Perimenopause and Work Performance Anxiety: Handling Brain Fog, Memory Slips and Meetings in Your 40s

Perimenopause Brain Fog at Work

You’re in your 40s, sitting in a meeting you could have run in your sleep ten years ago.

You used to be:

• The one who remembered every detail

• The fastest problem-solver in the room

• The person others leaned on for clarity

Now you’re:

• Losing words mid-sentence

• Forgetting what you were about to say

• Re-reading the same email three times

• Dropping small balls you never used to drop

On the outside, you’re still functioning.

On the inside, you’re thinking:

“Am I burning out? Am I getting early dementia? Has everyone noticed I’m not as sharp?”

For many women in their late 30s and 40s, this is perimenopause colliding with work — and the anxiety it creates can be just as damaging as the symptoms.

This article covers:

• What perimenopause actually is (beyond “one day you stop bleeding”)

• How hormonal shifts can affect focus, memory, language and confidence

• Why performance anxiety spikes at exactly the stage you’re supposed to be “at your peak”

• Practical strategies you can use in meetings, deep-focus work and busy weeks

• How to talk (or not talk) about it at work without torching your reputation

This is general information, not individual medical advice. Always talk to a qualified clinician about your own symptoms and treatment options.

Perimenopause 101: You’re Not Imagining the Shift

Perimenopause is the transition phase leading up to menopause (the point when you’ve gone 12 months without a period).

It can start:

• As early as your mid-30s for some women

• More commonly in your 40s

And can last anywhere from a couple of years to close to a decade.

Key point:

Hormones don’t slide down in a straight, graceful line. They fluctuate — sometimes wildly.

Estrogen and progesterone levels can surge and crash, which affects:

• Sleep

• Mood

• Temperature regulation (hello, hot flushes)

• Pain sensitivity

• And yes, how your brain functions day-to-day

So if you’re feeling different in your 40s — not just in your body, but in your mental sharpness — that’s not you being dramatic. That’s physiology.

What Perimenopause Brain Changes Can Look Like at Work

Women often describe:

• Word-finding issues:

• “I know exactly what I mean but can’t find the word.”

• Short-term memory slips:

• Walking into a room and forgetting why

• Losing track of what you were saying mid-sentence

• Concentration problems:

• Reading the same paragraph repeatedly

• Struggling to follow long, dense conversations or documents

• Mental fatigue:

• Feeling “done” much earlier in the day than before

• Sleep-related fog:

• Waking at 2–4 am and then pushing through a full workday

None of this means you’ve lost your intelligence, skills or experience. It means:

• Your brain is working under different hormonal conditions

• Your sleep quality may be compromised

• Your nervous system is carrying more load (career, caregiving, aging parents, teen kids, health worries)

The problem is not that you’re suddenly incapable.

The problem is that the environment around you rarely adjusts.

Why Performance Anxiety Blows Up in Your 40s

Perimenopause hits at the exact life stage where many women are:

• In or approaching senior roles

• Carrying major financial responsibilities

• Managing kids, teenagers, partners, and aging parents

• Expected to be “rock solid” and “a safe pair of hands”

So when brain fog, memory slips or emotional swings appear, it can trigger:

• Fear of being seen as past your peak

• Fear of being replaced by younger colleagues

• Fear of confirming stereotypes about women being “too emotional” or “unstable”

This performance anxiety can then amplify itself:

• Worrying about messing up → more adrenaline → worse sleep → more fog → more mistakes → more worry

You end up in a loop where you question your identity as the competent, capable one.

Important reality check:

Experiencing perimenopause symptoms does not erase the 15–25 years of expertise you’ve built. It adds friction — it doesn’t erase value.

Step 1: Track What’s Actually Happening (Not Just How It Feels)

When anxiety is high, it’s easy to catastrophise:

• “I’m messing everything up.”

• “I’m not good at my job anymore.”

Before you rewrite your whole story, get some data:

• For 2–4 weeks, jot down:

• When you feel foggy (time of day, cycle day if you still track)

• Sleep quality (hours, night wakings)

• Specific situations where you blank (e.g. large meetings vs 1:1, reading vs speaking)

• Caffeine, alcohol and stress spikes

Patterns often emerge:

• Fog is worst after multiple nights of poor sleep

• Word-finding issues cluster at certain cycle phases

• Large, fast-moving meetings are harder than deep-focus solo work

This isn’t to blame or “biohack” your way out of perimenopause — it’s so you can be strategic, not self-loathing.

Step 2: Get a Proper Medical Check, Not Just “You’re Just Getting Older”

Do not accept a shrug if:

• Symptoms are affecting your work and quality of life

• You’re dealing with brain fog, sleep disruption, mood swings, heavy or erratic bleeding, hot flushes or joint pain

A good clinician will:

• Take a detailed history (cycles, symptoms, mood, sleep, family history)

• Consider blood tests (not as a one-off “yes/no” for perimenopause, but as part of the picture)

• Check for other contributors:

• Thyroid issues

• Iron deficiency or anemia

• Vitamin B12 or D deficiency

• Sleep disorders, depression, anxiety

Then you can discuss treatment options, which may include:

• Hormone therapy (if appropriate and safe for you)

• Non-hormonal medications for specific symptoms (e.g. hot flushes, mood, sleep)

• Targeted lifestyle changes that are realistic for your life stage

You’re not “bothering” anyone by asking for help. Your brain, job and relationships are on the line.

