The Silent Shift: What Women Aren’t Told About Their Bodies

A symptom brushed off for a decade becomes a diagnosis that lands later than it should have. It happens quietly, in the space between what a woman’s body is telling her and what she has been taught to notice.  

That gap was the focus of the health panel at “Health.Wealth.Her,” held on the 12th of August, in support of Yayasan Jantung Malaysia. I was not on stage for this part of the evening as I already had my turn on the wealth panel. I was in the audience, listening the same as everyone else, and this is the impression it left on me.

The health panel was moderated by Rina Ho and featured Dr Rowina Lynne Murray (Clinical Cardiologist and Internal Medicine Physician, IJN), Dr Lennie Soo (Integrative Neuro-Counselling Psychologist and Mental Health Speaker), and Dr Jaspal Singh Sachdev (Consultant Obstetrician and Gynaecologist, Park City Medical Centre). The gap they spent the evening unpacking was this: how much of what happens in a woman’s body gets noticed, only once it has already gone further than it needed to.

Listen To the Panel Discussion Here 

What Is Happening in Your Body Before You Notice

Perimenopause can begin much earlier than many women expect, sometimes in the mid-thirties, often just as careers, families, and responsibilities are becoming more demanding. That alone was news to me, and I suspect to a fair number of people in the room.

Cardiologist Dr. Rowina highlighted that changes are not always obvious. Cholesterol profiles can shift, and blood vessels can become less flexible, often without producing symptoms that immediately prompt a medical check. It is why she stressed regular screening from the late thirties onwards matters, rather than assuming an earlier clean bill of health still tells the full story.  

Psychologist Dr. Lennie described this period as a “silent shift”, one that can affect a woman’s emotional threshold before she recognises anything distinctly physical. The key, she stressed, is to understand perimenopause as a transition rather than a disease.  

That distinction matters, but so does caution. Obstetrician Dr. Jaspal noted that other conditions still need to be ruled out first. Hormonal change can explain a great deal, but it should not become a catch-all explanation that prevents another diagnosis from being properly investigated.  

The Mental Load Finally Has a Name 

Ask most women what perimenopause looks like, and hot flushes are likely to come to mind. But according to the panel, the earliest signs are often much less visible: sudden panic attacks, disrupted sleep, a drop in confidence, or a stress tolerance that once felt dependable and suddenly does not.  

That is part of what makes the transition so difficult to recognise. The body may be changing before a woman has any language for what she is experiencing. Sleep, in particular, was one area Dr. Lennie described as non-negotiable, as it is not just self-care but also part of how the brain regulates emotion, concentration, memory, and stress. When sleep is repeatedly disrupted, the effects can begin to appear everywhere else.  

I took the lesson to be this: do not dismiss those changes simply because they do not look dramatic. Sometimes the earliest signs are the easiest ones to explain away.

Why Women’s Heart Symptoms Can Be Missed 

This was the point that stayed with me the longest. The overlap between perimenopausal and cardiac symptoms makes this even more complicated.   Palpitations, sweating, and breathlessness can all appear during hormonal changes, but they can also be signs of cardiovascular problems. That makes self-diagnosis particularly risky.  

It is not just perception. A University of Leeds study, part-funded by the British Heart Foundation and drawn from over half a million UK heart attack patients, found that women had roughly a 50% higher chance than men of receiving the wrong initial diagnosis after a heart attack, and that misdiagnosis carried a meaningfully higher risk within the following month. It is UK data, but Dr Rowina’s point was that the underlying pattern, women’s cardiac symptoms being harder to read, is not specific to one country.

She pointed to microvascular dysfunction as an example. The condition affects the heart’s smallest blood vessels and may not produce the type of blockage a standard angiogram is designed to detect. A woman can therefore experience genuine cardiac symptoms without the most obvious test revealing a clear obstruction.  

Part of the problem is also how symptoms are described. Women can experience chest pain at rates similar to men but may focus more heavily on accompanying symptoms such as breathlessness, palpitations, or fatigue.  

The issue is not necessarily that women’s heart attacks look completely different. It is that the way symptoms are experienced, described, and interpreted can make them easier to overlook

The Symptoms You Have Been Normalising

Cardiovascular risk does not begin and end with cholesterol, diabetes, and hypertension, either.  

A woman’s pregnancy history can also tell an important story. Dr. Rowina highlighted gestational diabetes, miscarriage, and pre-eclampsia as factors that are relevant to cardiovascular health long after pregnancy itself has ended. Family history matters too, particularly when heart disease has appeared at a younger age.

These details are easy to file away as a part of rather than recognise as information that may still matter years later. That tendency to normalise what has long been present extends beyond medical history. Live with pain, exhaustion, or discomfort long enough, and it can stop feeling unusual. It simply becomes the baseline.  

That is precisely why noticing change matters. Familiar does not always mean harmless.

What To Actually Do. Practically, This Week.

The advice the panel left the room with was less complicated than the science behind it.  

Protect your sleep. Keep routine health checks up to date. Pay attention when something changes, even if the change seems small. Book the bloodwork, ECG, or gynaecological review before a symptom becomes impossible to ignore.  

Where possible, bring the people closest to you into the conversation. A partner who understands what is happening is better placed to offer support rather than confusion when symptoms change.  

Hormone Therapy came up as another area where fear can sometimes outweigh understanding. Dr. Jaspal’s emphasis was on timing, individual risk, and proper monitoring rather than treating hormone therapy as universally good or bad. The decision should be based on the woman in front of the clinician, not on a generalised fear of treatment.  

Access matters too. Dr. Rowina pointed to Yayasan Jantung Malaysia’s community outreach and screening work as one way to bring assessment closer to people who might otherwise delay it. Dr. Lennie also highlighted the growing role of AI in initial mental health triage, not as a replacement for clinical judgement but as another route towards helping women reach the right professional sooner.  

Do You Know What Your Health Insurance Cover Actually Includes?

Access to care is only half the equation. One pattern I see often in my own work: women who assume they are covered for something. A specialist review, an extended hospital stay, maternity cover, or ongoing treatment for a chronic condition, only to find out mid-claim that they are not. It is rarely carelessness. Health insurance is written in a way that rewards a closer read, and most people only give it one once something’s already gone wrong.

If this conversation has you thinking about a screening or check-up you have been putting off, it is worth pairing that with a second question: do you actually know what your policy covers, and where the gaps are? We ran a short webinar earlier this year on exactly that: The basics of Health Insurance. What is typically included, and the questions worth asking before you ever need to rely on it. Watch the recording here.

The Question Worth Asking Yourself 

None of this requires waiting until something feels serious.  

Check earlier. Ask earlier. Notice what has changed. Stop treating your body as something that only deserves investigation once it has already gone wrong.  

Because preparedness in health is much the same as preparedness anywhere else, including the financial kind I spend most of my working life on. It is not about expecting the worst. It is about giving yourself more options before you need them.  

So, the most useful question I left with, and the one I would leave you with to: Is there a check, symptom, or conversation you have been putting off simply because nothing feels urgent yet?

Health. Wealth. Her. was designed to create space for conversations women do not always get to have in one room. Melbourne Capital Group is grateful to Dr Rowina, Dr Lennie and Dr Jaspal for helping bring those conversations into the open, and if the financial side of that same conversation is one you would like to have, connect with me on Linkedin or email me at helenthomas@melbournecapitalgroup.com.

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