January 10, 2026|Tania Mullan

MIDLIFE, EXPLAINED

Why Has My Body Gone Rogue

What menopause can change when chronic illness was already in the room. Because sometimes everything gets blamed on menopause. And sometimes menopause is missed, because everything gets blamed on the diagnosis you already have.

Written and edited by Tarnia Mullan, Founder of SOMA Wellness Co. · December 2025 · Updated July 2026 · 15 min read

Quick Answer: Why can menopause hit differently when I already have a chronic illness?

Perimenopause does not simply add hot flushes to the condition you already have. Oestrogen and progesterone interact with the brain, sleep, pain, temperature regulation, bone, muscle, blood vessels and immune signalling. When they fluctuate, the whole "mixing desk" can change at once.

That can make an existing illness feel louder, familiar symptoms harder to interpret, or a previously compensated condition harder to ignore. It may also create a pile-up of menopause and chronic-illness symptoms that look almost identical. Menopause did not necessarily cause the disease. It may have changed the body in which the disease is being experienced.

You reach your 40s and your body seems to open a complaints department with no closing hours.

One friend has Hashimoto's. Another has rheumatoid arthritis. Someone is being investigated for lupus. Somebody else has Crohn's. Another has finally been diagnosed with fibromyalgia after years of being told her tests were normal. A woman who ate bread for forty-five years now knows more about coeliac food labels than she ever wanted to.

Meanwhile, your own body is changing the rules without circulating the memo. Your joints ache. Your legs feel heavy. You cannot recover from a busy day. The brain fog is familiar, but different. The fatigue is familiar, but deeper. Sleep has become a badly run night shift. Your skin, digestion, pain, bladder, temperature and tolerance for noise have all joined the meeting.

Then comes the medical system's filing approach.

If you already have MS, every new symptom can be stamped MS and sent to the same department. If you do not have a diagnosis, everything may be stamped menopause. If you have anxiety in your notes, your menopause symptoms can end up in that bucket instead.

Women with complex health histories know this feeling. The answer is not always that the original diagnosis was wrong. The answer is often that a woman can have more than one thing happening at once, and her body is not a filing cabinet.

The bucket problem

This is what happens when a real diagnosis becomes the only lens.

Fatigue? The "diagnosis". Pain? The "diagnosis". Brain fog? The "diagnosis". Mood and sleep? Understandable, because of the "diagnosis".

The diagnosis can be real. The treatment can be necessary. And the bucket can still become so large that menopause, sleep disruption, nutrient deficiencies and the cumulative cost of years spent pushing your nervous system are barely discussed.

The opposite mistake happens too. A woman reaches midlife and every symptom is waved away as "hormones". New weakness, severe pain, unusual bleeding, neurological change, thyroid symptoms or inflammatory illness still need proper assessment. "It is probably menopause" must not become the new "it is probably stress". If the wider pattern is still unclear, start with How Do I Know If I'm in Perimenopause?

The useful question is not, "Which single explanation is right?" It is, "What changed, what was already there, what is overlapping, and what deserves a fresh look?"

"It took me 10 years to get a diagnosis. I felt like a hypochondriac." — Toni Braxton, speaking about her lupus diagnosis [19]

Her experience does not prove a menopause connection. It captures the human cost of symptoms being real before the medical system has found the right name.

Why menopause matters when illness was already in the room

Oestrogen is not only a reproductive hormone. Its receptors are found throughout the body, including in immune cells, the brain, bone, blood vessels and connective tissue. It influences inflammation, temperature, sleep, cognition, pain processing and the way different systems communicate. [2,3]

That is why I still like the mixing-desk metaphor. Hormones are not one light switch marked MENOPAUSE. They are part of a desk with dozens of sliders: immune signalling, sleep depth, pain sensitivity, muscle recovery, brain energy, blood vessels, skin, gut, mood, temperature and the body's response to threat.

During perimenopause, someone starts moving the sliders. Not all in the same direction. Not at the same speed. Not with the same result in every woman.

If your system was already carrying autoimmune disease, fibromyalgia, chronic pain, migraine, a cancer history, treatment-induced menopause, long COVID, trauma or years of broken sleep, the change may land on a body with less spare capacity. The hormonal transition is not the whole story. It changes the terrain your body is already struggling to function within.

