Dementia is a spectre that has loomed large in my family. I watched as it slowly chipped off parts of both my grandmothers, with a gradual fog entering their eyes as time went on. It left a deep fear within me that I might someday suffer the same fate.

That fear remained in the background until 18 months ago, when I started to experience the first flickers of peri-menopause in the form of brain fog.

I gradually started to forget things at an increasingly alarming rate, whether that was walking into a room and forgetting what I’d come in for, or not being unable to remember names of people I had known for years.

This didn’t feel like middle-aged forgetfulness – it felt like something more insidious. The thunderbolt moment came when I forgot the bank account number that I have had since I was 12. It became clear this wasn’t stress or juggling things; it was perimenopause.

A recent study of 180,000 postmenopausal women by the Norwich Institute for Healthy Ageing found that taking hormone replacement therapy (HRT) may reduce the risk of dementia by 10 per cent and Alzheimer’s by 16 per cent. More women are diagnosed with dementia than men, which is thought to be partly due to living longer. This study, however, suggests that perhaps menopause may also play a role.

But what we also need is a greater understanding of perimenopause and menopause, combined with better education of doctors. I’ve interviewed women who have previously taken early retirement because they were worried their brain fog was early-onset dementia. There are a vast spectrum of perimenopause symptoms, and people are usually more vocal about the physical symptoms – hot flushes, poor sleep – than they are about the mental aspects. Then there are the 500,000 women who can’t take HRT for medical reasons too, such as having had hormone-sensitive breast cancer or blood clots.

Despite menopause training being mandatory for GPs for the last two years, I still hear a worrying number of women whose requests to try HRT have been dismissed because they are deemed “too young” to be experiencing perimenopause.

While guidance has since been amended to perimenopause starting around the age of 45, previously it used to be around the age of 47. And even then, intersectionality matters too – Black and South Asian women are more likely to experience perimenopause earlier than Caucasian women.

As I approached 40, I had women telling me that starting HRT was a gamechanger and insisting most should start taking it earlier than they currently do. Fed up of unsolicited advice around perimenopause, I dismissed this as armchair doctoring. But at 44, their advice was starting to make sense to me.

I happened to be writing a book called , which had a chapter around the climacteric – the word given to the three stages of menopause, which includes peri and post-menopause. When I interviewed author and journalist Mariella Frostrup, who is also the Government’s Menopause Employment Ambassador, something she said stuck with me.

“I still talk to educated, well-informed women who don’t understand that perimenopause begins for the majority of women in your early forties and that a lot of the symptoms and long-term damage happens during that time,” she said. The word “damage” hit home and prompted me to make an appointment with my GP.

I’d heard horror stories of women being dismissed or being given antidepressants when actually what was needed was HRT. So I went in there not asking if I should be prescribed HRT – but arguing that I needed it.

My plan was to try it for three months and if I didn’t notice a difference, stop taking it. I didn’t feel dramatically different in my first month, but after the second and third month, I noticed a palpable effect. Although I had one of the most stressful work years of my life, the HRT made it manageable.

A year later, while my memory isn’t what it once was, it is much better than before. I feel more like myself than I have done in a while. My anxiety levels are also lower, something that can be exacerbated in perimenopause.

I was lucky that I had a doctor who listened, but all too often I hear women telling me the opposite. On the flipside of that, I still see women with symptoms that impact their lives very negatively, but aren’t sure whether they are at the right age to get help.

The NHS states: “Recent evidence says that the risks of serious side effects from HRT are very low. If you’re under 60 years old, have menopause symptoms, and are not at high risk of breast cancer or blood clots, the benefits of HRT are likely to outweigh the risks.”

Of course, HRT is not right for everyone. But having spoken to a number of women in this period of their lives who report a sense of liberation and freedom after their symptoms were alleviated by HRT, it gives me a very good horizon to steer for, and I hope others feel the same.