10 Ways Perimenopause Can Impact Your Work (and What to Do About It)
Perimenopause can quietly influence everything from your focus to your energy at work—but with awareness and strategy, you can manage the shifts and keep thriving in your career.
For many of us, the word perimenopause doesn’t enter our vocabulary until it shows up in our lives. Medically, perimenopause refers to the transitional stage before menopause, when the ovaries gradually produce less estrogen.¹ It can begin as early as the 30s, though it most often starts in the 40s and can last anywhere from four to ten years.²
During this phase, fluctuating hormone levels can trigger a range of symptoms—irregular cycles, hot flashes, brain fog, disrupted sleep, and mood changes, among others.³ Because it unfolds gradually, many women mistake these shifts for stress, aging, or burnout, especially when we’re also balancing demanding careers, family responsibilities, or leadership roles.
The reality is that perimenopause doesn’t stay neatly at home. It shows up in the workplace—sometimes in ways that feel inconvenient, frustrating, or even discouraging. For women who pride themselves on being sharp, reliable, and resilient, these shifts can feel like an unwelcome intrusion on hard‑earned professional momentum.
This article explores 10 ways perimenopause can impact your work, paired with strategies to manage each one so you can protect both your performance and your well‑being.
1. Brain Fog and Memory Lapses
One of the most common—and frustrating—symptoms of perimenopause is brain fog. Fluctuating estrogen and progesterone levels influence neurotransmitters like acetylcholine and serotonin, which are central to memory and concentration.⁴ The result can feel like mental “blips”: forgetting names, losing your train of thought mid‑sentence, or struggling to recall details you’d normally retain with ease.
Workplace scenario: You’re leading a weekly team meeting, and midway through discussing project timelines, you suddenly lose the thread of what you were saying. Colleagues jump in to fill the silence, but inside you’re rattled—this isn’t like you, and you worry it undermines your credibility.
Why it matters: In environments where sharp thinking is prized, brain fog can feel like a threat to professional identity. For high‑achieving women, the fear that others might mistake these lapses for incompetence—or worse, disengagement—can create extra stress.⁵
What you can do:
Use external systems: Lean on tools like shared project trackers, written agendas, and digital reminders to offload memory demands.
Practice retrieval strategies: Repeating information out loud or writing quick recap notes strengthens recall.⁶
Be transparent (strategically): In trusted settings, a lighthearted acknowledgment (“I’m having a brain‑fog moment”) normalizes the experience without diminishing authority.
Prioritize rest: Poor sleep amplifies cognitive lapses, so addressing sleep hygiene is essential (we’ll cover that in Section 2).
2. Sleep Disruptions and Next‑Day Performance
Perimenopause often brings changes in sleep architecture, thanks to hormonal fluctuations that affect circadian rhythm and core body temperature.⁷ Night sweats, insomnia, or waking up multiple times during the night are common. The consequence is more than just feeling tired—it’s reduced alertness, lower productivity, and a shorter fuse for workplace stressors.⁸
Workplace scenario: After a night of tossing and turning, you walk into a full day of back‑to‑back meetings. By the afternoon, you’re running on caffeine and sheer willpower. Normally, you’d be sharp in brainstorming sessions, but today it feels like wading through molasses. You forget key points you wanted to raise and leave the room frustrated with yourself.
Why it matters: Consistently poor sleep chips away at cognitive capacity, emotional regulation, and decision‑making.⁹ In high‑stakes workplaces, this doesn’t just affect individual performance—it can shape how colleagues perceive reliability and leadership presence.
What you can do:
Set a wind‑down routine: Limit screens before bed, use blackout curtains, and keep your bedroom cool to offset temperature spikes.
Limit stimulants: Caffeine and alcohol can worsen sleep fragmentation, so cut them earlier in the day.
Try cognitive techniques: Practices like mindfulness meditation or progressive muscle relaxation have been shown to improve sleep onset and quality.¹⁰
Seek medical support: If sleep disruptions are persistent, a clinician can help identify whether hormone therapy or other interventions might be appropriate.
3. Mood Swings and Emotional Regulation at Work
Hormonal fluctuations during perimenopause don’t just affect the body—they directly influence neurotransmitters tied to mood, including serotonin and dopamine.¹¹ The result can be unpredictable emotional shifts: irritability, anxiety, or sudden dips in motivation that feel out of character.¹² At work, this may show up as snapping at a colleague, tearing up in a meeting, or feeling inexplicably overwhelmed by tasks that normally feel manageable.
Workplace scenario: You’re wrapping up a long day when a team member asks for last‑minute feedback on a project. Instead of calmly addressing it, you feel irritation spike and your response comes out sharper than intended. Later, you regret it—knowing the frustration wasn’t about the request itself but about how depleted you felt in the moment.
