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Showing posts with label Universal. Show all posts
Showing posts with label Universal. Show all posts

September Is Perimenopause Awareness Month


What Exactly Is Perimenopause?


If there's one thing I've realised from learning more about this stage of life, it's this: many women enter perimenopause without really knowing what to expect.

We know that menopause is when menstruation stops. This is the simplest explanation.

But perimenopause, the transition phase before menopause, can last up to 8 to 10 years before menopause actually occurs.


During perimenopause, which Dr Mary Claire Haver describes as the Zone of Chaos, hormones such as estrogen, progesterone and testosterone become increasingly unpredictable, and the effects can show up in ways that don't immediately seem hormonal at all: brain fog, anxiety, poor sleep, mood changes, joint aches, palpitations, changes in body composition and many more.

Which is why, so many women in their 40s seem to describe similar experiences:

"Maybe I'm just stressed."
"Maybe I'm just getting old already lah."
"Why don't I feel like myself anymore?"

And then you finally start connecting the dots.

Discovering the Perimenopause Rollercoaster


My Blog Posts


I thought estrogen was just a reproductive hormone. Here's what I learnt about estrogen's role in brain fog, mood, sleep and other perimenopause changes.

Why do anxiety, irritability, and poor sleep feel different in perimenopause? Here's what I learnt about progesterone and feeling less steady in midlife.

Feeling flat, less motivated or low in energy? Here's what I learnt about testosterone in women and how it may affect drive, strength, and midlife.

Aha. No wonder lah!

Perimenopause Deserves More Conversations


Awareness matters because recognising that these changes could be related to perimenopause gives us more context. It helps us ask better questions, seek appropriate support and have more informed conversations about what is happening to our bodies.

If you're wondering whether some of the changes you’ve been experiencing could be related to perimenopause, you can also reach out to Menopause Asia.

It is a digital platform that connects women with independently licensed doctors, reliable information and practical midlife health resources, with the aim of making menopause support easier to access and navigate. Menopause Asia itself is not a healthcare provider; medical consultations are provided independently by licensed healthcare professionals.

Sometimes, knowing what might be happening is already a very useful first step.

So this September, maybe tell another woman what you've learnt too.

Because the more openly we talk about perimenopause, the less likely someone else is to spend years thinking: "What on earth is wrong with me?"

❤️ Share this with a woman who might need her own Aha, No Wonder Lah moment.



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Where Did My Spark Go?


After learning about the chaotic behaviour of fluctuating estrogen and progesterone during perimenopause, I thought I understood this whole hormone situation.

Then testosterone came along.

Women Have Testosterone Too


What? Seriously? 

Did you know that women have testosterone too? This was probably the first misconception I had to get rid of.

Testosterone is not exclusively a male hormone. Women produce it too, just in smaller amounts.


In women, testosterone supports:

  • Energy and vitality
  • Libido
  • Muscle and strength
  • Bone health
  • Confidence and drive
  • Cognitive sharpness
  • Skin and hair

Okay wait.

So, estrogen has its hands in almost everything.

Progesterone is involved in calmness and sleep.

And now testosterone is in the picture, deciding whether I still have energy, drive, and motivation.

How many functions are these hormones actually running? 😑

The "I've Lost My Spark" Feeling


Because low testosterone in women can be described less like feeling unwell and more like this vague sense of flatness.

It's not necessarily sadness or depression. Just... "I don't feel like I used to."

Some women describe it as:

"I've lost my spark."
"I feel flat."
"I'm going through the motions."
"I don't recognise myself."

That whole cluster stood out to me because it's such a subtle thing.

There may not be anything dramatically wrong; you're still functioning, going to work, doing what needs to be done, and showing up.

But somewhere along the way, the enthusiasm feels smaller and the drive is less.

The "I can't be bothered" moments become more frequent.

And you may start wondering, "Am I just tired? Lazy? Burnt out? Bored? Getting old? Or is there something else going on too?"

Then There Is the Energy Problem


This one is interesting, because "tired" can mean so many things.

There's sleepy tired, physically exhausted tired, and mentally overloaded tired.

And then there's this other kind of "tired" where you can technically do something but just don't feel like it.

Because the motivation, enthusiasm, and that forward momentum are missing.

Now to be fair, sometimes I genuinely cannot be bothered because the thing is annoying and I have reached that stage in life where I no longer want to waste energy pretending otherwise. 😂

But still.

