No Less Of A Woman

There are some parts of women’s health that we are finally beginning to talk about more openly.

And then there are the parts that still seem to be whispered about.

For me, perimenopause has never really been about hot flushes.

It has been about my mind.

My story began in July 2019, when I was 41.

Until then, I had never particularly struggled with PMS. I wasn’t someone who could predict my period because I suddenly became emotional or irritable every month. So when I began experiencing significant psychological changes around my cycle, it was very unfamiliar and occasionally frightening.

My GP initially diagnosed me with PMDD aka Premenstrual Dysphoric Disorder, and I was prescribed the oral contraceptive pill in an attempt to regulate the hormonal swings.

For a while, it helped.

But eventually I began experiencing increased migraines and other problems, and it was actually a friend who asked me:

“Could this be perimenopause?”

It turned out that she was right. I was so fortunate for this friend who is a Sexual Health nurse who had recognised these issues, not just because of her career path, but because she was experiencing perimenopause issues too. I cannot thank her enough for highlighting this to me.

So, what I had thought was PMDD was actually the beginning of my perimenopausal journey.

And I have been navigating it, on and off, ever since and for the most part, the HRT prescribed helped immensely.

My menopause didn’t look how I expected it to

When we talk about menopause and perimenopause, we tend to hear about the physical symptoms.

Hot flushes.

Night sweats.

Changes in periods.

Sleep disturbances.

For me, those were never the main story.

One of the few physical symptoms I experienced was formication (skin crawling) the bizarre sensation of insects crawling across or underneath your skin when nothing is actually there. Mine felt like the skin on my shoulder blade was rolling - like when you get a massage - but it would happen six or seven times a day. It was such a weird sensation, I got to the point where I would ask my (now ex) husband if he could see it moving.

But the symptoms that affected me most were psychological.

Anxiety.

Tearfulness.

A feeling that everything had suddenly become unbearably heavy.

And, on very rare occasions, suicidal thoughts.

Those episodes were nearly always connected to a very specific hormonal window, usually in the couple of days before a bleed.

And there was another pattern.

Something would trigger me.

Often it would involve the perception that I had upset somebody, disappointed somebody or caused somebody pain.

On an ordinary day, I could look at the same situation rationally.

I could think:

That’s uncomfortable.

I wish that hadn’t happened.

I need to deal with that.

But during that hormonal window, the same event could become enormous.

I would feel an overwhelming need to fix it.

My thoughts would often turn inward.

I am a terrible person.

I'm not good enough.

No-one needs me.

I'm no use to anyone.

And sometimes I would spiral to a place where I genuinely no longer wanted to be here.

That is an extraordinarily frightening place to find yourself.

Especially when, a couple of days later, you can feel completely like yourself again.

“But I’m not depressed”

As my perimenopause progressed, these episodes became more frequent.

At the same time, my periods began becoming shorter rather than simply disappearing, which meant I could no longer reliably predict when that vulnerable hormonal window was approaching.

Add to that the enormous stress I have been living under since late April 2022, the deterioration of a 30-year relationship, separation in late 2025, divorce commencing in February 2026, financial and legal pressures and rebuilding my life in another country... and it became increasingly difficult to know when something was going to tip me over the edge.

What I found particularly frustrating when seeking help was the assumption that the answer must be antidepressants. I was a Pharmacy Technician by trade, I know medication and all the side effects they cause, I've been through post natal depression - I know what depression is like and this is not it! I also know that I did not require any form of antidepressant medication and I still now refuse it.

My experience has never felt like depression.

For most of the month, I function completely normally.

I work.

I laugh.

I make plans.

I deal with difficult situations.

I can receive an upsetting email and think, "flipping heck, that's annoying", (most likely in other more choice words from a typical Burnley girl vocabulary), and can carry on with my day.

But put exactly the same situation into the wrong hormonal window and my reaction can be dramatically different.

That distinction matters.

I wasn’t asking somebody to take away normal emotions or to numb me.

I was asking for help with the unpredictable moments when my hormones appeared to hijack my ability to regulate them.

Reaching the point of saying: enough

When I returned to Dubai recently, following advice from my therapist who has been amazing and supportive, I spoke in detail with a clinical psychiatrist about everything I had been experiencing.

After hearing the history and the cyclical nature of the episodes, she suggested that it might be time for me to discuss surgical menopause with my gynaecologist.

I did.

And my gynaecologist agreed that we had reached the point where a hysterectomy, together with removal of my ovaries, was the best option for me to consider. She asked if I needed 2 weeks to think about it. I said "no". I was that desperate for these episodes of hormone fluctuations to stop so she applied for the insurance approval straight away.

