Sally Williams spent three years struggling with deteriorating mental health and a disintegrating personal life before discovering that perimenopause was the underlying cause. During that period, she was admitted to hospital eight times across separate stays totalling almost 11 months, left her finance job, became separated from her teenage son, and found herself in life-threatening situations—all while doctors initially attributed her symptoms to depression rather than hormonal change.
"No one joined the dots," Williams said. "It was only me... I joined the dots and it was transformational to start hormone replacement therapy and literally come back to life."
Williams, from the Wychavon area, later self-diagnosed after recognising the connection between her symptoms and perimenopause. She now advocates for greater awareness of this transitional phase, which she describes as a critical but often overlooked period in women's health.
What is perimenopause and why is it misunderstood?
Perimenopause is the years leading up to menopause, typically beginning around age 46, during which women continue to menstruate while experiencing menopause symptoms. The condition can manifest as anxiety, mood swings, brain fog, hot flushes and irregular periods. Many women find that hormone replacement therapy (HRT) helps alleviate these symptoms, though it is not suitable for everyone.
According to research cited by Wychavon District Council, women experiencing perimenopause are significantly more likely to report suicidal thoughts and experience depression and anxiety—a connection that remains poorly understood by many healthcare professionals.
How did Williams's symptoms develop and what was the impact?
When her symptoms began in her late 40s, Williams consulted doctors who initially suspected depression. Her symptoms started in 2018 with anxiety, panic attacks and insomnia, escalating to multiple suicide attempts. One particularly severe incident left her in a wheelchair for three months following polytrauma, an experience compounded by the isolation of the Covid-19 pandemic.
"I had multiple attempts on my life, two significant ones, one where I was in a wheelchair for three months for polytrauma, and this was in Covid, so there were no visitors. I had no contact with anyone," she explained.
The toll on her family was profound. Williams left her job during the perimenopause period and became increasingly isolated, withdrawing from friends and family for three years. Her teenage son, unable to receive the care and attention he needed, eventually left school and moved in with his father.
"I lost my job. I didn't see my friends, my family for three years and I was a recluse. I was self neglecting. And my son, who was in his teens, I probably saw him three times. He had leave his school and his friends and he had to go and live with his dad because he couldn't see me. I couldn't care for him."
Williams described herself as
"unrecognisable"before her diagnosis, a transformation that underscores the severity of perimenopause when left undiagnosed and untreated.
What role did HRT play in her recovery?
After recognising the possible cause and starting HRT, Williams's mental health improved within months. HRT works by topping up and stabilising oestrogen levels, sometimes in combination with a synthetic or bioidentical version of progesterone. However, Williams emphasised that while HRT proved transformational for her, it may not be suitable or effective for all women.
"I think men need to come into the conversation as well, and I'm not just talking husbands and partners, I'm talking sons," she said. "It was devastating and there's relationships that have been broken that will never be put back together. I'm very sad about that."
Why does Williams emphasise the perimenopause years as critical?
Williams is vocal about reframing how society understands the menopause transition. Rather than viewing menopause itself as the danger zone, she argues that the years leading up to it—what she calls the
"run up, it's the 45 to 54"—represent the period when women are most vulnerable to severe mental health crises and life disruption. This perspective challenges the common assumption that menopause is the primary concern, when in fact the perimenopause phase may pose greater risks.
Her advocacy has gained traction locally. Wychavon District Council made women of perimenopausal age a priority group in its Wellbeing in Wychavon programme in April 2026, where Williams now volunteers as a peer mentor. Additionally, Williams is contributing to a Royal College of Psychiatrists book intended to improve understanding of the link between hormones and mental health.
What public awareness activities is Williams undertaking?
Williams is scheduled to speak about her experience at Meno Fest on 7 October 2026 at Worcester Rugby Football Club as part of Menopause Awareness Month. The free event aims to help attendees understand how perimenopause and menopause affect every aspect of life, from physical and mental health to relationships, work and family dynamics.
Prior to that, a Wychavon "Story of Hope" workshop featuring Williams was held on 28 April 2026 at Watersedge in Bishampton, open to the public and to health and support professionals seeking to deepen their understanding of perimenopause and its mental health implications.
What support is available?
If you have been affected by the issues in this story, help and support is available through appropriate health services and support organisations.
