Perimenopause and menopause can take you by surprise, disrupt your day, and make you feel like your body isn’t your own. Add a hectic work schedule to the mix, and it’s easy to feel like you’re barely keeping up. As more women speak openly about these transitions, many realize they need tried-and-true strategies to thrive at work and not just survive another day.
“During perimenopause and menopause, fluctuating and declining estrogen impacts both the body and the brain in very real ways,” Jessica Shepherd, MD, board-certified ob-gyn and advisory board member-women’s health and longevity at PVOLVE, tells SELF. Women may notice changes in energy and stamina, along with shifts that affect everything from comfort at a desk to physical resilience during long workdays. And it’s not just physical—cognitive changes are common too.
“Many women report brain fog, slower word recall, difficulty concentrating, or feeling less sharp when multitasking,” Shepherd notes. These changes aren’t a reflection of motivation, intelligence, or capability, they’re normal biological transitions. “When unsupported, however, they can quietly impact productivity, confidence, and day-to-day performance at work.”
The good news: symptoms during this stage respond well to intervention. “Hormone therapy, targeted nutrition, and consistent strength-based exercise have all been shown to significantly improve mood, memory, energy, and overall cognitive performance.”
Here, four working women share their top strategies for managing perimenopause and menopause on the job. Read on for small changes you can make today to boost both your health and professional performance.
Plan around your energy
As she navigates perimenopause, Natalie Trice, 51, of Tiverton, England, has stopped treating symptoms like a personal weakness—and started planning around them instead.
“One of my biggest shifts has been to stop seeing symptoms as a personal failure and accept them as a fact of life that I have to plan around,” the publicity firm founder tells SELF. “Brain fog and fatigue are real, so I build in thinking time before meetings, avoid back-to-back calls, and leave at least 30 minutes between them to get outside and reset. When I travel, sleep is nonnegotiable. I choose quiet hotel rooms, bring my supplements and snacks, and use Notion to offload everything—from to-do lists to travel details.”
Heather Hirsch, MD, a physician and author of The Perimenopause Survival Guide, says Natalie’s approach is strongly supported by research. “Strategic breaks, limiting cognitive load, and proactive planning protect executive function and stress recovery,” she tells SELF. “Offloading mental clutter and building intentional reset time into the day are powerful tools during hormonal transitions.” Hirsch suggests adding short movement breaks or light stretching to further boost circulation and mental clarity.
Design your workday round your peaks
As a therapist in private practice in Wilmington, North Carolina, Kiki Jacobson, 41, is used to helping others regulate their emotions—but perimenopause forced her to rethink how she structured her own workday.