I find it striking that testosterone is also associated with drive and vitality, because those are not usually the things women are taught to connect with hormones.

Strength Training Is a Big Deal



Declining testosterone has been linked to reduced muscle mass, less physical resilience and shifts in body composition. This is probably the most practical takeaway I got from this topic.

Experts put a lot of emphasis on resistance or strength training and suggest two to three sessions a week as an important part of supporting strength and muscle in midlife.

Strength training seems to be the "prescription" for almost everything related to perimenopause, bone health, muscle mass, and metabolism.

Sigh, I suppose this is one of those moments where I can no longer pretend I didn't get the memo.

Looks like I need to stop avoiding strength training. 😑

Excuses Vs Context


Anyway, learning about hormones isn't about finding an excuse.

It's about understanding that sometimes there is more context behind the question, "Why don't I feel like myself anymore?"

Maybe the better questions are, "What has changed?" and "What can I do?"

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Why Don't I Feel As Steady As I Used To?


After learning about estrogen, I thought, okay... at least now I understand a little better why perimenopause can feel so random.

Then there's one more hormone in the picture: progesterone.

Just like estrogen, I associate progesterone with pregnancy or fertility. That's it.

What I didn't realise is that progesterone is closely linked to sleep, anxiety, mood, and that general sense of feeling calm and steady.

And when I learnt that?

Aha. No wonder lah!

Progesterone Is the Underrated Hormone


Estrogen gets a lot of attention when we talk about menopause. And progesterone seems to be the quieter one sitting somewhere at the back.

But I'm beginning to realise this quiet hormone may explain some of the things that bother me the most. Things like:

  • Why am I more easily overwhelmed than before?
  • Why does anxiety appear when there isn't actually anything specific to be anxious about?
  • Why can I be physically tired, but my brain refuses to switch off?
  • Why don't I feel as emotionally steady as I used to?

That last one really caught my attention because sometimes it isn't even about being sad, angry or anxious. It's just this feeling of... I used to handle things better.

Let me to explain what that means:

  • I begin to realise things that I would previously just let them be; now they suddenly irritate me more.
  • Stress seems to use up my mental bandwidth way faster than what I'd like to admit.
  • Some days I just have less tolerance for nonsense.

Okay, maybe the last one is also age and experience. 😂

But still.

It made me wonder how much of what we describe as "I've changed" could actually be happening alongside hormonal changes too.

Progesterone Apparently Starts Changing Early



This was another thing I didn't know.

I always assumed all our hormones basically started declining together as we approached menopause.

Progesterone is produced after ovulation. But as we move through our late 30s and 40s and ovulation becomes less consistent, progesterone production can also become less consistent.

You may still be having periods, not having hot flushes, or not even be thinking about perimenopause. But hormonally, things may already be changing.

Aha. No wonder lah!

This also made me realise why the beginning of perimenopause can be so confusing.

We tend to look out for the stereotypical menopause symptoms. No hot flush? Still menstruating? Then surely everything is normal, right?

Except the changes may have started much earlier and may show up in completely different ways.

Then There Is the Anxiety


This was actually one of my bigger aha moments.

I recently understood that anxiety can worsen when progesterone declines, while fluctuating estrogen can also contribute to it.

My immediate response was basically: AHA. NO WONDER LAH.

So progesterone is fluctuating; estrogen is going up and down like a rollercoaster.

And my nervous system is somewhere in the middle, going, "Good luck everybody!" 😂

Of course, anxiety has many causes, and I'm not going to blame every anxious moment on hormones.

Work, family, traffic, incompetent people are... well, incompetent people.

But what I find frustrating is the kind of anxiety that sometimes seems to come from nowhere.

Nothing particularly terrible has happened >> You're not consciously worried about anything >> Yet somehow your body feels unsettled >> Your mind is restless >> You're more easily triggered >> And you can't quite explain why

You feel me?

And Then There Is Sleep...


...or the lack of it.

I have recently also been learning about the relationship between progesterone and sleep, particularly that progesterone has calming effects in the brain and is associated with restorative sleep.

Which brings me to another question: How can you be tired and STILL not want to fall sleep easily?

I can be physically exhausted and I know I should sleep.

But somehow my brain thinks 11pm is an excellent time to play brain games. One round, then another round, then another, and one hour passed.

Earlier I joked that perhaps I'm addicted to dopamine.

