Experiencing perimenopause has many alarming downsides. But it can also be sexy…

I started using the HRT patches at 42, after a seemingly catastrophic failure that sent me climbing into a Sainsbury's fish stick freezer. My mental health was horrible. I felt totally out of my skin, dissociated and had lost my sense of myself. I told a therapist that I was related to Mrs. Dalloway, a chronically depressed - and arguably narcissistic, bourgeois fictional Virginia Woolf character. She suggested that these feelings could all be due to perimenopause, a term I had only vaguely heard of, in passing, even as a former nurse. Perimenopause, she told me, can be an extremely difficult road, lasting up to a decade before menopause itself.

My GP didn't bat an eyelid at my weird symptoms but offered me low dose HRT patches and described side effects as minimal for most people. Some women experience breast tenderness or nausea, or headaches, but, she said, this has usually subsided. I was hoping the patches would lead to fewer perimenopausal symptoms and balance my mood, some comfort, and at least some realism.

Instead, within 24 hours of putting a patch on, i suddenly started thinking about sex all the time, a side effect i hadn't expected. I was totally perplexed by this midlife sexual awakening – and more than a little unsettled by it. In my forties, it felt weird and wrong to be so obsessed with sex. I had imagined that lust and desire would drift away, leaving me with other pursuits, like gardening. I expected to lose interest in romantic love, or at least, confidence in my forties, identifying with psychotherapist Susie Orbach's description: "Some find the decline of youth and beauty to be a source of grief and shock. Meanwhile, menopause arrives, seeking out our vulnerabilities like a guided missile, just as we need all of our strength to cope with everyday life."

But in addition to being absorbed with the stresses of everyday life, I walked around with a burning body and a mind like an erotic playground. I was confused and disoriented. Like everyone else in our culture, I was spoon-fed the narrative that sex resides in the realm of the young and the realm of the well Everything I've seen on TV or in the movies confirms what Lynne Segal, Emeritus Professor of Psychosocial Studies for the Birkbeck's birthday, wrote, "While the signs of physical aging are routinely downplayed in the lead actors, who routinely take on the roles as still vigorous and desirable characters (whether heroes or villains), the reverse applies to older actresses, if they are allowed to appear on screen”.

Surely, as well as the obvious misogyny of the absence of older women on our screens, there was nothing sexy about getting old. I had read about (and was beginning to experience) some of the symptoms that can affect a midlife woman's sex life: vaginal dryness, atrophy, difficulty reaching orgasm, weak bladder, fatigue, insomnia, depression, lack of confidence in se… 42 years clearly not a good time to have any sexual awakening. And yet something propelled me, a kind of rage against the idea that I was done with desire. I was lucky enough to be surrounded by love, with a rich life filled with friends and interests, but the unexpected side effects of my HRT patches reminded me that I wanted a romantic relationship too. p>

Understanding both what I wanted or what I needed and the links between sexuality and aging was not easy. Like many of my midlife friends, I was also single when this all started, and I was navigating dating as my body (and mind) was falling apart in dramatic ways. In her book Why We Love, anthropologist Helen Fisher suggests that dating is a game designed to “impress and capture”, a game that is not necessarily about honesty but about novelty , excitement and even danger, which can boost dopamine levels in the brain.

All of this could have appealed to my younger self, who wanted to be anything who except me, frankly, but in my 40s, I craved authenticity, truth, and the ultimate goal of feeling good about myself. I wanted the real intimacy that comes with being open, warts and all - what a psychotherapist