Step 3: Tactical Adjustments for Workdays (Brain Fog Edition)

You can’t reorder your hormones on demand, but you can adjust how you work.

1. Externalise Everything You Can

Stop relying on your brain as a storage device. Use:

• Calendar reminders (with more detail than you think you need)

• Task lists broken into micro-steps

• Meeting prep notes with key points written out, not just in your head

Before important meetings:

• Write down the 3 main points you want to make

• Keep that in front of you so you can glance down when words disappear

This is not a downgrade. This is a professional using tools.

2. Protect Your Deep-Focus Windows

If you notice:

• You’re sharper in the morning → protect a 60–90 minute block most days for high-cognition work

• You fade after lunch → schedule admin, emails or lower-stakes tasks then

Where you can, avoid:

• Booking back-to-back high-stakes meetings in your worst brain window

• Forcing concentration when you’re already obviously fried

You may not have perfect control, but even small shifts help.

3. Use Simple Grounding in the Moment

When you blank in a meeting, anxiety spikes. To interrupt the spiral:

• Pause, take a slow breath, and use a bridging phrase:

• “Let me just pull that back together for a second…”

• “I want to make sure I phrase this clearly — what I’m trying to say is…”

• Glance at your notes and keep going

Most people are far more focused on themselves than on your brief pause.

Step 4: Decide How (and Whether) to Talk About It at Work

You do not have to disclose perimenopause at work if you don’t want to. It’s private health information.

Options range from:

1. Say nothing medical, just describe impact:

• “I’m dealing with some health-related sleep issues at the moment. I’m still committed to my role, but I may need to rely more on written checklists and occasional schedule tweaks while I work through it with my doctor.”

2. Name “hormonal changes” without specifics:

• “I’m dealing with some hormonal changes that are affecting my sleep and concentration on some days. I’ve got medical support, but I may need a bit more flexibility with big meeting timing over the next few months.”

3. Explicitly name perimenopause (only if it feels safe):

• “I’m in perimenopause, and it’s affecting my sleep and focus on some days. I’m undergoing treatment, and most of the time I’m fine, but I wanted you to know why I’m making some changes to how I structure my work.”

Your decision should be based on:

• Your manager’s track record with health disclosures

• The culture of your organisation

• Your legal protections (or lack of) around age, gender and health discrimination

If your gut says “this will be weaponised against me,” focus on describing functional needs, not labels.

Step 5: Challenge the “Peak at 40, then Decline” Story

Perimenopause brain changes can make you feel like:

• “I’ve peaked, it’s all downhill.”

• “Younger colleagues are the future; I’m the past.”

Reality:

• Your 15–25 years of experience, context and pattern-recognition are huge assets.

• Many women restructure their careers in their 40s/50s, not because they’re failing, but because they’re done tolerating bad systems.

• Once symptoms are properly recognised and treated, many women report a significant improvement in cognitive function and energy.

It’s not that you’re suddenly “not good enough.” It’s that:

• The system expects you to be 25 forever

• There’s almost no built-in support for the physiological transitions half the workforce will experience

You’re allowed to be angry at that, not just afraid.

How Sistapedia Fits In: Your Brain Fog Is Data, Not Just “A Phase”

Perimenopause + work performance anxiety is exactly the kind of reality Sistapedia® is built around.

We’re creating the world’s first AI-verified marketplace and social platform focused solely on women’s reproductive health across the full lifecycle:

• Periods, contraception, PCOS and endometriosis

• Fertility, IVF, pregnancy and postpartum

• Perimenopause, menopause and long-term health

For Sistas (You)

On Sistapedia, you can:

• Share what perimenopause at work actually feels like — the forgotten words, the performance reviews, the quiet panic

• Read other women’s strategies for managing brain fog, sleep issues and meetings without self-destructing

• Access AI-verified content and Q&As that don’t treat perimenopause as an afterthought

💖 When you share your story and support others, you can apply for your free Pink Tick — our verification for Sistas whose lived experience is helping re-write the script on midlife, work and hormones.

For Clinicians, Coaches, Employers & Experts

If you’re a:

• GP, menopause specialist, endocrinologist or psychiatrist

• Workplace psychologist, leadership coach or HR leader

• Organisation designing menopause and midlife policies

…Sistapedia is where you can:

• Create a professional profile

• Share evidence-based strategies for supporting perimenopausal women in the workforce

• Apply to become Crown Verified — our verification for qualified experts, clinics, services and organisations in women’s reproductive health.

👑 Crown Verification signals that you understand perimenopause as a serious health and work issue — not just “a few hot flushes.”

Final Thoughts: You’re Not “Losing It” — You’re Moving Into a New Phase

If you’re blanking in meetings, misplacing words and feeling like a stranger to your own brain, you’re not broken and you’re not alone.

You’re a woman in a body that is:

• Changing hormonally

• Carrying heavy responsibilities

• Operating in systems that barely recognise any of it

You deserve:

• Proper assessment and treatment

• Adaptations that let you keep using your expertise

• A narrative that doesn’t end your story at 45

✨ Join Sistapedia, the global sisterhood, and step into a space where perimenopause and work aren’t separate conversations — they’re finally part of the same reality.