Maybe not literally, but I have definitely trained my brain to expect entertainment right until bedtime instead of winding down.

So now I'm experimenting. No brain games for about an hour before sleeping.

Brain, please understand that office hours are over. 😭


Having More Context Is Important


When you're more anxious, sleeping badly, easily overwhelmed and not feeling as emotionally steady as before, it is very easy to turn everything inward.

Why am I like this nowadays? Why can't I handle stress like I used to? Why am I so easily irritated? Am I just becoming grumpier as I get older?

To be fair, yes, hormones may not be the explanation for everything.

But for me, learning about perimenopause isn't really about finding a hormone to blame or pigeonholing symptoms. It's about having more context. Because once you understand that something may be changing inside your body, you stop interpreting every change as some kind of personal failing.

The thought then changes from, "What is wrong with me?" TO
"Ahhh... so THAT might be what's going on."

And there it is again.

Aha. No wonder lah!

Next experiment: convincing my brain that bedtime is for sleeping, not achieving a new high score. 😑

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I Thought Estrogen Was Just A Reproductive Hormone


Previously, if someone asked me what estrogen does, I would answer like this: estrogen is a female hormone involved in menstruation, reproduction, and finally menopause.

But recently I started learning about perimenopause, and lo and behold! I just got to know that estrogen has receptors in almost every tissue in the female body and influences hundreds of different functions.

Guess what my immediate reaction is?

Aha. No wonder lah!

Did You Know that Estrogen Is Involved in Almost Everything?


The estrogen receptors are found in the brain, heart, bones, skin, gut, bladder, joints, and blood vessels. Gosh! I now understand why the list of things women experience during perimenopause can seem completely unrelated.

How many of these symptoms do you experience? These are some of the most common ones:

Brain fog, difficulty finding words, sleep problems, anxiety, irritability, joint aches, changes in body composition (belly fat), changes to periods, hot flushes, and night sweats.


When you put it all together, you start thinking, "Wait... are you saying these things can all happen at the same stage of life?"

Take the Menopause Quiz


If you're unsure about what's going on with your body, especially if you don't feel quite right but aren't diagnosed with clinical conditions, try this (peri)menopause quiz/symptom checker from Menopause Asia. It will be insightful.

The Brain Fog


This one caught my attention because it's so annoying. Have you ever experienced the following?

  • You are talking halfway through a sentence, and suddenly the word you wanted is just... gone.
  • You walk into a room and forget why you went there.
  • You read the same paragraph three times and realise that absolutely nothing has registered.
  • You know that you know someone's name, but your brain refuses to retrieve it.

And when it starts happening more often, you start to think, "Is there something wrong with me?"

What I didn't realise before is that estrogen also plays a role in brain function, including memory, language, concentration, processing, and mood.

Estrogen supports processes involving acetylcholine, which is important for memory and learning, blood flow to areas of the brain involved in focus and decision-making, synaptic plasticity, and neurotransmitters such as serotonin and dopamine.

So when estrogen fluctuates during perimenopause, that's why some women experience cognitive slowness, difficulty retrieving words, trouble concentrating, or that strange feeling of mental static.

Aha. No wonder lah!

Estrogen Doesn't Just Drop Dramatically During Perimenopause


This was another big aha moment for me. For years, I thought hormones were high when we were younger, then declined as we got older, and finally became very low at menopause. Simple, right?

But... perimenopause doesn't behave quite so politely!

Estrogen does not decline in one nice, smooth line. During perimenopause, estrogen actually fluctuates quite dramatically like a rollercoaster before eventually settling at a lower level after menopause.


Source: LinkedIn

Now this makes the unpredictability of this stage make a little more sense.

  • Why do I feel relatively normal one week and quite unlike myself another week?
  • Why does something suddenly bother me when it never used to?
  • Why can a symptom appear, disappear, and then return?

How Much Have I Been Blaming on "Getting Older"?


This is probably the part that has made me think the most. There are so many little changes that are incredibly easy to dismiss once you reach your 40s. You basically just lump everything into the "getting older lah" bucket.

  • Tired more easily? Must be because old already lah.
  • Brain fog? I just have too many things to remember lah.
  • Stubborn belly fat? Metabolism slows down liao lah.
  • Easily triggered, irritable? Stress from work, driving, incompetent people...
  • Can't fall asleep fast enough? I play too much phone before sleep lah.

