Florence’s Story | Before The Change.
Florence is a financial advisor in Toronto. At 44 years old, she’s fairly settled; a rising career, a partner who recently moved in, two cats named Frank and Fiona. Her office hours are mostly regular, though international meetings sometimes keep her up past midnight. It may have been for this reason that her doctor named her recent exhaustion on lifestyle.
But exhaustion was only a part of it. She began to wake up drained, even after a full night’s sleep. Coffee helped for the first hour or two before her mood deteriorated, irritability and impatience that she later described as,
“a brain fog I couldn’t think through”
Doing her due diligence, Florence booked an appointment, fairly sure that something was wrong with her body. She was told that it’s likely stress, either from work or adjusting to her new living space. That the hum of anxiety was just a temporary symptom. Meticulous by habit, she began logging her own symptoms, tracking dates and patterns that included, but weren’t limited to, anxiety.
One month later, at her second appointment, the answer hadn't changed.
Rest more.
Take a few days off.
It's probably just stress.
Perimenopause is the transitional phase into menopause. It typically begins in a woman’s mid-40’s and can cause fluctuations in oestrogen and progesterone levels for the next decade. This causes significant changes to mood, sleep, and cognitive function.
By her third visit, the fog, anxiety, and mood swings still hadn’t changed. Florence then brought up the idea of perimenopause herself. She was told that there wasn’t much to suggest a hormonal cause to her physical symptoms, and that it was more likely to be signs of depression or anxiety.
This exchange is common enough, a woman raises a hormonal explanation and is redirected toward a mental health diagnosis instead. One woman in an Australian survey described spending six years attributing her symptoms to perimenopause and menopause, without a single doctor over that time ever raising it as a possibility themselves.
“I would burn out so fast. I knew it was abnormal for me and fortunately I had a log of my symptoms to prove it.”
What Florence Wishes She Knew
These are the medical texts that influenced this narrative if you would like to take a closer look at the complexities of female healthcare
#EndGenderBias Survey Detailed Report. (2024). [online]
A national survey on gender bias in healthcare found that over half of women who reported bias in their medical treatment felt it was due to their gender, and over 70% felt unheard by clinicians. It supports Florence’s experience with repetitive appointments and clinical advice.
An online survey of 947 perimenopausal women found that over 90% had never been taught about menopause at school, and more than 60% felt ill-informed regarding the most common of symptoms such as mood swings, brain fog, and fatigue. These symptoms shaped Florence’s experience and hint at a larger conversation regarding menopause and education.
Of 80 Australian clinical guidelines, 46 made no mention of gender at all. Therefore, gender gaps are embedded in the guidelines that clinicians rely on.
A BMJ editorial on medical misogyny reports that nearly 1 in 10 women see their GP more than 10 times before receiving proper support for menopausal symptoms. It provides real data for the repetitive narrative that Florence lives through, an early stage of this pattern.
This editorial piece calls for more recognition of the stigma and gendered ageism that surround menopause. The dismissal that Florence faces in this narrative reflects this lack of information, support, and medical treatment during a natural life stage.