Cancer belongs in the wider conversation, though not in the autoimmune bucket. Cancer treatments can trigger early menopause and leave long-term fatigue, pain, sleep and cognitive effects. The National Cancer Institute is careful, stating: stress has not been proven to cause cancer, although laboratory research suggests chronic stress biology may influence progression. [13] That whole-body lens matters.

What the evidence tells us: this is women's health, not a fringe issue

Nearly 80 percent of people living with autoimmune disease are women. NIH's Office of Autoimmune Disease Research describes more than 140 chronic autoimmune diseases and related conditions. [1]
A 2025 clinical review concluded that menopause may influence the onset, course or clinical features of autoimmune and rheumatic disease. But menopause does not push every disease in the same direction. [2]
Reviews of MS and menopause find substantial overlap in fatigue, cognition, mood, sleep and bladder symptoms. A 2026 scoping review reported lower relapse activity, alongside greater neurodegeneration, functional decline and symptom burden after menopause. [7,8]
Fibromyalgia is not classified as a classic autoimmune disease. However, a 2024 review and a 2026 study describe substantial overlap in pain, fatigue, brain fog and sleep, with symptom burden often worsening around the menopausal transition. [9,10]

"About 80 percent of people living with autoimmune disease are women. That is not a niche issue. That is a women's health issue." — SOMA, based on NIH data [1]

A broad lens does not mean throwing every condition into one fashionable basket. Autoimmune disease involves the immune system attacking the body's own tissues. Fibromyalgia is generally understood as a complex pain and sensory-processing condition, although immune and neuroinflammatory mechanisms are still being studied. Cancer involves abnormal cell growth and has its own biology, treatment pathways and risks.

They belong in the same article for a different reason: women living with any of them can reach menopause with symptoms that overlap, treatments that complicate the options, and a nervous system that has already spent years responding to pain, uncertainty, medical procedures and the ordinary fear of not knowing what the body will do next.

When menopause enters that picture, most people ask, "Is this hormones or illness?" A more useful question is: "How are hormones, illness, treatment, sleep, pain and stress biology now interacting?"

The feedback loop medicine can no longer dismiss

Your nervous and immune systems are not separate departments with no shared calendar. They communicate in both directions. Immune signals reach the brain. The brain and autonomic nervous system can influence inflammation through neural and hormonal pathways. The vagus nerve, sympathetic nervous system and HPA axis are part of that conversation. This is established neuroimmune biology. [4,5]

Illness can activate threat inside the nervous system. Pain, inflammation, infection, frightening symptoms, scans, procedures and uncertainty all give the nervous system real reasons to stay alert. A nervous system that remains highly activated can then disrupt sleep, digestion, pain thresholds, energy, mood and recovery. Those changes can make the illness experience louder. That is the loop.

This is what an integrated body looks like. Physical illness affects the nervous system, and nervous-system state affects physical processes. The arrows run both ways.

Circadian rhythm belongs here too. Immune cells and inflammatory processes follow daily timing signals. Sleep disruption and circadian misalignment can alter immune activity, while pain and inflammation can destroy sleep. [6] That does not make morning light a treatment for MS or lupus. It means rhythm is part of the environment in which the body tries to regulate, repair and restore. The full sleep pattern is unpacked in Exhausted at 3 p.m., Yet Wide Awake at 3 a.m.

Researchers are also testing targeted medical neuromodulation. In a 2026 sham-controlled trial in difficult-to-treat rheumatoid arthritis, an implanted vagus-nerve device produced a statistically significant improvement at three months. [5] This is evidence that a neuroimmune pathway can be deliberately influenced by a targeted medical device. It is not evidence that humming or slow breathing produces the same disease-modifying effect.