Why it matters: Women in leadership often face the double standard of needing to project authority while also being seen as approachable.¹³ Mood swings can feel like a betrayal of both goals, leading to self‑criticism and extra energy spent on emotional “damage control.” Over time, this can erode confidence and relationships at work.
What you can do:
Notice patterns: Track when mood fluctuations are most likely to appear (e.g., around cycle changes or after poor sleep). Awareness helps you anticipate and manage triggers.
Build in buffers: Short breaks between high‑stakes meetings or deep‑work sessions can lower reactivity.
Practice grounding techniques: Simple tools like box breathing or a quick walk outside can regulate stress responses in the moment.
Seek support: If mood changes feel overwhelming, a clinician may recommend therapies such as CBT (cognitive behavioral therapy) or, in some cases, medication.¹⁴
4. Hot Flashes and Physical Discomfort at Work
Hot flashes are among the most recognizable symptoms of perimenopause. They’re caused by hormonal fluctuations that affect the hypothalamus, the part of the brain that regulates body temperature.¹⁵ These sudden waves of heat—often accompanied by flushing, sweating, or a racing heartbeat—can last for seconds or minutes, and they tend to strike at inconvenient times.
Workplace scenario: You’re presenting quarterly results to senior leadership when a hot flash hits. Your face feels flushed, sweat beads at your hairline, and you’re suddenly convinced everyone can see what’s happening. You power through, but the distraction makes it harder to stay focused and confident.
Why it matters: While hot flashes aren’t harmful, the embarrassment or discomfort they cause can undermine confidence.¹⁶ For women in high‑visibility roles, the fear of being judged—or of losing composure in front of colleagues—can add an extra layer of stress, compounding the physical experience.
What you can do:
Dress strategically: Opt for breathable fabrics and layers so you can adjust quickly.
Stay prepared: Keep a portable fan, cooling towel, or even an extra blouse at your desk.
Create comfort zones: If possible, position yourself near airflow in meetings or keep a small fan at your workspace.
Practice calm resets: Slow, paced breathing has been shown to help regulate hot flash intensity.¹⁷
Talk to your doctor: Hormone therapy or non‑hormonal medications may be appropriate if symptoms are severe or frequent.¹⁸
5. Irregular Cycles and Unexpected Symptoms at Work
One of the hallmark signs of perimenopause is cycle irregularity. Periods may come closer together, farther apart, or arrive unpredictably.¹⁹ For some women, bleeding becomes significantly heavier, while for others it becomes lighter or sporadic. This unpredictability can create both physical and logistical challenges in the workplace, particularly during high‑stakes days when focus and composure are critical.²⁰
Workplace scenario: You’re leading a full‑day workshop with external partners when your period arrives—unexpectedly and heavily. You didn’t bring supplies because your cycle has been inconsistent for months, and now you’re left scrambling between presentations. The physical discomfort and anxiety about managing appearances make it nearly impossible to stay fully present.
Why it matters: Beyond the obvious logistical stress, irregular cycles can trigger embarrassment, disrupt concentration, and even influence attendance at key events.²¹ For women in leadership positions, who may already feel pressure to perform flawlessly, this added layer of unpredictability can heighten stress and self‑consciousness.
What you can do:
Plan for variability: Keep menstrual supplies at work, in your bag, or in your car so you’re covered if cycles arrive unexpectedly.
Use technology: Cycle‑tracking apps can help identify patterns, even when irregular, and provide a heads‑up about potential windows of change.
Prioritize comfort: If heavy bleeding is an issue, consider products designed for longer wear (such as menstrual disks, cups, or high‑absorbency options).
Seek medical advice: Persistent heavy bleeding or extreme irregularity can sometimes signal conditions like fibroids or thyroid issues, which are important to rule out.²²
6. Changes in Energy and Motivation at Work
Perimenopause often brings shifts in energy levels that go beyond typical fatigue. Fluctuating hormones can impact metabolism, thyroid function, and even mitochondrial efficiency, which together influence how much “fuel” your body has to draw on each day.²³ Many women report feeling drained more quickly, struggling with mid‑afternoon slumps, or finding it harder to summon motivation for projects that once energized them.²⁴
Workplace scenario: You start the week feeling focused, but by Wednesday afternoon, your energy flatlines. A project that usually excites you now feels like an uphill climb. Instead of diving in, you find yourself procrastinating, staring at the screen, or avoiding tasks altogether—not because you’ve lost interest, but because your body and mind feel depleted.
