Menopause Masking: The Hidden Cost of Pretending You’re Fine

'Whatever you do, don’t tell your manager - trust me.'

I came across this comment on a menopause forum recently, and it stayed with me.

For many women, menopause is not just about managing symptoms. It is also about managing how visible those symptoms are to everyone else.

You might be sleeping terribly, struggling to find words, feeling more anxious than usual, battling hot flushes or noticing your confidence has taken a hit.

But each morning you still get up and start your day. 

You get dressed. You go to work. You look after children or parents. You join the meeting. You answer the emails.

And you try to look as though everything is completely normal.

That is menopause masking.

What does menopause masking look like?

Masking is the effort we put into hiding what is really going on.

It might mean over-preparing for a meeting because you are worried your concentration will let you down.

Double-checking everything because your memory does not feel as reliable.

Laughing off a hot flush.

Pretending you are 'just fine' after another night of broken sleep.

Or simply deciding not to tell anyone that you think menopause might be contributing to how you feel.

There are understandable reasons why women do this.

International research involving more than 13,000 workers across six countries found that nearly one in 12 women going through menopause reported workplace discrimination. Some believed they had missed out on promotion or pay rises, while others said their symptoms had contributed to them leaving their careers altogether.

Against that backdrop, keeping quiet can feel like the safer option.

But masking comes with its own cost.

Hiding symptoms takes energy too

When you are already struggling, pretending that you are not struggling creates another job. There is the symptom itself, and then there is the effort required to hide it.

The vigilance.

The overthinking.

The internal voice saying. Don't let anyone notice. The shame that should not be there. 

Over time, that can be exhausting.

And perhaps more importantly, masking can stop us getting help.

Many menopause symptoms can be improved. There may be medical treatments, lifestyle changes, workplace adjustments or practical strategies that make a real difference.

But nobody can support a problem they do not know exists. Or one that has been minimised to the point no one else sees it. 

Sleep can make everything feel harder

At The Sleep Project, this is the part we see again and again. Menopause can have a significant impact on sleep.

Hot flushes and night sweats may wake you. Anxiety or racing thoughts can make it harder to switch off. Many women spend hours awake at 2 or 3am struggling to get back to sleep. Others experience pain, restless legs or simply find that their sleep becomes lighter and more fragmented.

Then you have to get up and function the next day.

Poor sleep can affect:

• brain fog

• mood and patience

• confidence

• energy and motivation

• our ability to cope with stress

One of the most unhelpful messages around menopause is that symptoms, particularly poor sleep, are something women simply have to tolerate.

They are not. Sleep can be fixed. And probably more easily than you think. 

That does not mean every difficult night needs treatment or that sleep needs to be perfect. But if symptoms are persistently affecting your sleep, wellbeing or ability to function, it is worth asking for help.

A UCL survey of around 1,600 women found that more than three quarters did not feel sufficiently informed about menopause themselves.

If the people experiencing it do not always understand what is happening, we certainly cannot assume their partners, families, colleagues, or managers do.

If you are masking, where can you start?

You do not have to announce your menopause to the world. But you also do not have to carry everything alone.

A useful first step can simply be to take stock of what has changed.

Ask yourself:

• How am I sleeping?

• Has your sleep changed in the last year or two?

• Are you waking hot, waking early or struggling to switch off?

• What would genuinely make things easier?

  Support does not have to mean dramatic changes. Sometimes small adjustments can make a surprisingly big difference.

• And perhaps most importantly: How much energy am I spending pretending everything is fine?

This Menopause Month, perhaps we need to talk less about coping. Women are very good at coping. Sometimes too good. We need to start with action. 

If you are ready to sleep better, get in touch or start our Retrain our Sleep supported programme today.

Sleep therapies like CBT-I cure insomnia in 70-78%, even when the underlying cause for their poor sleep is menopause. It works as well as HRT, have no side effects and is suitable for anyone who is ready to change their sleep.