A wider evidence ladder — established, developing and hypothesised:

Established: Sex hormones, autonomic activity, circadian clocks and immune signalling interact. Chronic stress also produces measurable changes in sleep, sympathetic activity and immune function. [2–6]
Developing: Menopause may change the course or symptom burden of chronic and autoimmune conditions. The effect differs by disease and woman. Medical neuromodulation is now being tested in inflammatory disease. [2,5,7–10]
Hypothesised: Long periods of survival-mode physiology, trauma-related stress and repeatedly overriding the body contribute to vulnerability or symptom persistence in chronic illness. This is biologically plausible and clinically observed. [18]

Here is what I found when I followed the thread

During COVID, I became the woman attending online summits with a notebook, listening to physicians, neuroscientists and trauma researchers explain the body from angles I had never been offered in a neurology appointment. I was not looking for a reason to reject medicine. I was looking for the missing chapter: what might be contributing to an immune system that seemed permanently on high alert, beyond the necessary medical work of suppressing disease activity.

Gabor Maté's work was one of the first places I heard chronic stress, emotional suppression, social conditions and disease discussed as one integrated health story. Maté states his position more strongly: "Long-term stress … can turn the immune system against oneself." [20] That is his clinical interpretation, not proof that stress caused any individual woman's autoimmune disease.

The work of Bessel van der Kolk helped bring the physiological imprint of trauma into public language. His contribution here is the insistence that trauma affects the nervous system and the whole organism, and that recovery may need body-based work as well as words. [16]

They both share a refusal to split mind, body, environment, stress, relationships and illness into sealed rooms. A large Swedish cohort also found an association between stress-related disorders and later autoimmune diagnoses. [18]

A Peek Behind the Curtain: When every answer became 'Multiple Sclerosis'

The missing chapter in my own health story

I had two autoimmune diseases diagnosed in my mid-40s: MS and VKH.

At my worst, walking more than short distances became difficult and I often needed a wheelchair. Specialists were trying to stop disease activity and preserve function. I am grateful for that care. But once MS was written across the file, almost every new symptom was folded into it.

Nobody sat me down and said: "You are also moving through menopause. Oestrogen affects the brain, bone, sleep, pain, temperature and immune system. This transition may change how your existing condition feels, and some symptoms may overlap so completely that we need to look at both."

The first dramatic shift in my nervous system came at a retreat built around naturopathic care, circadian rhythm, sleep, light, gut-friendly food, movement, nature and repeated nervous-system practices. At first the quiet irritated me. By the end, I heard the kookaburras I had somehow not heard all week. I was walking more freely. I was humming. My body-wide pain had dissolved.

Over time, my function continued to improve alongside HRT, nutrition and somatic movement with a strong focus on nervous-system work. I cannot scientifically separate which part did what. I can only tell the truth: prioritising my nervous system changed the trajectory of my life, and I would be dishonest to remove that just because it does not fit neatly inside one medical evidence box.

That experience became the question behind SOMA: how do we help women bring small, repeatable cues of rhythm, safety and restoration of their nervous systems into ordinary life?

With warmth, Tarnia Mullan Founder, SOMA Wellness Co.

Why "rest and digest" matters

"Rest and digest" is shorthand for parasympathetic activity, the part of autonomic regulation associated with recovery, digestion and conservation. The practical idea is a body needs to activate when required, then come back down to baseline when the danger has passed.

The problem is not the stress response. We need that for survival. The problem is never getting enough recovery, with the body becoming stuck in "activate" mode and rarely switching into "rest and repair" mode.

A woman can spend years in pain, caregiving, financial stress, medical uncertainty, poor sleep and constant responsibility. Her body may become very good at pushing through and very bad at receiving the message that it is allowed the time to stop.

The point is not that a slower breath, a retreat or a nervous-system practice can be credited with healing MS or a Crohn's flare. The point is that regulation is biologically relevant. Autonomic signalling reaches into sleep, digestion, pain processing, endocrine rhythms and inflammatory pathways. When the body spends more time in "rest and repair" mode, those systems operate in a better internal environment. Researchers are testing parts of that idea through vagus-nerve signalling, the inflammatory reflex and other forms of medical neuromodulation, with promising results in specific clinical settings. [4,5]

For me, that shift was not merely "coping better". It felt like function returning, symptoms settling and life becoming possible again. I cannot isolate one variable or promise the same result to another woman. SOMA's position is not that nervous-system work cures disease. It is that nervous-system regulation belongs in the whole-health conversation, because the body does not divide itself into an emotional part and a medical part.

