I had a baby at home and a toddler. I was waking at two in the morning, then three, then sometimes not getting back to sleep at all — and not, or not only, because the baby was waking me. The waking was internal. I would lie in the dark with my mind running. My period had stopped, then returned, then come irregularly and much heavier than it had ever been. I lost over twenty kilograms — close to fifty pounds — in a stretch of time that no diet or training programme could have explained. I had a kind of anxiety I had not known I was capable of. My stomach had its own opinions about everything I ate.

I was also, at the time, in what I would now describe as an emotionally toxic cycle with the father of my children. I was postpartum from my second. The cycle had been running for over a year by the time my body started speaking to me in the language of the menopausal transition, and I — already enthusiastically in the longevity space, tracking my biomarkers, reading the literature — concluded I was probably in perimenopause.

I want to be honest about that. I was paying close attention. I was getting labs run. I was in the data in a way most women never get to be. And I still misread my body. I read it through the framework I had been taught to read women's bodies through, which is one that begins with reproductive aging and works outward. The framework had no place for what was actually happening, which was that the relationship I was in had reorganised my nervous system around survival, and my biology was simply doing what biology does when it is asked to stay alert for that long.

It was only after the fact that I could look back and trace the threads — and see the whole image for what it was. I want to be honest that the after is recent. This is not a story I am telling from a decade of distance. It is one I came out of not long ago, and I am writing it close to the ground, while it is still legible.

I am not writing this dispatch because I have something rare to disclose. I am writing it because I think the misreading I made is the misreading thousands of women are making right now, this week, in their own bodies — and the longevity category, as it has been built, is not equipped to help them see it.

I want to describe what I was experiencing, because I think it is recognisable to more women than the literature acknowledges.

I could not fall asleep at night. My mind ruminated — over what had been said, what had not been said, what I would say tomorrow, what I should have said earlier. When I did fall asleep, I would wake at two or three, fully alert, unable to drop back down. Then the frustration would set in. The baby was asleep. I could be sleeping. I was not sleeping. I could not sleep. Some nights I slept three hours. Some nights I slept what looked like a normal stretch but woke from it more tired than when I had lain down.

My periods became erratic. After my second was born they did not return for much longer than they had with my first. When they did return, they came at unpredictable intervals, and they came much heavier than they had been before. The luteal phase intensified — the week before my period became its own ordeal. Then I would ovulate, and the period would not come at all. I tracked it carefully. The tracker did not have a category for what was happening.

The anxiety was constant and physical. It was not the kind of anxiety that arrives in waves and passes. It was a low, continuous hum that I had begun to mistake for my actual personality. My stomach reacted to everything. The weight came off and kept coming off — over twenty kilograms in a stretch that should not have produced that kind of loss. I felt, increasingly, like a stranger to myself — a woman doing the work of mothering on the outside while the inside ran on a different operating system entirely.

The symptoms read, on paper, like perimenopause. They were not perimenopause.

I had been in the wellness space for a long time. I knew what worked for me — meditation, short ice baths, saunas, breathwork, training. None of it was producing what it usually did. The same protocols that had carried me through every other difficult stretch of my life were not reaching whatever this was. That, more than any single symptom, was what told me something deeper was going on than what I was consciously aware of.

When you have lived in fight-or-flight long enough, it stops feeling like fight-or-flight. It feels like your baseline. The thing that has gone wrong with you. The personality you have become. The kind of mother you are.

That last one is the part I want to be careful with, because I think it is the cruellest part of what chronic relational stress does to a woman who is also raising children. I was not the mother I knew I was. I was the mother that survival had made of me. The patience was thinner. The presence was harder to find. The version of myself that I had always trusted with my children's days was being filtered through a nervous system that had no spare capacity to be patient or present with anyone, including them.

