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Tara Loader Wilkinson

For most women, menopause – the stage in life when monthly periods stop and the ability to get pregnant ends – starts between the ages of 45 and 55.
For about one per cent of women, however, premature menopause kicks in before the age of 40. Globally, that is about 5.8 million women between the ages of 30 and 39.
Claire Blackshaw was among them. She was 32 and enjoying life in Hong Kong when, she now realises, she first experienced signs of premature menopause.
When Blackshaw got her diagnosis seven years later at the age of 39, it was too late to have children.

She feels deep “grief and frustration” over this and wants to save others from a similar fate. “I feel passionate about communicating my story to younger women to help them spot the signs of premature menopause,” she says.
Premature menopause is also known as primary ovarian insufficiency.
One of the first symptoms Blackshaw – who was the public relations director for a luxury hotel in Hong Kong at the time – recalls was hot flushes when she spoke during meetings.
“I remember them creeping up the back of my neck. I thought it was anxiety and embarrassment, or maybe even humidity,” she says.
She experienced other perimenopausal symptoms when she returned to the UK in 2014, including frequent brain fog, anxiety and recurrent periods of low mood and low confidence.
I would love to see girls and women better understand the power of hormones, to recognise symptoms
Claire Blackshaw
She put them all down to depression, which she had been diagnosed with in her early twenties.
In March 2020, during a bout of Covid-19, she developed new symptoms: severe night sweats, incontinence and itchy skin. She was diagnosed with long Covid.
Other symptoms arose, including debilitating joint ache, increased anxiety, a racing heart and frequent suicidal thoughts. She was treated with antidepressants and beta blockers, and offered sick notes for time off work along with talk therapy.
From November 2020 until January 2021, while staying with her parents in the UK, she felt she could barely make it through each day.

“I would push myself to lunchtime and thought, if I can get to lunchtime, then I can get to the evening; if I can get to sleep, I can get some peace. But I would be terrified of going to bed because I knew I would wake in the depths of darkness and have suicidal ideation.”
To get through what she calls the worst days of her life she kept a diary, rating her feelings from one to 10, “One being suicidal and 10 being optimistic. Throughout that whole time, each day I was between a one and a four.”
Blackshaw was continuously treated with antidepressants. She says she battled with the side effects of the drugs and questioned whether depression was the sole reason for her low mood.
“I always had an instinct there was something more to it and was convinced it was related to my underactive thyroid. Although that was medicated, it seems I was close to the answer all along.”
Our medical training, specifically in perimenopause, was lacking … Many women are unaware of it
Laurena Law, a Hong Kong-based doctor who became a perimenopause specialist
The thyroid plays a critical role in the endocrine system, the body’s network of glands and organs that produce, store and release hormones. In women the ovaries – which produce the hormones oestrogen and progesterone – form part of this system.
Blackshaw took antidepressants but her hormonal issues were not treated until later. She later realised the depression resulted from an intolerance to the hormone progesterone, which occurs in 10 to 20 per cent of women.
However, although doctors had asked Blackshaw about her menstrual history, her blood was taken for testing only after she paid for private healthcare at a women’s clinic in London to freeze her eggs.
She was found to have extremely low amounts of follicle-stimulating hormone – which meant there was almost no chance of retrieving even a single egg during in vitro fertilisation (IVF).
Doctors recommended hormone replacement therapy (HRT) to protect her reproductive organs should she opt to try IVF with a donor egg.

Today Blackshaw, who is now based in London and leads the global PR team for a multinational corporation, feels more like herself thanks to HRT.
Because of her progesterone intolerance, though, she is considering having a hysterectomy.
While she comes to terms with that and not being able to have biological children, she is keen to help others prepare for their future.
“I would love to see girls and women better understand the power of hormones, to recognise symptoms and work in harmony with their bodies,” she says.
Blackshaw’s story is extreme but not unique.
Hong Kong-based doctor Laurena Law began to specialise in perimenopause treatment after she started experiencing symptoms five years ago. At the time she could not find anyone with the expertise to properly help her.
“I realised our medical training, specifically in perimenopause, was lacking … Many women are unaware of it,” she says.
In the past few years awareness around the subject has grown, particularly within some corporations that are establishing menopause policies.

Standard Chartered’s medical benefits for employees now include coverage for treatment of menopause-related symptoms. Insurer AXA also has a menopause benefits system for employees.
“As a result women may now be more open to talking about it,” Law says.
In 2024, Hong Kong’s first menopause festival, called What the Fog, took place. It is set to return on October 17, 2025, after a positive reception from attendees and sponsors.
When it comes to treating perimenopause and menopause, Law recommends adopting what she calls a “Mediterr-Asian” diet: “swap the red wine polyphenols for tea and spices, eat vegetables, fruit and whole grains, and omega fatty acids, and prioritise protein.”
She advises eating one gram of protein per kilogram of body weight a day to maintain muscle mass.
Law also recommends resistance training at least twice a week, targeting the back, legs, chest and core, as well as sleep optimisation, reducing toxic substances such as alcohol and nicotine, relaxation therapies and keeping a supportive community around you.
Traditional Chinese medicine (TCM) also has some answers. Hong Kong-based TCM practitioner Elizabeth Yau says about half of her patients seek help for perimenopausal symptoms.