Why it matters: In workplaces that reward stamina and “always‑on” productivity, dips in energy or motivation can feel like personal failings rather than physiological changes.²⁵ This misperception not only chips away at self‑confidence but may also impact performance reviews or advancement if left unaddressed.
What you can do:
Optimize your schedule: Tackle high‑focus tasks during peak energy windows (often mornings) and reserve lighter tasks for when energy dips.
Support your body: Prioritize nutrient‑dense meals with steady protein and complex carbs to help maintain energy balance throughout the day.
Build in movement: Short walks or stretching between meetings can reset energy and improve focus.
Adjust expectations: Recognize that motivation fluctuates, and build systems—like accountability check‑ins or structured deadlines—that help keep momentum going.
Seek medical evaluation: If fatigue is severe or persistent, it’s worth testing for thyroid changes or iron deficiency, which can worsen during perimenopause.²⁶
7. Shifts in Confidence and Professional Identity
Perimenopause doesn’t just affect the body—it can subtly reshape how women see themselves at work. Hormonal fluctuations influence mood and cognition, but they can also intersect with societal narratives about aging and capability.²⁷ For some women, this stage brings an unexpected dip in self‑confidence, even in areas where they’ve long excelled.²⁸
Workplace scenario: You’re asked to present in a leadership meeting on a topic you’ve mastered for years. Normally, you’d feel at ease. But lately, you’ve noticed a new undercurrent of doubt—second‑guessing your talking points, rehearsing more than usual, and wondering whether colleagues notice you hesitating. Nothing in your performance has changed, but your internal sense of authority feels shakier.
Why it matters: Confidence is deeply tied to leadership presence. When self‑assurance falters, others may misinterpret it as uncertainty or lack of expertise.²⁹ For women in male‑dominated fields, this shift can feel especially destabilizing, reinforcing systemic biases that already undervalue women’s authority.
What you can do:
Name the shift: Recognize that confidence dips during perimenopause are common and often physiological, not a reflection of your true abilities.
Anchor in evidence: Keep a record of accomplishments, positive feedback, and metrics of success to remind yourself of your proven track record.
Practice grounding techniques: Deep breathing or mindfulness before high‑stakes moments can help restore calm and presence.
Reframe leadership identity: This stage can also be a chance to lean into authenticity, embracing a leadership style that values wisdom, collaboration, and perspective.
Seek mentorship or peer support: Talking openly with trusted colleagues or networks can normalize the experience and provide reassurance.³⁰
8. Increased Stress Reactivity and Emotional Sensitivity
Hormonal fluctuations during perimenopause can intensify the body’s stress response, making women more reactive to pressure and more sensitive to emotional triggers.³¹ Cortisol levels may spike more easily, and serotonin—the neurotransmitter linked to mood regulation—can dip with declining estrogen.³² As a result, challenges that once felt manageable may now feel overwhelming or provoke stronger emotional reactions.
Workplace scenario: A colleague gives last‑minute feedback that your team’s proposal needs major edits before tomorrow’s deadline. Normally, you’d roll up your sleeves and get it done. But today, the stress feels outsized—you’re anxious, irritable, and on the verge of tears. You manage to push through, but afterward, you wonder why you felt so destabilized by something routine.
Why it matters: Heightened stress reactivity can affect decision‑making, strain relationships, and create a sense of unpredictability in how you show up at work.³³ For leaders, this can be particularly concerning: emotional regulation is often perceived as a marker of stability and reliability.
What you can do:
Build stress buffers: Incorporate daily practices like journaling, exercise, or mindfulness to regulate the stress response before workplace challenges escalate.
Communicate boundaries: Proactively clarify realistic timelines or capacity with colleagues to minimize last‑minute crises.
Leverage recovery time: After particularly stressful moments, give yourself space to reset—whether through a short walk, a private breather, or stepping away from your desk.
Consider professional support: Therapy, coaching, or stress‑management workshops can provide tools for navigating heightened emotional sensitivity.
Medical options: For some women, interventions like hormone replacement therapy (HRT) or non‑hormonal medications may help stabilize mood and stress response.³⁴
9. Physical Symptoms That Disrupt Daily Work
Hot flashes, night sweats, and sleep disturbances are some of the most widely recognized symptoms of perimenopause—and they can significantly interfere with work.³⁵ Hot flashes can strike without warning, causing sudden sweating, flushing, and discomfort during meetings or presentations. Meanwhile, disrupted sleep from night sweats or insomnia leads to daytime fatigue, which compounds concentration and mood challenges.³⁶
Workplace scenario: You’re in the middle of a client presentation when a hot flash hits. Your face feels flushed, beads of sweat form, and your blazer suddenly feels stifling. You power through, but afterward, you’re left feeling self‑conscious and distracted. The following morning, after a night of poor sleep, you struggle to focus in back‑to‑back meetings.
