“What’s wrong with me?” is a question that I’m hearing more and more from women in their midlife. What fascinates me is how often they are convinced that they must be doing something wrong. These women describe having felt confident and capable before, but now they’re overwhelmed, doubting themselves and unsure who they are. Relationships feel harder and intimacy changes. They’re trying to understand why things they once took in their stride have become so difficult, often blaming themselves before we’ve even explored what might be happening.
Common questions women ask are around whether it’s burnout or perimenopause, hoping for an explanation that will help them feel like themselves again. Going through midlife myself has given me a deeper empathy for that feeling of losing your sense of self, questioning your worth and measuring yourself against other women who seem to have it all together. They often come asking, “What’s wrong with me?” but as we talk, another question begins to emerge: “Who even am I now?”
When a woman tells me she’s overwhelmed, I want to know what her day involves. Perhaps she’s getting children out to school before work, ordering a parent’s prescription in her lunch break or remembering whether there’s anything in the fridge for dinner. For a woman without children, it might be work, caring for relatives, supporting a partner or managing everything alone. When so much of your time goes into meeting other people’s needs, eventually, you may struggle to say what you enjoy or want for yourself, especially if being the person everyone relies on has become how you measure your worth.
Perimenopause can affect confidence through changes in mood, anxiety, disturbed sleep and difficulty concentrating. Physical symptoms can also affect how comfortable you feel in your body. These symptoms need assessment and a discussion about suitable treatment, including HRT where appropriate.
It isn’t all your hormones, though. Depression, anxiety and other health problems, such as thyroid disease or anaemia, may need considering depending on the symptoms. Understanding what is happening at home and work is also part of that.
It can be difficult to feel comfortable in a changing body when you’re judging it against how you used to look or how another woman looks now. What strikes me is how easily a change in appearance, whether that’s looking older or carrying more weight around your middle, becomes another thing to blame yourself for, as though you’ve let yourself go. When you’re already questioning who you are, feeling less at home inside your own body can add to that uncertainty.
By midlife, many women have spent decades building their expertise and work may be somewhere they feel valued beyond their responsibilities to others. If they begin doubting themselves there, it can shake an identity they’ve built over years, particularly when other parts of their lives are changing too.
Vaginal dryness or pain may make sex uncomfortable, while stress, exhaustion, medication and relationship difficulties can affect desire. Intimacy can feel like yet another demand when you’re desperate for time to yourself, leaving you feeling guilty because you still love your partner. There are physical symptoms we can treat and conversations couples may need support with.
Meanwhile, the roles that have helped define you may be changing. Children need you differently, parents need more care, or work no longer gives you what it once did. Illness, bereavement, a relationship ending or a future that looks different from the one you imagined can leave you wondering where you fit.
By midlife, a woman may have spent years being valued for how much she does for everyone else, so asking what she wants can feel surprisingly difficult. What worries me is how readily many women see that uncertainty as something wrong with them. How much space have they had to actually be themselves when so much of their time has been shaped around other people’s needs? I find it hopeful when women begin to question those expectations, and I’d like us to make it easier for them to express their needs without feeling they’re letting someone down.
If you recognise yourself here, please tell your GP what has changed and how it’s affecting you. Notes about your sleep, mood, periods and symptoms can help when it’s difficult to explain everything. Mention changes in intimacy or feeling you’ve lost your sense of worth too, because these help us understand what support you need.
When you find yourself asking “What’s wrong with me?”, take a moment to ask “What’s been happening to me?” too. Changes in your health, relationships and responsibilities can affect how you feel about yourself, especially when you’ve been trying to manage everything without enough support. You deserve help making sense of it, and you’re allowed to question what you’ve always accepted and decide what you need now.