I want to be honest about something else, which I did not see at the time and have come to see since. The reason the relationship I was in had the biological effect it did was not only the relationship itself. It was that the dynamic was meeting something much older in me — patterns my nervous system had learned long before I met him, in childhood, in the years a body decides what kind of vigilance counts as ordinary. I am not going to write about that here in any detail. It is not the subject of this dispatch, and it is the kind of work that belongs in private, with people equipped to hold it. But I want to name it on the page, because I think it would be dishonest not to. The biology a woman brings to her partnerships is not invented in those partnerships. It is rehearsed.

I did not realise any of this at the time. And honestly, who is thinking of this when they are in the midst of it? When you are postpartum, and parenting a toddler, and managing the daily logistics of a relationship that costs you more than it gives — there is no part of the day that includes the question is my biology being shaped by the conditions I am living in? You assume the symptoms have a medical explanation because medicine is what the world tells you to ask. You do not ask whether your relationship is doing something to your endocrine system, because the framework you have been given does not include that question.

The father of my children and I separated and moved into different housing. I want to keep the rest of that private. What matters here, for the purpose of this dispatch, is what happened to my body in the months after.

The change was not immediate. The nervous system that has been holding itself in survival for a long time does not simply release on the day the conditions release. It releases slowly, in increments, often without the woman herself recognising what is happening until she notices, months in, that she has slept through the night and not braced for the morning. The body has a memory of vigilance that takes time to undo.

But the body undid it. My sleep returned first. Then the anxiety started lifting — not gone, but no longer the room I lived in. My stomach calmed. The weight settled. And then, after some months, my period came back. On time. Thirty-two days. Not too heavy. Not too light. The cycle I had known for most of my adult life, returning as though it had simply been waiting for me to come home to it.

The most important thing I want to say about that period of return — the one that mattered more than the data on my cycle tracker — is what came back with it. I became the mother I knew I was. Not by trying. Not by reading better parenting books or working on my patience or learning a new framework. By no longer being the mother that survival had made of me. The biology released, and the woman I had always been was waiting underneath it.

Once I was through the worst of what I have just described, I went and looked — carefully, because the topic is too consequential for a tidy answer — for what the research said about what had happened to me. About both layers of it.

The literature exists. It is just not where most women, or most clinicians, are looking.

A 2019 analysis in JAMA Internal Medicine of 2,016 women in the Kaiser Permanente Northern California health system found that emotional intimate partner violence — by which the researchers meant chronic emotional pressure, criticism, control, the wearing-down kind of relational dynamic that does not leave physical marks — was independently associated with 36% higher odds of sleep disruption, 50% higher odds of night sweats, and 60% higher odds of painful intercourse during the menopausal transition (Gibson et al., 2019). Women with clinically significant symptoms of post-traumatic stress had more than three times the odds of sleep difficulties.

I want to pause on the term emotional intimate partner violence because it sits at one end of a clinical spectrum, and the spectrum matters. The research literature uses intimate partner violence as an umbrella term that ranges from chronic emotional dynamics — the kind a great many women in long relationships will recognise some version of — through to physical and sexual abuse. The Kaiser study isolated the emotional category specifically, and the finding that emotional dynamics alone produced this scale of biological signal is, to my mind, the more important finding for the woman reading this dispatch. You do not have to have been in danger in order for your body to have been registering chronic strain. The biology does not require a threshold of severity to respond. It responds to what is sustained.

The research on the second layer — the older one — is less complete, more contested, and also harder to dismiss once you have read it. The Penn Ovarian Aging Study, which has followed a cohort of women for close to two decades, found that women with a history of two or more adverse childhood experiences had a 2.58-fold increased risk of first-episode major depression during the menopause transition — meaning the depression that arrived was, for many of them, the first time they had ever met the criteria for it (Epperson et al., 2017). A separate analysis from the same cohort found that women with high childhood adversity arrived at the late perimenopausal inflammatory window with substantially elevated baseline IL-6, TNF-alpha, and other markers of chronic systemic inflammation (Metcalf et al., 2021).