Perhaps sometimes those explanations may absolutely be part of it. But learning more about estrogen has made me a little less willing to automatically throw everything into the "I'm getting older" bucket.

The Biggest Shift for Me


I'm not trying to explain every little thing that happens to me with hormones, and I'm definitely not suggesting that every ache, forgotten word, bad night's sleep or bad mood is only caused by estrogen.

But I'm starting to understand that midlife isn't always as simple as "you're getting older".

The more I learn about perimenopause and estrogen, the more I feel reassured because understanding why something might be happening makes it feel a little less random.

I have a feeling there will be another Aha. No wonder lah! coming very soon. 😅

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Why The Thursday Murder Club Made Ageing Look So Interesting

Image source: Wikipedia

I watched The Thursday Murder Club on Netflix the other night. It was star-studded – Helen Mirren, Ben Kingsley, Pierce Brosnan, Celia Imrie, David Tennant, and Tom Ellis, to name a few.

It was entertaining too; there were murders to be solved, plenty of amateur sleuthing, a retirement village full of personalities, and a group of older people who were far more capable than anyone around them initially assumed.

The biggest entertaining gem for me was how the movie portrayed ageing. Because it neither portrayed ageing merely as inevitable physical decline nor disguised ageing with inspirational messages about "staying young and not looking your age".

Instead, The Thursday Murder Club showed something I think we do not see often enough on screen: people who have aged, accumulated experience, lost things, lived through things, and are still curious about the world.

Retirement Does Not Mean You Stop Being Useful


The Thursday Murder Club consists of four retirees who spend their Thursdays looking into unsolved crimes. Joyce is a retired nurse. Elizabeth is a former intelligence operative. Ron was a trade union activist. Ibrahim is a psychiatrist.


Elizabeth understands strategy and how people behave when they are hiding something. Ibrahim understands psychology. Ron knows how to confront people and mobilise others. Joyce understands people in a quieter way. She observes, listens and often gets information precisely because people do not see her as threatening.

Their careers may have ended, but their knowledge did not disappear. I really liked that.

We tend to associate usefulness with employment. Once someone retires, there is almost an assumption that the productive part of life has ended and the remaining years are mainly about leisure, healthcare and grandchildren.

But a person who has spent forty years practising medicine, teaching children, running businesses, solving problems, caring for patients, raising families or managing difficult people does not suddenly lose all that knowledge because they no longer have a job title.

Experience does not expire at retirement.

The Characters Are Old, and That Is the Point


Another thing I appreciated was that the movie did not try to make ageing look youthful. The characters are older, and the story allows them to be older.

They talked about health concerns, grief, illness, and how time is no longer unlimited. But none of those things cancel out curiosity, humour, intelligence or purpose.

There is a common way of praising older people that sounds something like, "She is 75 but still behaves like she is 40!" It sounds complimentary, but underneath it is the assumption that being younger is still the ideal.

The Thursday Murder Club offers a much more interesting possibility:

What if seventy years of living actually makes someone more interesting?

Ageing and becoming less relevant are not the same thing.

Joyce Was Probably My Favourite


I also have to mention Joyce, and not only because we share the same name. Hahaha!

When she first joins the group, she seems like the least intimidating member of the club. She is docile, friendly, and very ordinary when compared to Elizabeth, who appears capable of organising an international espionage operation before breakfast.

But Joyce has her own kind of intelligence. As a former nurse, she understands people. She notices small things, she listens, and because she does not immediately look like the smartest or most dangerous person in the room, people underestimate her.

That actually becomes an advantage.

You know what? There is something very satisfying about watching a character whose strength comes not from being loud, dominant or obviously brilliant, but from decades of paying attention to human beings.

Perhaps This Is What Interested Me Most


Perhaps the most obvious reason for why I immensely enjoyed this movie is that I have become increasingly interested in what happens as we move through midlife and eventually into older age.

There is so much conversation about ageing from a medical perspective. We talk about disease prevention, physical decline, healthcare costs, retirement planning and longevity.

All of those things matter.

But there is another question that interests me just as much:

What happens to identity?
Who are we when the titles start disappearing, and when are we no longer the manager, the doctor, the teacher, the business owner or the person everyone calls when something needs to be solved?

The Thursday Murder Club gives a surprisingly simple answer:

You are still the person who spent decades becoming who you are.
The job may end, but the expertise remains.
Stay curious, stay relevant.

