When Menopause Masquerades as Poor Performance: A Call to Reframe Capability

 When Menopause Masquerades as Poor Performance: A Call to Reframe Capability

It usually begins with something subtle.

She starts arriving a few minutes later than usual. Her notes might be more scattered, her words slower to find. A team member mentions that she’s “snappy” in handovers. She sighs in meetings. She rubs her temples. One day, she forgets an important detail that would normally be second nature.

Then the whispers begin.

“She’s struggling.”
“Something’s off.”
“Is she okay?”
“Maybe this job is too much now.”

But what if the question isn’t about performance at all?

What if it’s about perimenopause or menopause, and we’ve never been taught to recognise it?

The Invisible Pause

Despite all the awareness campaigns and headlines, menopause remains largely invisible in the workplace. And yet, it’s not a rare experience. It’s universal for those who menstruate and reach midlife. It’s not “just a phase” or a list of symptoms on a pamphlet. It’s a full-body, full-being transformation—a neurological, physiological, and emotional transition that can last years.

And yet, for many women, it plays out silently beneath fluorescent lights, in team meetings, shift patterns, and performance reviews.

As a nurse, social care leader, trauma-informed educator, and someone who has lived through the fog, I can tell you: menopause can feel like losing parts of yourself in real time.

But when this happens in the workplace, especially in high-responsibility roles, the changes are often misinterpreted as a failure to cope, a drop in standards, or the dreaded label of "not being resilient enough."

What the Workplace Sees vs. What’s Really Happening

Here’s what employers and colleagues often notice:

• Forgetfulness
• Lowered concentration
• Increased emotional sensitivity.
• Reduced stamina
• Changes in communication style
• Absence from work or medical appointments
• Loss of confidence

And here’s what’s often whispered in response:

• “She’s becoming unreliable.”
• “Her performance is inconsistent.”
• “She might not be suitable for that promotion.”
• “We need to keep an eye on her.”

But beneath that observable surface, the lived reality for the woman might include:

• Insomnia due to night sweats and temperature changes
• Mood swings driven by oestrogen and progesterone fluctuations.
• Cognitive fog that turns words to static
• Increased anxiety, often for no obvious reason
• Pain, joint stiffness, or headaches
• A loss of identity and confidence that makes her question everything.

This isn’t a failure of performance.
It’s a failure of recognition.

Somatic Insight: What the Body is Holding

In trauma-informed and somatic terms, menopause is not just a hormonal shift—it is a systemic shift. The nervous system recalibrates, often entering heightened or blunted states of activation. For many, it can feel like living in a constant loop of fight, flight, freeze, or fawn, without the vocabulary to name it or the space to express it.

And when the body is dysregulated, performance suffers, not from a lack of skill or will, but because the internal experience is disorganised and overloaded.

What’s worse is that many women don’t connect the dots themselves. They feel as if they’re deteriorating. That they’re “not coping.” That something is wrong with them.

Now imagine trying to carry all of that and being told you’re underperforming.

The Shame Spiral

When menopausal symptoms are met with performance reviews or support plans instead of understanding, a silent shame spiral begins.

The woman may begin to doubt herself:
“I’ve always been good at this—what’s happening to me?”
“Why can’t I focus anymore?”
“I’m no good to anyone.”

If left unaddressed, this spiral can lead to:

• Early retirement or resignation
• Loss of confidence and identity
• Missed promotions and stalled careers.
• Worsened mental health.
• Increased use of antidepressants or anxiolytics (instead of appropriate hormonal or holistic support)

And let’s not forget, many women going through menopause are at the height of their careers and have years of wisdom, experience, and mentorship to offer. The system loses them just when they could be leading others through it.

What a Trauma-Informed, Menopause-Aware Culture Looks Like

When we apply a somatic and trauma-informed lens to menopause in the workplace, we don’t just adjust workloads or turn down the thermostat. We begin by asking better questions:

• What does this person need to feel safe in their body and their role?
• How can we make space for physical and emotional fluctuations without judgement?
• What does flexibility look like in practice, not just policy?
• How do we move from silence to support?

Here are some real, practical steps:

1. Create Safe Conversations

Train managers in trauma-informed and menopause-aware communication. Normalise asking, “How are you really feeling?” and “Would adjustments be helpful?”

2. Policy That Names Menopause

Include menopause in absence, performance, and well-being policies. Don’t bury it under generic terms like "women’s health" or “stress.”

3. Risk Assessment Matters

Just as we assess for physical hazards, we must assess for invisible ones too—like temperature control, uniform discomfort, fatigue, cognitive load, and emotional labour.

4. Flexible Structures

Consider job-share options, altered shift patterns, or reduced hours during particularly intense symptom phases. Menopause doesn’t last forever, but burnout might.

5. Leadership That Leads By Example

Encourage senior leaders to speak openly about their menopause journey, including the messy, vulnerable bits. Visibility smashes stigma.

Let’s Talk About Intersectionality

Not all menopause experiences are the same. Some start early due to surgery or medical treatment. Some happen in silence because of cultural shame. For trans men and non-binary people, menopause may be further complicated by gender dysphoria and lack of inclusive language or support.

And for Black, brown, or mixed-heritage women (like myself), there are often layers of generational silence, cultural expectation, and racialised perceptions of strength that make disclosure even harder.

A truly trauma-informed, inclusive response must recognise all of this—not just the biology, but the identity, culture, and context that shape a woman’s experience.

Final Thoughts: Reframing Capability

What we often view as “performance concerns” in midlife women are frequently the unseen cost of an unsupported transition.

The tragedy is not just that we lose experienced, compassionate women.
It’s that we often push them out just when they need support the most.

It’s time to stop conflating symptoms with shortcomings.
To stop mistaking nervous system dysregulation for disinterest or decline.
To stop placing the burden of coping on women alone.

Instead, let’s reframe capability as contextual, support as leadership, and menopause as a moment for community, not judgement.

 

When you make space for women to regulate, they will rise.

And they’ll take others with them.

With love Caron 💜💗