What that body of work suggests, taken together with what the Kaiser study found about adulthood relational pressure, is that the nervous system does not distinguish between what happened to it in childhood and what is happening to it now. It carries both. The biology in midlife is the sum. A woman whose system was set to vigilance in early life and then re-encountered a dynamic that activated that vigilance in adulthood is not carrying two separate physiological loads. She is carrying one continuous one, laid down over decades.

I want to be careful not to make this sound monocausal, because it was not. A body under sustained strain is usually under it from more than one direction at once. There was, in fact, another variable in those same months — an environmental one, in the apartment I was living in — that I did not see until I was out of it, and which I will write about in a later dispatch. The point of this one is not that there was a single cause. The point is that the framework I was handed was not looking for any of them.

None of this was hidden. It was published, peer-reviewed, sitting in journals available to any clinician who searched for it. But the framework most women encounter at midlife does not include the question of what their relational conditions — past or present — might be doing to their endocrine and immune systems. So the framework gets applied — perimenopause, anxiety, weight gain, sleep disturbance — and the woman is sent home with management strategies for the symptoms while the cause is left in place.

If you are reading this and recognising yourself in the years I have just described, I want to say three things.

The first is that what your body is doing is not, necessarily, what you have been told it is doing. The symptom cluster of chronic relational stress and the symptom cluster of perimenopause overlap to a degree that the clinical framework is not equipped to disentangle in a fifteen-minute appointment. Sleep disturbance, cycle irregularity, anxiety, weight changes, stomach issues, the sense that you are not the woman you used to be — these can be relational and biological at the same time, and treating only the biology will not resolve what is happening.

The second is that what your body has been doing is reversible. Not on a timeline anyone can promise — the nervous system holds its memory of vigilance, and the release happens at its own pace. But the body is responsive. The inflammation comes down. The sleep returns. The cycle, in many cases, comes back. Your biology has been recording something specific, and when the recording conditions change, the biology has somewhere to go.

The third is that I do not want this dispatch to be read as a prescription. The last thing a woman in the middle of what I have just described needs is another list of things she is failing to do — meditate more, regulate better, breathe correctly, eat the anti-inflammatory diet. What I want her to have is what I did not have at the time. Not a protocol. A frame. The knowledge that what is happening in her body might be the conditions of her life speaking through her biology — and the recognition that her body is telling her something serious, and worth hearing.

There is a register the longevity category does not have a vocabulary for, and which the topic of this dispatch may finally require us to find one for. It is the recognition that a woman's body is not only a system of biomarkers but a long document — written across decades, by hands that were not always her own. What she inherited from her mother. The safety, or absence of safety, in her childhood. The partnerships she stayed in and the ones she left. The years she carried more than she could carry. None of it disappears. It is laid down in the regulatory baseline she brings to forty-three, and forty-seven, and fifty-two.

To read that document with care is not, in my view, a spiritual posture in the sense the wellness industry has flattened the word. It is closer to what an editor does with a manuscript that has been a lifetime in the writing. You read what is there. You honour what the writer has been trying to say. You do not project your own meaning onto a passage the body has been forming with its own intelligence, in its own time.

The work is to recognise the body as the document it is — and to read it as something serious.

There is a sentence in my founder's note that I have been quoted on more than any other, and the reason I want to bring it back here is that the topic of this dispatch is exactly what that sentence was reaching for.

Longevity is the means. Meaning is the point.

I did not write that sentence having theorised it. I wrote it having lived the version of my life in which longevity, as the category usually defines it, would have been unbearable. The point of a long life is not the length. It is the woman you are in it. The mother you can be in it. The presence you can bring to the people and the work you love.

A woman who has lived through chronic relational stress and is now in perimenopause — or who thinks she is in perimenopause, and may not be — is not a patient with elevated risk factors to be managed. She is a woman whose biology has been quietly recording a life, and who, now, in the most consequential decade for her long arc, has the opportunity to read what it has been recording and decide what the second half of her life will be for.

The biology is not separate from the life. The body keeps the reading. The work is to learn how to interpret it — and then to act on what it has been telling you.

I stand by you in this.
— Belinda Singkepe Holloway