Puberty in reverse: inside the powerful Front & Female conversation on menopause and perimenopause

She was equally clear that the symptoms of this transition are far broader than popular understanding suggests. Beyond hot flushes and night sweats, Damodaran described joint pain, sleep disruption, mood changes and a profound internal shift: “We women lose ourselves, in terms of what is happening inside.” She explained bone loss, cardiovascular changes and accelerated organ ageing are all part of the picture and that perimenopause. “The red flags would be any change from the norm that you notice, and we have to listen to our body.” The transition period leading up to menopause, can begin as many as seven to ten years before a woman’s periods actually stop.

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It was Vengadasalam who turned the spotlight on the psychological dimension, noting it is frequently misunderstood even within the medical profession. “Sometimes I call it puberty in reverse,” she said. “Things that never bothered you before start bothering you. Even stable friendships can feel very disrupted.”

She described how highly capable women would arrive at her clinic presenting with new anxieties, panic attacks, erratic sleep and an unsettling inability to concentrate, often without any idea that perimenopause was the underlying cause. “They are so much more easily overwhelmed, or there’s increasing sensitivities,” she explained, noting that these women were sometimes mistakenly referred to cardiologists or other specialists, with menopause never entering the diagnostic conversation.

“You may also see transient low moods, a loss of pleasure or a sense of not being able to keep up with the social energy of the room. Fatigue can come in, and many women don’t realise that these could be the earliest signs of menopause,” Vengadasalam added. Changes to executive function, that is the ability to plan, organise and make decisions, were also a telling early marker. “A woman’s role is so tied up in running a household, caring for ageing parents or children leaving home. It’s a time of a lot of life changes, and that’s when women tend to feel very overwhelmed.”

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The conversation shifted to a quietly alarming reality: the toll menopause takes on women at the height of their professional lives. Damodaran revealed that a significant portion of women are experiencing menopausal symptoms at work. Within that subset, “women have either thought about stopping work, taking time off or have actually put in their resignation letters.”

She described female CEOs standing up to address their teams and forgetting names, experiencing hot flushes mid-presentation or keeping spare clothing at the office due to excessive sweating. “That leaves them less confident,” Damodaran said. “The anxiety comes in because they are now surrounded by younger generations dismissing them as old. Even bosses may not understand that here is a woman just trying to show her worth.”

Damodaran’s prescription for employers boils down to basic human decency. “You just need to listen,” she said. “Simple things, like work from home policies or being able to take time off and return. A kind, empathetic way of handling it will play a big role, because women just need to be heard.”

Vengadasalam added that the temporary nature of symptoms was a crucial message. “It’s important for people to know symptoms are temporary, often coming in waves, but it will not last forever.” She emphasised the importance of being aware, and reaching out to mothers, sisters, cousins and other women to not feel alone in the experience.

“Women in the workplace need to discuss menopause, not to fear it but be able to experience the transition in the healthiest way possible while supporting one another. Things like body image, fear of weight gain are very real fears as is grieving a loss of self,” Vengadasalam said. “Women need to be sisters to one another, kind and respectful during this time.”

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Damodaran advised caution against sourcing information on social media. Vengadasalam further noted: “A lot of countries have regulated national menopause forums and websites.”

No experience is the same. “Every woman is different, and generalisations cannot be made about what any one woman may go through in menopause. It is determined by life’s stressors at that particular time,” Damodaran also said. “You need to see your doctor, because you may assume a treatable thyroid disorder might be a symptom of menopause. But if you do need hormonal support, then you need it to be well.”

Both doctors closed with advice that was personal and practical. Damodaran urged women to resist comparison and silence. “Listen to your body,” she said. "It is not a failure to ask for help.” Vengadasalam’s counsel was gentler still: a reminder that grace, during this season of life, is not a luxury but a necessity. “Pace yourself. Prioritise sleep, movement and strength, one at a time. Find what works for you and do that. Giving yourself a lot of grace is needed at this time.”

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