From a TCM perspective three main factors affect perimenopause. These include a deficiency of qi – or energy – from birth, or resulting from chronic illnesses, an excessive workload or frequent late nights.
Secondly, poor lifestyle habits, including overconsumption of cold or raw foods, can have a negative effect. Thirdly, Yau points to high stress levels, which can lead to an earlier onset of menopause.
To reduce perimenopause symptoms Yau advises against overworking, to eat foods such as black sesame seeds, walnuts and dried longan, and limiting raw or cold food intake.
She also suggests prioritising sleep and having regular acupuncture to support overall wellness.
Certain herbal remedies are beneficial for hormonal imbalance. Angelica sinensis (female ginseng), rehmannia root and white peony root are some of the commonly used ones.
“With care, ovarian ageing may be temporary and improved,” Yau says.
If you have suicidal thoughts, or you know someone who is, help is available. For Hong Kong, dial +852 18111 for the government-run “Mental Health Support Hotline” or +852 2896 0000 for The Samaritans and +852 2382 0000 for Suicide Prevention Services. In the US, call or text 988 or chat at 988lifeline.org for the 988 Suicide & Crisis Lifeline. For a list of other nations’ helplines, see this page.
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Menopause kicks in before 40 for one per cent of women. Photo: Shutterstock 

Claire Blackshaw put her perimenopause symptoms down to  depression and other issues. By the time her condition was diagnosed, it was too late to have children. She wants other women to avoid what happened to her. Photo: Claire Blackshaw

Blackshaw did not at first put her hot flushes and anxiety down to menopause. She is passionate about sharing her story with other women. Photo: Claire Blackshaw

Blackshaw in the UK, where she is now based. She went through her darkest days there, but now feels more like herself again. Photo: Claire Blackshaw

A woman applies a hormone replacement therapy patch to her stomach. HRT helped Blackshaw with her depression and other symptoms. Photo: Getty images

Hong Kong-based doctor Laurena Law began specialising in perimenopause treatment after she started experiencing symptoms five years ago. Photo: May Tse

TCM practitioner Elizabeth Yau says half her patients see her for treatment of perimenopausal symptoms. Photo: Elizabeth Yau

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Charlotte Chan, who overcame depression and anxiety and volunteers in youth mental health projects in Hong Kong. Photo: Charlotte Chan.

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Chan (second right) joined Weez Walk in 2022. Photo: Charlotte Chan

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Studies suggest eating more fruit, vegetables, whole foods and those containing antioxidants and the right fats helps women  avoid brain fog as they transition into menopause. Photo: Shutterstock


Marketing consultant Aparna Rao says the natural transition to menopause, perimenopause, has caused a lack of focus, general cloudiness of mind and sluggishness in thinking over the last two years. Photo: Aparna Rao

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Lisa Mosconi is an associate professor of neuroscience and director of the Women’s Brain Initiative at Weill Cornell Medicine, in New York. Photo: lisamosconi.com 

To fight brain fog, ensure your diet includes the right kinds of fats, such as extra virgin olive oil, avocados, nuts and seeds. Photo: Shutterstock

Antioxidant-rich foods can help protect brain health, especially in perimenopause. These include hot and sweet red peppers, artichokes, broccoli, cauliflower, kale and Brussels sprouts. Photo: Shutterstock

Fruit and berries, especially blueberries, mulberries and blackberries, are rich in phytonutrients, fibre, and antioxidants that support gut and brain health. Photo: Shutterstock

Metabolic health coach Krithy Bopiah advises consuming traditional, familiar foods to protect brain health. Photo: Krithy Bopiah

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Hot flushes linked to menopause can cause significant anxiety in women. A new app that harnesses the power of hypnotherapy has been developed to help women track and manage hot flushes and other symptoms associated with menopause. Photo: Shutterstock

Christine Deschemin is the founder of the Renewed Edge Hypnotherapy & Counselling Centre in Hong Kong. Photo: Kylie Knott

The EverCalm app was tested by asking women to share some of their symptoms. Photo: Renewed Edge Hypnotherapy & Counselling Centre

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The EverCalm app helps women track and manage their menopause symptoms. Photo: Renewed Edge Hypnotherapy & Counselling Centre

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Lifestyle

Health & Wellness

Health

Claire Blackshaw was working in Hong Kong when, undiagnosed, symptoms of early menopause began. Now she’s out to help women see signs of it


Claire Blackshaw was working in Hong Kong when, undiagnosed, symptoms of early menopause began. Now she’s out to help women see signs of it.


Reproductive health

Disease

How to age well

Mental health