What Perimenopause Can Look Like at Work — Before You Know It's Perimenopause

When perimenopause hit me in my mid-40’s I had no idea why suddenly my joints hurt, why I couldn’t remember action items from my last team meeting, and why I just didn’t feel like myself. If you’re feeling that, here’s the info I wish someone had shared with me when I was 40.

I know I wouldn't have checked every box, but a few years later, when things actually started changing, I might have reached for a different explanation. I simply figured I was burned out and ready to be doing something else.

We talk about menopause like it's a 50s thing — hot flashes, cycle changes, done. But perimenopause can start years earlier, and at work it rarely announces itself with a hot flash. More often, it just looks like a career problem.

Late 30s. You're building — bigger teams, kids, aging parents, the next promotion — and you're not thinking about hormones at all. Then sleep gets weird. Your cycle shifts. Stress hits differently than it used to. You think you need a vacation, or to exercise more, or to get better at managing everything. Maybe you do. But this is the age to start noticing your baseline, so you can actually recognize it later when something changes.

Early 40s. The job you've done well for years suddenly takes more out of you. You reread the same paragraph twice. You're mid-sentence in a meeting and the word you need just isn't there. You know the answer — you just can't retrieve it fast enough, so you start writing more things down. Nobody's told you cognitive changes can come with perimenopause, so instead of “my body is changing,” you think: what's happening to me? This is often where the career impact actually starts — because your confidence in your capability changed, even though your capability hasn’t changed at all.

Mid-40s. Now other people start noticing too. You're quieter in meetings because you're afraid of losing your train of thought. You stop raising your hand for the stretch assignment. Feedback that used to roll off you suddenly doesn't. Your manager reads it as less engaged, less confident, maybe thinking you don't want the next job. You might be reading it the same way, and neither of you knows what's actually going on. This is the pattern that helped me create Spark and what I focus on breaking for others: behavior gets interpreted, interpretation becomes a story, and that story starts making career decisions for you.

Late 40s. “Maybe I should step back.” This is the red flag. By now you've likely spent a few years compensating — working harder to produce what used to come easy, hiding the fog, apologizing for being emotional. Eventually you stop raising your hand. Decide you've lost your ambition. I call this career withdrawal — rarely one big decision, usually a hundred small ones. Deloitte's 2025 global survey backs this up: women reporting menopause symptoms said it had undermined their confidence at work, cost them opportunities, or had them considering leaving altogether.

50s. You may finally understand what was actually happening — which brings relief, and a harder question. What decisions did I make when I didn't know? Did I step back when I didn't need to? But menopause isn't the end of ambition, and your 50s aren't the epilogue. For a lot of women, they're the start of something else entirely.

If you're 35, 38, 40, and reading this thinking that's years away — good. You're exactly who I want reading it. Know your baseline. Pay attention when it shifts. Talk to your doctor. And don't let a change in how you feel quietly become a verdict on who you are.

If you're already living it: give yourself the same grace. See what's changing. Pause before deciding what it means. Ask better questions. Respond with real support. Keep yourself in the room. S.P.A.R.K.

The real goal is bigger than getting women through menopause. It’s keeping their confidence, their ambition, and their careers intact along the way.