Work-impacting anxiety in perimenopause is more common than most women realise — and the vast majority suffer in silence, because there is no language for it in Indian workplaces and no established way to explain to a manager or HR department that your hormones are affecting your ability to function professionally.

What you are experiencing is real and it is medical. Oestrogen withdrawal lowers the anxiety threshold significantly, making ordinary professional situations — meetings, presentations, difficult conversations — feel physiologically overwhelming. The physical symptoms are real too: racing heart, difficulty breathing, a sense of dread that arrives in the morning before you’ve even had time to think about what the day holds.

Please see a doctor rather than trying to push through alone. A gynaecologist can assess whether HRT is appropriate — and for many women, oestrogen stabilisation has a significant effect on anxiety within weeks. A psychiatrist or psychologist can offer CBT (Cognitive Behavioural Therapy), which has strong evidence for perimenopause-related anxiety, or antidepressants if medication is appropriate. Both treatment routes can be used together.

iCall (9152987821) offers accessible, affordable mental health support across India. If you are having thoughts of self-harm at any point, please call 112. You deserve proper treatment for this — it is a medical situation, not a weakness, and it has solutions.