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What Project Hail Mary Says About Courage, Life, and the Small Things That Matter

Note: This image is created with the help of ChatGPT; please excuse how Rocky looks.

Project Hail Mary Is Not the Sci-Fi Movie You'd Expect


I watched Project Hail Mary expecting a sci-fi story about saving Earth from an extinction-level crisis. But what stayed with me was not the science or the mission. It was how the movie explored resilience and the kind of courage that was obviously absent at the beginning of the protagonist's story.


Dr Ryland Grace, the protagonist, is not introduced as a typical hero. Well, this is not a superhero movie. Yes, he is an intelligent and knowledgeable scientist, but he is also reluctant and clearly does not want to sacrifice himself for the greater good. He does not want to volunteer for a one-way ticket mission. He does not initially believe that being qualified means he must be willing to die.


That is why his eventual transformation towards the end of the movie is really meaningful. Initially you could call him a messed-up coward. But his bravery develops gradually, through circumstances that force him to decide what matters most when there are no easy options left.


Courage Does Not Always Begin With Willingness


One of the strongest parts of Grace's character arc is that he does not begin as a hero. He does not give a grand speech about saving humanity (ref: 1996 Independence Day movie), nor does he willingly step forward when asked to risk his life. In fact, he resists the idea because he understands exactly what the mission may cost him.



Image Credit: Cinemablend


His reluctance could easily have made him unlikeable, but instead it makes him more human. Most people would probably hesitate if they were told that their knowledge made them useful, but that using it could also mean never seeing Earth again.


Grace's fear is reasonable, and the movie does not treat self-preservation as a moral failure. As the movie progresses, what changes him is not a sudden personality shift. It is a series of decisions made under pressure, where he repeatedly chooses to continue solving the next problem even when he is afraid, uncertain, or physically exhausted.


By the time he has the opportunity to return to Earth, he is no longer the same person who initially refused to sacrifice himself. He has already endured isolation, memory loss, failure, danger, and the responsibility of knowing that billions of lives depend on what he does next. More importantly, he has formed a friendship with Rocky that becomes as real and important to him as his responsibility to Earth.


When Grace realises that Rocky may not survive the journey home, he is faced with a final decision. He can continue towards Earth and preserve his own chance of returning, or he can turn back and save his friend. This time, nobody forces him, nor is there an authority figure making the decision for him, and there is no guarantee that his sacrifice will be recognised.


He turns back because it is the right thing to do. That moment is powerful because Grace's courage is no longer theoretical. He makes the critical decision when it matters, even though it costs him his potential future back on Earth.


Fragile Yet Brave


Ryan Gosling's performance makes this transformation believable because he does not play Grace as someone who suddenly becomes fearless. Grace remains emotionally vulnerable, physically limited and sometimes overwhelmed by the situation he is in.


He panics, doubts himself, gets frustrated, and grieves. And yet, he continues. This combination of fragility and bravery is what gives the character emotional weight. Grace's courage exists alongside fear. He does not stop being afraid; he simply becomes capable of acting despite it.


There is something empowering about watching a character who does not fit the conventional image of a heroic saviour. Grace is not a soldier, an astronaut or an action hero. He is a scientist and a teacher who must use observation, logic, improvisation and persistence to survive.


His strength lies in his ability to keep thinking when circumstances become impossible. When he makes mistakes, he adapts. When his plans fail, he tries a different approach. His resilience is not dramatic in the usual cinematic sense but in the repeated act of trying again.


Rocky Is Not the Alien We Usually See


I also loved the way Rocky was designed and written. Sci-fi movies often rely on generally recognisable visuals when portraying alien life, such as grey or green skin, oversized eyes, humanoid bodies or insect-like features. They are also frequently presented as threats, invaders or predators whose existence immediately places humanity in danger.


Rocky is none of these things. He is not humanoid (well, in all fairness, he does look like an arachnid); his body, environment, language, and biology are genuinely alien. Yet despite those differences, his personality is immediately captivating.



He is intelligent, curious, loyal, practical and capable of forming a deep emotional connection with Grace. Their friendship develops through shared work, mutual dependence, and the gradual construction of trust. They begin as two beings who cannot even communicate, yet they eventually become partners who understand one another beyond language.


The movie makes Rocky lovable by showcasing that friendship can form even when two lives are radically different. This is one of the most hopeful ideas in the story.


