I've never loved public speaking, but since hitting perimenopause, it's turned into a full-blown phobia. How do I navigate this with a job that requires me to present to my team from time to time?
I hear you! The other day, I was trying to impress a handsome fellow Scandinavian, telling him I regularly go skiing in Norway and when he asked me where, I went bright red and simultaneously felt an icy wind blowing in the empty space between my ears. The word Hemsedal had temporarily completely disappeared… despite visiting the resort twenty times over the last two decades.
It's actually yet another example of female resilience that we continue to show up and speak up during the menopause transition. It's a sad and oft-cited fact that one in ten women leaves their job during menopause, and this is in no small part due to the decline of that pesky hormone oestrogen that we rely on so much.
Why do we lose confidence in perimenopause?
You don't specify why you think you've developed your 'phobia', but low oestrogen can definitely add to the plummeting of confidence that frequently accompanies this time of life.
As if it wasn't enough to be navigating hot flushes, insomnia and all the other surface symptoms of midlife hormonal turbulence, to top it all, our brain starts to let us down.
Brain fog is a benign word for the confidence-sapping memory loss that can occur where we lose our train of thought entirely or struggle to find the right word. Feeling as though you are functioning through a head full of cotton wool makes speaking up at a friend's dinner, let alone your annual conference, extra stressful. On bad days, I struggle with a one-on-one!
Other symptoms of perimenopause that might exacerbate feelings of insecurity include insomnia and night sweats. There's nothing like lack of sleep to rob you of your cognitive skills and make your heart race at the very thought of speaking out loud.
Hot flushes and public speaking
Hot flushes – that most famous of menopause symptoms - can be hard to navigate in a public setting. Many women have told me that they are far more likely to have their faces streaming with sweat when pressure mounts. Thankfully, these days you won't be laughed off the podium for mentioning a hot flush and you'll find a much more sympathetic audience for menopause symptoms. My policy, which isn't for everyone, has just been to own it; "Oops, there goes my brain fog!", or, "Is there air con in here? I'm fit to melt".
Banishing shame
The most important thing to remember is that there is nothing to be ashamed of about navigating menopause. Thankfully, all these issues can be eased.
1. CBT
When making my BBC television programme The Truth About The Menopause, I interviewed women with catastrophic hot flushes, and was heartened to discover how Cognitive Behavioural Therapy, or CBT, can offer respite.
I was initially dubious about CBT, finding the suggestion that women can THINK their way out of menopause (i.e. it's all in our minds), pretty insulting. But there is compelling data showing that CBT techniques can reduce the impact of some symptoms. There's a helpful fact sheet on the patient arm of the British Menopause Society website and the NHS offers some talking therapy courses specifically for menopause (look on nhs.uk for self-referral).
2. HRT
HRT is the easiest way to alleviate the majority of issues if you are able to use it. It's the NICE first-line treatment for many symptoms of menopause, including depression (which can affect confidence).
3. Lifestyle habits
I also think that yoga, breathing, mindfulness and meditation all might sound a bit wishy-washy but they really can be beneficial in calming frazzled minds and have some good evidence.
4. EFT
Something I came across when researching my US book, Menopause is Hot, is what's known as tapping or EFT – Emotional Freedom Technique - and I have friends who swear by it to reduce stress.
It's based on Chinese Medicine, and a 2021 study concluded that tapping for eight weeks significantly reduced the mean score for depression in postmenopausal women. Dr. Jill Wener, whom I interviewed for the book, has created easy-to-follow YouTube videos on tapping. You feel like a fool, but honestly, give it a go.
5. Make time for you
And look after yourself. This is frequently a period of time when we are being tugged in all directions; kids, parents, domestic and work, so making sure you ring-fence your own needs is essential and will help ensure your confidence returns in other areas.