Why it matters: Visible symptoms like hot flashes can feel mortifying in professional settings, leading to anxiety about when they might strike next.³⁷ Sleep issues, in turn, erode cognitive performance and resilience. Together, these physical symptoms can create a cycle where exhaustion and embarrassment undermine professional confidence.
What you can do:
Prepare for hot flashes: Dress in layers, keep a water bottle nearby, and discreetly use cooling tools (such as handheld fans or cooling cloths) if needed.
Prioritize sleep hygiene: Maintain a consistent bedtime routine, avoid caffeine late in the day, and create a cooler sleep environment.
Strategize your schedule: If poor sleep is frequent, plan high‑stakes work for mornings, when focus is stronger.
Explore treatment options: Lifestyle adjustments help, but some women benefit from medical interventions, including hormone therapy or non‑hormonal prescriptions.³⁸
Normalize the conversation: If comfortable, share with trusted colleagues or supervisors that you’re managing symptoms—this can reduce stigma and foster understanding.
10. The Opportunity for Growth and Redefining Success During Perimenopause
On a more upbeat note, while perimenopause often feels like a season of loss—of energy, confidence, or ease—it can also be a turning point for growth.³⁹ As hormones shift, many women reassess what truly matters in their work and lives. This can spark deeper clarity around values, priorities, and boundaries, leading to more authentic ways of leading and working.⁴⁰
Workplace scenario: After months of navigating sleep disruptions, brain fog, and fluctuating energy, you realize your old pace is no longer sustainable. Instead of pushing harder, you start rethinking how to delegate, set boundaries, and focus on the projects that actually align with your long‑term goals. Surprisingly, colleagues respond positively, and your leadership feels more grounded than before.
Why it matters: Perimenopause is not a signal of decline. For many women, it becomes a catalyst for reimagining success—not as endless productivity, but as a balance of impact, well‑being, and fulfillment.⁴¹ This reframing not only benefits individual careers but also shifts workplace culture when leaders model healthier ways of working.
What you can do:
Reflect on values: Use journaling or coaching to clarify what truly motivates you at this stage of life.
Redefine success: Shift from external markers (titles, hours, constant availability) to measures like influence, legacy, or balance.
Model openness: When safe, talk about your experience with colleagues to normalize the conversation and reduce stigma.
Leverage wisdom: Embrace the perspective gained from years of experience, and let it guide how you mentor, lead, and influence.
View it as a reset: Instead of resisting change, consider this a natural invitation to design a career—and life—that’s more aligned with who you are now.⁴²
Final Thoughts
Perimenopause is often an invisible chapter of women’s professional lives—rarely discussed, yet deeply impactful. For high‑achieving women balancing leadership, ambition, and personal demands, these changes can feel especially disorienting. But knowledge is power. By naming the shifts, anticipating challenges, and equipping ourselves with strategies, we not only protect our work performance—we also reclaim agency over this transition.
Rather than a derailment, perimenopause can be reframed as a reset: an opportunity to lead with more authenticity, set healthier boundaries, and align work with values. And when women in leadership normalize this conversation, it has a ripple effect—reshaping workplace cultures to be more compassionate, inclusive, and sustainable for everyone.
Further Reading to Empower Your Journey
The Work Shift: A Guide to Menopause for Working Women ★
A workplace-focused handbook for professionals and HR leaders that explores symptoms, accommodations, and strategies for sustaining productivity and inclusion during perimenopause.
What Fresh Hell Is This?: Perimenopause, Menopause, Other Indignities, and You ★
With wit and honesty, Heather Corinna brings perimenopause to life through personal narrative—deconstructing taboos and normalizing the experiences many women share.
Perimenopause Power ★ (Maisie Hill)
A science-based handbook built specifically for navigating hormonal shifts—covers mood swings, brain fog, and symptom management with clarity and compassion.
The New Menopause: Navigating Your Path Through Hormonal Change ★ (Dr. Mary Claire Haver)
A clinically grounded and holistic guide that addresses hormone therapy, nutrition, and lifestyle strategies for thriving during perimenopause and beyond.
The Working Women’s Guide to Menopause: When the Heat Is On ★ (Gail Gibson)
Targeted advice specifically tailored to women balancing midlife transitions and demanding careers, with sharp, work-centric strategies.
Why These Books Are Worth Your Shelf Space
Grounded in research and clinical insight, offering evidence-based strategies (no fluff or pseudoscience).
Relatable stories that validate what many of us quietly experience during this transition.
Actionable tools, from symptom logs to workplace scripts, making it easier to advocate for wellness + productivity.
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