Life Is Not Always a Monster


Another aspect of Project Hail Mary that I found fascinating was the way the movie portrayed life itself.


The central threat is not an army of violent aliens. There is no hostile civilisation planning to invade Earth, and there are no giant creatures attacking cities. The crisis is caused by a microscopic life form known as the 'Astrophage' that feeds on stellar energy and gradually reduces the output of stars.


The solution is also microscopic. 'Taumoeba' is another single-celled organism, small enough to be overlooked yet powerful enough to change the fate of entire solar systems because it feeds on 'Astrophage'.


Image Credit: Geek Tyrant


This creates an interesting contrast with the way life is often portrayed in science fiction. Alien life is usually imagined as something large, visible and threatening. In Project Hail Mary, life exists at the smallest possible scale, but its consequences are enormous.


Astrophage is not evil. Taumoeba is not heroic. They are simply organisms behaving according to their biology. One consumes energy. The other consumes the first organism. Neither understands that planets, civilisations and billions of lives depend on their existence.


That simplicity makes the story more interesting because the survival of two intelligent species ultimately depends on understanding the behaviour of single cells.


Small Things Can Change Everything


Rocky says that "life is reason", and that idea runs through the entire movie. Life does not need to be physically large, technologically advanced or emotionally complex to have significance. Astrophage and Taumoeba are tiny organisms, but each one has the ability to change the future of entire worlds.


The same can be said of many of Grace's decisions. His story is shaped by a series of smaller choices, not in a dramatic, heroic way. He investigates, communicates, and trusts Rocky. At the very climax of the movie, he chooses to turn his ship around to save his best friend.


Each decision appears limited to the immediate problem in front of him, but together they determine the survival of Earth, Erid and Rocky.


This is perhaps the part of the movie that resonated with me the most. We often associate meaningful change with large gestures, major achievements or highly visible acts of courage. Yet many important outcomes begin with something smaller, such as one decision, or one piece of information, or one person refusing to give up.


Small does not mean insignificant. Sometimes the smallest element in a system becomes the one thing capable of changing everything.


Doing What Matters When It Becomes Necessary


By the end of the film, Grace has become the kind of person he initially did not believe himself capable of becoming.


He does not save two worlds because he always knows what to do. He saves them because he remains willing to learn what must be done next. He does not return to Earth as a celebrated hero. He chooses to remain on Erid, where he continues teaching and begins a life completely different from the one he left behind.


There is something fitting about that ending. Grace does not need public recognition to validate what he has done. His growth is already visible in the fact that he willingly chose responsibility, friendship and sacrifice when those choices became necessary.

That is what makes Project Hail Mary such a beautiful and powerful story.


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When My Patience Ran Out Before the Day Did and Everything Feels Like the Last Straw


A Reflection on Parenting, Perimenopause and Emotional Bandwidth


Some days don't begin badly, yet by the time they end, you find yourself reacting far more strongly than you normally would.

Yesterday was one of those days. To be fair, nothing major happened. There wasn't an emergency; nobody fell sick except me, who's been prescribed with antibiotics for the next two weeks.

Looking back, it was really just an ordinary Sunday filled with the usual responsibilities that come with family life. Yet by the end of the evening, I found myself becoming irritated by almost everything.

It Started As an Ordinary Day


The afternoon was spent sending my children to and from their sports practice. That in itself wasn't unusual, but making several trips in the afternoon heat while my knee was hurting made the whole experience feel more tiring than it normally would have. The car was hot, the traffic wasn't particularly enjoyable, and by the time I had finished all the driving, I was already feeling physically drained.

Later, our dinner plans changed, which meant adjusting the evening schedule. Again, it wasn't a major problem. These things happen all the time.

When we finally sat down to eat, my meal arrived with raw onions even though I had specifically asked for them to be left out. I dislike raw onions enough that I always mention it when ordering, so seeing them sitting on top of my food was frustrating. It wasn't the end of the world, but it certainly didn't improve my mood.

When we got home, I realised my youngest hadn't really packed his school bag properly. He had simply stuffed everything inside. His worksheets were folded, crushed and crumpled to the point that I jokingly told him they looked like salted vegetables.

That was when I started nagging. Quite a lot, if I'm being honest. Somewhere in the middle of my lecture, I remember saying, "How you do small things is how you deal with big things. That's character building."

