The Peri Diary is where the lived experience lives. Not the clinical version, not the sanitised version — the one that happens at 9:30pm when you're holding on by a thread, and the one that asks why men get tube ads and women get silence. These are the stories that needed telling.
"We write because we weren't warned. Because no one told us. Because putting words to the experience is the first step to not feeling alone in it — and because sometimes the truest thing you can do is say exactly what happened."
The Peri Diary is written from inside the experience. It is honest, sometimes raw, and always real. If something here sounds like your life, that's the point. You're not alone. You never were.
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Three in four women don't know perimenopause can trigger a new psychiatric illness. The Royal College of Psychiatrists has finally spoken. It shouldn't have taken this long.
Men, if you're feeling irritable, tired, and have a low sex drive, it's your hormones — at least according to ads plastered across every London Underground station. Read that symptom list again. It's the same one women are told to push through.
I had to leave dinner tonight. Just got up and left while everyone was still waiting for food. They saw someone being rude. They didn't see that my body literally cannot regulate itself anymore.
I had to leave dinner tonight. Just... got up and left while everyone else was still waiting for food that never came.
We'd been at the museum all afternoon — lovely, actually. Then dinner at 8pm. Pre-ordered everything because it was a big group. Should have been simple.
By 9pm, I could feel it starting. That familiar tightness in my chest. The way my hands start to feel shaky. Brain going fuzzy around the edges.
By 9:30, I was holding on. Trying to stay present in conversation while my body was screaming. That specific rage that builds when your blood sugar crashes — not anger at anything, just this wild, primal fury that makes you want to flip the table.
10pm. Still no food. I had to leave.
I mumbled something, grabbed my bag, and walked out. Got on the bus home with my hands trembling and my vision going a bit sparkly at the edges.
Your basic needs become emergencies. Skipping a meal isn't "oh well, I'll eat later." It's your cortisol spiking, your hands shaking, your brain fogging, your rage building until you want to scream at everyone and nothing all at once.
And the worst part? You can't explain it without sounding dramatic.
"I had to leave because I hadn't eaten" sounds like nothing. It sounds like a choice. It sounds manageable.
But "my fluctuating hormones mean my body can't regulate blood sugar properly anymore, so going 6 hours without food sent me into a physical crisis that would have resulted in either a panic attack or saying something I'd regret" — that sounds insane. Even though it's the truth.
Got home. Too late to eat, according to every rule I've ever learned about healthy eating.
Ate anyway. Mixed nuts. Because the alternative was going to bed in crisis mode and guaranteeing I wouldn't sleep.
Couldn't take my supplements because I'd eaten. Another small failure to add to the pile.
Lay in bed, wired and exhausted at the same time. Cortisol still pumping through my system. Fell asleep sometime after 2am.
Woke up at 5:30. Headache. Exhausted. Emotionally raw. Body still recovering from yesterday's emergency.
A cheerful, apologetic message about having a health condition that requires regular meals. Mentioned the museum was lovely. Added an emoji.
Made it sound manageable. Made it sound like a quirk.
Didn't say: "The restaurant's incompetence put my body into crisis mode and I'm still paying for it 12 hours later."
Your needs become invisible emergencies. The world isn't set up for bodies that can't just "push through." And you spend half your energy managing the actual symptoms, and the other half managing other people's perceptions so you don't seem difficult, dramatic, or broken.
I'm not broken.
My body is just operating under different rules now. Rules that the world doesn't acknowledge. Rules that even I am still learning.
And I'm so tired of pretending it's all fine.
I was talking to a friend about perimenopause when she asked me if I'd seen the ads on the tube about "male hormones." She said they were everywhere in the tube stations.
"How come they don't do this for women?" she said. "What about PCOS, or endometriosis, or peri and menopause?"
She was right. The ads were everywhere.
Men, if you're feeling irritable, tired and have a low sex drive, the problem is a lack of testosterone, at least according to adverts plastered across London Underground stations.
"It's not him, it's his hormones," says one such ad from Voy, which promises that you'll "feel healthier, happier and stronger" with a testosterone top-up, but experts told The Telegraph that the claims are "exaggerated, unethical and dangerous".
