuff that makes you a functional adult.

When estrogen starts fluctuating wildly — which is what happens in perimenopause, often for YEARS before your periods actually stop — these neurotransmitter systems go haywire.

Your brain has less of what it needs to do what it used to do without thinking.

This isn't weakness. This isn't "just getting older." This isn't stress (though stress makes it worse). This isn't in your head.

Well. It IS in your head. It's in your neurochemistry. Which is entirely real and not something you can willpower your way through, no matter what the wellness industry tells you.

The Great Unmasking (Or: Why Women Get Diagnosed With ADHD at 47)

Here's where it gets interesting.

If you've spent your life compensating for undiagnosed ADHD or autism — and a LOT of women have — perimenopause often blows your cover.

Estrogen has a particularly cosy relationship with dopamine. When estrogen drops, dopamine function drops with it. If you were already running on lower dopamine (hello, ADHD), this is... not good.

Those coping strategies you built? The lists, the routines, the colour-coded systems, the alarms, the sheer force of will? They were compensating for a brain that already worked differently. They took enormous effort to maintain — even when they looked effortless from outside.

(They didn't feel effortless, did they? You were working twice as hard as everyone else just to appear normal. I know. Me too.)

Perimenopause removes the buffer. The estrogen that was quietly propping up your dopamine system starts fluctuating, and suddenly the compensation isn't enough anymore.

This is why so many women get diagnosed with ADHD in their 40s and 50s. Not because they suddenly developed it. Because the hormonal scaffolding they didn't even know they had got kicked out from under them, and what was always there became impossible to hide.

Same for autism. The masking that cost you everything? Unsustainable now. The sensory sensitivities you white-knuckled your way through? Intensified. The exhaustion after social interaction? Through the roof.

If you've always suspected something was different about you — if you've always had to try harder than everyone else seemed to — perimenopause might be when the truth finally stops hiding.

"But My Doctor Said My Hormones Are Normal"

Oh, this one makes me want to scream.

Woman goes to doctor. Describes brain fog, fatigue, mood swings, can't focus, can't remember anything, feels like she's losing her grip. Doctor runs bloods. Doctor says hormones are "normal." Woman goes home feeling gaslit and crazy.

Here's the thing. Hormone levels fluctuate WILDLY during perimenopause. A blood test captures one moment. Your estrogen might be "normal" at 9am Tuesday and crashed by Thursday afternoon.

Also — and this is important — "normal" ranges are huge. You can be within the normal range and still have dropped significantly from YOUR normal. If you've always run high and now you're running low, that's a massive change for your body. Even if both numbers technically fall within "normal."

And honestly? A lot of doctors aren't trained to connect hormonal changes with cognitive symptoms. They're looking for hot flushes. They're not thinking about executive function.

If what you're experiencing doesn't match what you're being told, trust yourself. Get a second opinion. Find someone who specialises in menopause. Your brain fog is not imaginary just because it didn't show up on a blood test.

Meanwhile, Life Continues to Expect Things From You

Of course, this is all happening while you're still supposed to function at full capacity.

The mental load doesn't pause for perimenopause. The job still expects performance. The family still needs managing. The house is still a mess. The emotional labour doesn't magically redistribute itself. (Wouldn't that be nice.)

You're trying to run the same life with a brain that's been significantly handicapped — and nobody around you has any idea. You don't look different. You're not visibly ill.

So you fake it. Push through. Stay up late trying to catch up. Beat yourself up for not being able to do what you used to do. Wonder what's wrong with you. Wonder if you've always been this useless and just didn't notice.

The exhaustion compounds. The shame compounds. The self-loathing compounds.

This is not sustainable. And the pushing-through is making it worse. (I learned this the hard way. Please learn from my mistakes.)

What Actually Helps

I'm not going to give you "10 tips for thriving in perimenopause!" because that kind of thing makes me want to throw my laptop across the room. But here's what I've seen actually work — for me, and for the women I see in my practice.

Get assessed for ADHD or autism. If you've never been evaluated and any of this is ringing bells, consider it. Not because there's something wrong with you — but because understanding your brain changes everything. It changes what strategies might actually work. It changes how you talk to yourself. It determines whether you're working with your brain or constantly fighting against it.

Find a menopause-literate doctor. HRT isn't for everyone, but for a lot of women it's been life-changing. The research has moved on a lot since the scary headlines of the early 2000s. Find someone who's actually up to date and can help you figure out what makes sense for you.

Drop some balls. I know. I know you can't. Except — I'm willing to bet there are things you're doing that you don't actually have to do. You've just never questioned them. This season of life requires ruthless prioritisation. Some things are going to fall. You might as well choose which ones rather than letting exhaustion choose for you.

Stop trying harder. I mean it. The trying harder is part of what's exhausting you. Your brain doesn't need more pressure. It needs support. The old strategies aren't failing because you're not trying hard enough. They're failing because the conditions changed.

Lower your standards. I know this is hard to hear. But whatever your internal bar is set at, it's too high for right now. Done is better than perfect. Good enough is good enough. This is not the season for optimisation. This is the season for getting through with your sanity intact.

Tell someone. The isolation makes everything worse. I know you've been hiding how much you're struggling. Find one person — friend, partner, therapist — who you can be honest with. The relief of dropping the pretence is enormous.

Medication is an option. If ADHD is part of the picture, stimulant medication can help a lot. Some women find it works even better alongside HRT. If depression or anxiety have crept in (and they often do), those are treatable too. There's no prize for suffering without support.

The Grief Is Real

Here's something else nobody mentions.

There's grief in this.

Grief for the brain you used to have. The ease you used to feel. The competence you took for granted. The years you might have had if you'd known sooner what was going on.

If you're feeling that — or anger, or frustration, or despair — that's not weakness. That's a reasonable response to a real loss.

You're allowed to be sad. You're allowed to be furious that nobody warned you. You're allowed to struggle.

On Timing

Perimenopause can start in your early 40s. Sometimes late 30s. It typically goes on for 4-8 years before menopause (defined as 12 months with no period). Some women sail through. Others — raises hand — get absolutely flattened.

If you're reading this thinking "but I'm too young for menopause" — perimenopause might still be what's happening. The hormonal chaos starts long before periods stop.

If you're past menopause thinking "I wish I'd known this then" — understanding what happened, and that it wasn't your fault, still matters. Even retroactively.

The Bit I Want You to Take Away

Your coping strategies didn't fail because you're weak, lazy, or broken.

They failed because they were built for a hormonal environment that no longer exists.

The rules changed. Nobody told you. You kept playing the old game and wondered why you kept losing.

Now you know.

Stop beating yourself up. Get support. Build new strategies for the brain you have now — not the brain you had at 35.

It's a recalibration. A hard one. But you'll get through it.

If this resonated: I write about neurodivergence, hormones, trauma, and the ways our brains and bodies try to protect us — even when it doesn't feel protective. Free to subscribe on Podia. https://drmel1.podia.com/