The School Bag Wasn't Really the Problem


I don't regret correcting my son. I still believe that small habits matter. Taking care of your schoolwork, putting your belongings away properly and doing simple tasks with care are all part of learning responsibility. Those habits don't develop overnight, and as parents, it is our responsibility to teach them consistently.

At the same time, I also had to ask myself whether I had really been reacting to the school bag.

Looking back over the day, it seemed more likely that my patience had already been gradually worn down long before I saw those crumpled worksheets. My son's school bag simply happened to be the last thing that required my attention after a day that already felt physically and mentally tiring.

Perhaps the school bag wasn't really the problem. It was simply the moment when I no longer had enough emotional reserve to respond with the same patience I might have had on another day.


When Your Emotional Reserves Become Smaller


That thought led me to another realisation. Over the past year, I have been made aware of perimenopause, and I have become increasingly aware that my emotional capacity is not always what it used to be.

I don't think perimenopause makes women irrational, nor do I think it creates problems where none exist. The frustrations are often genuine. A waiter who ignores a dietary request is still being inattentive. A child who carelessly stuffs important worksheets into a school bag still needs to learn responsibility.

What seems to have changed is my ability to absorb one inconvenience after another without feeling completely depleted.

There are days when I seem to move from one responsibility to the next without much opportunity to pause. Work, family schedules, driving, meals, household matters and all the countless small decisions that keep a home running don't suddenly disappear because hormones begin to fluctuate.

The responsibilities remain the same.

Sometimes, however, the emotional reserves available to deal with them become smaller. I suspect many women in midlife recognise this feeling, even if we don't always talk about it openly.

After a day of juggling work, family responsibilities, physical discomfort and countless small decisions, there simply isn't as much room left to absorb another disappointment without feeling its full weight.

Parenting Doesn't Stop Because Perimenopause Starts


One thing I don't want this reflection to become is an excuse for losing my patience.

My son still needed to be corrected. He still needs to learn that taking care of his belongings is part of becoming a responsible person. If he develops good habits now, those habits will hopefully stay with him as he grows older.

But, at the same time, it dawns on me that parenting doesn't suddenly become easier because our children grow older, and neither does it pause while we navigate the physical and emotional changes of perimenopause.

In many ways, both journeys are happening at the same time.

While my children are learning discipline, responsibility and resilience, I am learning how to manage a body that doesn't always respond the way it used to. Some days require more patience than I have readily available, and that is something I am still learning to recognise before it spills over into the people around me.

Maybe This Is Another Conversation We Need to Have


Much of the conversation around perimenopause understandably focuses on symptoms such as irregular periods, hot flushes, sleep disturbances and hormone replacement therapy. Those discussions are important because many women spend years wondering why they no longer feel like themselves.

What receives less attention, at least from what I have observed, are the small moments that happen inside our homes: the school runs, the dinner plans, the messy schoolbag, and the overflowing laundry basket.

The conversations that become sharper than we intended because our emotional bandwidth has quietly been stretched to its limit.

These moments may seem insignificant on their own, but they make up much of everyday family life.

Fun, huh?

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The Cost of Staying Well: What Happens Between Healthy and Hospitalised?


Recently, I came across two articles that, at first glance, seemed to have little in common.





The first discussed rising healthcare costs in Malaysia and argued that preventive healthcare is one of the most effective ways to reduce long-term healthcare expenditure.



The second explored perimenopause and menopause, highlighting how many women experience symptoms such as fatigue, anxiety, sleep disruption, brain fog and declining confidence, often without realising that hormonal changes may be contributing to these experiences.

One was about healthcare economics, whereas the other was about women's health.

The Growing Cost of Chronic Disease



For more context, Malaysia is facing a growing burden of non-communicable diseases (NCDs). Diabetes, cardiovascular disease, obesity and cancer continue to place pressure on individuals, families, employers, insurers and healthcare providers.

Traditionally, conversations around healthcare costs have focused on hospital bills, insurance premiums and access to treatment.

Increasingly, however, healthcare experts are pointing towards prevention as a more sustainable solution.

The logic seems straightforward.

If fewer people develop chronic diseases, healthcare utilisation may decrease. If diseases are detected earlier, treatment is often simpler, less invasive and less costly than managing advanced-stage conditions.

From both a health and economic perspective, prevention appears to make perfect sense.

At least on paper.