I already use medically prescribed hormone replacement therapy.

But my own ovarian hormones are still fluctuating extremely erratically in the background. At times they may add to what I am taking; at others, they may fall away. The aim of removing the ovaries is to induce surgical menopause so that my hormone replacement can then be managed at a more consistent prescribed level.

This is a very individual medical decision, and certainly not a treatment suggestion for other women.

For me, though, it represents something enormous.

Predictability.

Stability.

Safety.

My health insurance approval for surgery has now come through, and I am currently waiting for the remaining investigations before we can proceed.

When I received the insurance approval - just this morning-, I cried.

Not because I was frightened about losing my womb. Not at all.

Because I felt relieved.

Profoundly relieved.

For the first time in years, it felt as though there might actually be an end point to this particular battle. No more having to worry about where I could possibly be in my cycle, no more worrying about how I might react to something stupid.

“How do you feel about losing your womb?”

When I told some of my friends what had been recommended, several of them gently asked how I felt about it.

Would I feel less feminine?

Would I grieve my fertility?

Would having a hysterectomy make me feel like less of a woman?

And the answer, for me, is very simple.

No.

Absolutely not.

I was surgically sterilised at 26 because I knew I did not want any more children and I was having an umbilical hernia repaired, so that was the caveat to having that surgery.

My ability to carry a pregnancy has never been the thing that defined my femininity.

My womb is an organ.

It is not the source of my womanhood.

My femininity lives in far more than that.

It lives in my body.

My sensuality.

My relationships.

My tenderness.

My strength.

My intuition.

My experiences.

The way I love.

The way I nurture.

The way I occupy the world.

None of those things disappear just because an organ is removed.

And right now, the thing I value above everything else is being able to trust my own mind again.

The side of menopause we don't talk about enough

The Davina McCall’s Channel 4 documentary called Davina McCall: Sex, Mind and the Menopause was the second part of a two part documentary on menopause. It helped bring much-needed attention to the fact that menopause can affect far more than body temperature and periods, it can affect relationships, work and mental wellbeing too.

And this part matters.

According to the Office for National Statistics, in 2024 the highest female suicide rate in England and Wales was among women aged 45 - 49. That statistic does not mean menopause is the sole cause. Suicide is complex and influenced by many factors, but it underlines why serious mental-health symptoms in midlife women cannot simply be dismissed as “hormones” or something they should endure.

I know what it feels like to experience thoughts that do not feel like the real you.

I know what it is like to come out of that window and wonder how your mind managed to take you somewhere so dark.

And I know the fear of wondering when it might happen again.

That is why, for me, this surgery isn't about losing something.

It is about getting something back.

Me.

No less of a woman

After surgery, I will still be me.

I will still be feminine.

I will still be sensual.

I will still be emotional.

I will still be complicated.

I will still be a mother, a nanna, a friend, a woman and a coach.

I also hope one day, to once again be a "significant other" or "girlfriend" or "wife" or "life partner" to someone who loves me equally in return too.

I simply hope I will no longer have to wonder whether an ordinary life event is going to collide with an invisible hormonal window and turn into something dangerous.

I want to be able to experience sadness without fearing where it might lead.

I want to feel anger without it turning against me.

I want to feel rejection without my entire sense of self collapsing around it.

I want to know that when I react to something, the reaction belongs to me.

And that, to me, is freedom.

Why this matters in my work

One of the areas I am developing within my coaching work is supporting women through major life transitions.

Menopause.

Ageing.

Divorce.

Grief.

Child loss.

Abortion.

Life changes.

The moments when a woman looks at her life and realises that the version of herself she has always known is changing.

Some of those transitions are chosen.

Some are forced upon us.

Some involve enormous grief.

And some can ultimately become a doorway into something new.

My experiences do not make me an expert on another woman's life. We all experience things in different ways.

They do, however, give me a deep respect for how complicated these transitions can be.

My role as a coach isn't to tell you what your answer is.

It isn't to “fix” you.

It is to sit beside you while you find your own answers.

To help you hear yourself when everything else feels noisy.

To shine a light on the path when you cannot quite see where you're going.

And perhaps to remind you that changing, ageing, grieving, starting again or losing parts of the life and body you once knew does not diminish you.

You are not less of a woman.

And you know what? Neither am I.

Have you experienced severe psychological symptoms during perimenopause, surgical menopause or hysterectomy? I would genuinely love to hear about your experience in the comments. Particularly what changed for you afterwards.