"Are your men hormones getting the better of you?" says one of the company's ads. "Men get hormonal too," said another. Many clinics are also offering testosterone boosts, with promotional material that is "peppered with photographs of muscular, grey-haired men running athletically along beaches". They promise that testosterone prescriptions can help "low mood, low libido, erectile dysfunction, poor sleep, mental alertness and depression", plus "weight loss and gaining muscle at the gym".
Read that list again: irritability, tiredness, low sex drive, low mood, poor sleep, mental fog, depression.
These are the exact same symptoms women experience during perimenopause and menopause.
But when men have these symptoms, it's a medical crisis worthy of massive advertising campaigns across every tube station in London. Beach-running ads. Promises of feeling "healthier, happier, stronger."
We're dismissed. Gaslit. Not taken seriously.
The double standard is staggering. Men's hormonal health is validated, medicalised, and marketed to. Women's is invisible.
PCOS affects 1 in 10 women. Endometriosis takes an average of 7–10 years to diagnose. Perimenopause can start in your 30s and last a decade. These aren't rare conditions — they're affecting millions of women who are just expected to suffer quietly.
No tube station ads for us. No promises that we'll feel healthier, happier, stronger. Just silence.
"This is why Alinea exists. Because someone needs to talk about it. Because the silence is deafening. Because women deserve the same visibility, validation, and support."
We're not asking for special treatment. We're asking for the same treatment.
Three in four women don't know perimenopause can trigger a new psychiatric illness. That's not a knowledge gap — it's a systemic failure.
Last week, the Royal College of Psychiatrists published its first ever position statement on menopause and mental health. It shouldn't have taken this long. But here we are.
A YouGov poll commissioned by the RCPsych — representing over 20,000 psychiatrists — found that only 28% of women in the UK know that menopause can trigger a new mental illness. Meanwhile, 93% associate menopause with hot flushes. The awareness gap isn't just embarrassing. It has consequences.
These are not fringe statistics. Perimenopausal women are more than twice as likely to develop bipolar disorder, 30% more likely to develop clinical depression, and the risk of eating disorder relapse rises significantly during this hormonal transition. Suicide rates, the report notes, are higher among women of menopausal age.
For women with a history of postnatal depression or premenstrual mood symptoms, perimenopause isn't just a difficult chapter — according to the RCPsych's Dr Cath Durkin, it may represent "a period of particular clinical danger that has historically gone unrecognised."
"I was 35 when I first went to my doctor with symptoms I couldn't explain. For seven years, I was treated for depression while the real cause — perimenopause — went unidentified."
Sonja Rincón, founder of the Menotracker App, via The Guardian
The account published alongside the RCPsych report in The Guardian is the kind of story that should stop you. A woman, 35, presenting with crushing fatigue and low mood. Seven years of antidepressants — adjusted, increased, swapped out — while perimenopause went undiagnosed. "I lost confidence in my own body," she writes, "and even in my own judgment."
She is not an outlier. She is a pattern.
And the pattern is not distributed equally. A UCL study published concurrently found that 58% of Black women in the UK felt completely uninformed about menopause — and that many found the experience "psychologically damaging." More than half reported anxiety, yet significant numbers were misdiagnosed with anxiety or depression rather than perimenopause. As a result, barely one in five took HRT. The information gap compounds the access gap, and both are compounded by race.
The RCPsych is calling for mandatory menopause education in all medical and psychiatric training, workplace policies that address mental health alongside physical symptoms, and urgent government action across all UK nations. These are the right demands. They are also demands that shouldn't need to be made in 2026.
Dr Lade Smith, president of the RCPsych, put it plainly: "Women account for 51% of the population and all will experience menopause at some point. This is a societal issue for everyone. Simply put, we must do better."
At Alinea, we believe that information is the first form of care. That when a woman knows what is happening to her body — really knows, with language and data and other women's stories — she is less likely to spend seven years wondering what is wrong with her. She is more likely to walk into a GP's office and name it. She is less likely to leave without answers.
This report matters. Share it. And if any of it sounds familiar — the fatigue, the low mood, the sense that something has fundamentally shifted — you are not imagining it. You are not broken. You might just be in perimenopause.
Source: The Guardian, 1 March 2026 — Anna Bawden. Data: Royal College of Psychiatrists position statement on menopause and mental health; UCL study published in Post Reproductive Health.
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