The Prevention Paradox


The more I think about it, the more I wonder whether there is a gap in how we think about healthcare financing.

Many Malaysians are already investing in their health long before they receive a diagnosis.

We pay out of pocket for health screenings, consultations, supplements, fitness programmes, nutrition advice, menopause-related care and other preventive measures aimed at maintaining our wellbeing.

Yet much of the healthcare financing system remains designed around treatment rather than prevention. Support often becomes available only after a condition has been diagnosed or progressed to a stage that requires medical intervention.

This creates an interesting paradox.

We say prevention is important. We acknowledge that early intervention can improve outcomes and potentially reduce long-term healthcare costs.

We recognise that conditions such as diabetes, cardiovascular disease and even some cancers are influenced by years of accumulated risk factors.

Yet many of the costs associated with prevention continue to be borne primarily by individuals.

The result is a system where staying healthy can sometimes feel like a personal expense, while becoming sick unlocks access to healthcare benefits.

This is not a criticism of insurers, healthcare providers or policymakers. Healthcare financing is complex, and resources are finite.

However, it does raise an important question:

If prevention is truly the goal, how do we better support people during the years before they become patients?

The Missing Middle


This is where I think an important conversation is missing.

We often divide people into two groups: healthy and sick.

But real life is rarely that simple.

Between being healthy and being hospitalised lies a stage that many people will experience at some point in their lives, a period where health may be declining and symptoms may be emerging, yet a diagnosis has not been made.

They may not have a formal diagnosis. They may not require immediate medical intervention. Yet they do not feel 100% well.

They may be experiencing chronic fatigue, poor sleep, anxiety, hormonal changes, weight gain, declining fitness, elevated blood sugar, rising cholesterol or persistent stress.

These individuals occupy what I think of as the "missing middle" of healthcare, a space that receives far less attention than it deserves.

They are not seeking treatment for disease, but neither are they simply pursuing wellness. They are trying to prevent a decline in health before it becomes something more serious.

What Perimenopause Can Teach Us About Prevention


Perimenopause provides a useful example.

Many women in their forties and fifties experience significant physical, emotional and cognitive changes.

Sleep becomes disrupted. Energy levels decline. Concentration becomes more difficult. Anxiety may appear for the first time. Confidence may be affected.

At the very stage of life when women are being encouraged to exercise, manage their weight and reduce long-term health risks, they may be facing barriers that make these goals considerably harder to achieve.

The challenge is not a lack of knowledge. The challenge is that life circumstances and biological changes influence behaviour.

This is why prevention cannot be reduced to simple messages such as "exercise more" or "eat better".

Human beings are more complicated than that.

A Question Worth Exploring


As Malaysia grapples with rising healthcare costs, an ageing population and increasing rates of chronic disease, conversations about prevention will become even more important.


Bank Negara Malaysia's recent efforts to improve the sustainability of Medical and Health Insurance/Takaful plans reflect a broader recognition that healthcare financing cannot continue indefinitely without addressing utilisation and long-term health outcomes.

At the same time, healthcare providers continue to advocate for earlier screening, better health literacy and greater preventive care, while conversations around issues such as perimenopause remind us that many health challenges begin long before a formal diagnosis is made.

Yet an important question remains.

If prevention is truly the goal, how do we support people during the years before they become patients?

The more I think about it, the more I realise that the conversation about preventive healthcare may not simply be a healthcare conversation.

It is also a conversation about value.

Today, healthcare systems are exceptionally good at treating illness. Hospitals, specialists, medications and insurance plans are largely designed to respond once a medical condition has been identified.

But the years before a diagnosis are often less visible.

This is the period when individuals begin noticing subtle changes in their health, whether that is rising cholesterol levels, declining fitness, persistent fatigue, poor sleep, hormonal changes or other early warning signs that something may be shifting.

Many choose to take action during this period. They invest in screenings, exercise, nutritional support, health coaching, mental wellbeing and other preventive measures, often at their own expense.

The question is whether we place enough value on these efforts.

If prevention is truly the future of sustainable healthcare, perhaps the challenge is not only how to treat disease more effectively, but also how to recognise and support the work people do to stay well in the first place.

Which brings me back to the question that started this reflection:

What happens between "healthy" and "hospitalised"?

Because that space may hold some of the most important opportunities for improving health outcomes, reducing long-term healthcare costs and rethinking how we approach prevention altogether.

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