Why midlife can hit differently

It can feel as though everything arrives at once because several things really can converge:

The symptoms overlap. Menopause, MS, thyroid disease, fibromyalgia, iron deficiency, cancer treatment, depression, medication effects and sleep apnoea can all produce fatigue, cognitive change, pain and poor sleep. If the brain changes are the part frightening you most, What's Going On With My Brain? goes deeper.
The old compensations stop working. The woman who managed ADHD, trauma, pain or chronic illness through adrenaline, perfectionism and over-preparation may find that hormonal change removes some of the buffer she relied on.
Recovery becomes more expensive. One bad night can now cost three days. A busy weekend can trigger pain or exhaustion that used to clear by Monday. A couple of glasses of wine at dinner can now wreck your sleep.
Treatment choices become more complicated. Cancer history, autoimmune disease, clotting risk, liver health, thyroid disease and medication interactions can change the MHT, botanical and supplement conversation. HRT, Botanicals, Supplements or White-Knuckle It 'Naturally'? explains how different tools can do different jobs.
The medical system divides the body. The neurologist sees MS. The ophthalmologist sees VKH. The rheumatologist sees inflammation. The menopause clinician sees hormones. The psychologist sees trauma. The woman is the only person living inside all of it at once.

What can help when the whole picture feels tangled

1. Separate new from longstanding. Write down what is new, what is worsening and what is familiar. Note timing, sleep, cycle changes, infections, heat, medications and the effect on function. "Fatigue" is too easy to dismiss. "I can no longer cook dinner after a workday without lying down" gives a clinician something useful.

2. Ask both questions. Ask, "Could menopause be changing this?" and "What else must not be missed?" A menopause-informed GP and the clinician who manages your chronic condition may each hold a different part of the answer.

3. Protect circadian rhythm as infrastructure. Morning light, a fairly consistent wake time, treatment for sleep apnoea, quieter evenings and enough sleep opportunity are not glamorous. They are part of the environment in which pain, cognition, immune function and mood are regulated.

4. Practise downshifting before collapse. Pacing is not surrender. Rest before the crash. Use gentle movement within tolerance. Try slow breathing, humming, nature, trauma-informed therapy, sound, somatic work, creativity or safe social connection. Choose what your body can actually receive.

5. Review supplements and botanicals like active tools. Natural does not mean suitable for every health history. Cancer, autoimmunity, thyroid conditions, liver or kidney disease and medication combinations can change what is appropriate. Bring the entire list to a pharmacist or qualified practitioner.

6. Stop making support another item on your to-do list. The best practice is not the one that looks impressive online. It is the one you can repeat when tired. Support needs to be simple and easy to return to, or the overwhelmed nervous system will experience "healing" as one more job it is failing to do.

One simple thing to try today — create one cue your body can learn to recognise. Choose one repeatable moment for the next seven days. Morning light with a warm drink. Three longer out-breaths before opening your phone. Ten minutes outside after lunch. The same gentle wind-down cue at night. Do not redesign your life. Give your body one small, predictable signal that says: there is no tiger in the kitchen right now.

Where SOMA fits

SOMA is a nervous-system brand because this is the gap I kept finding. Women were offered a diagnosis, a prescription, a supplement stack or a vague instruction to reduce stress. Very few were given something small, beautiful and repeatable enough to help them practise regulation in ordinary life. Why the Nervous System? explains the larger thinking behind that approach.

The SOMA Duo is not an autoimmune treatment, an MS treatment or an alternative to prescribed medicine. It is a day-to-night botanical ritual, with a repeatable morning cue and evening cue that can sit beside the medical, nutritional, movement and nervous-system support that is right for you.

The formulas were designed with ingredient transparency and medication-aware caution in mind. Every woman's body and health history is different. If you take regular medication or live with a complex condition, check the full ingredient list with your clinician or pharmacist. → Explore the SOMA Duo

Your body is not the enemy

Maybe your body did not suddenly go rogue. Maybe several systems changed at once, and every explanation you were given was too small.

Maybe menopause mattered, even though you already had an invisible illness. Maybe autoimmune disease mattered, even though you were also in menopause. Maybe pain kept the nervous system alert, and the alert nervous system made pain harder to carry.

You are allowed to use medicine and still care about the nervous system. You are allowed to value emerging hypotheses, provided they are not sold to you as proven cures. You are encouraged to investigate your options and listen to how your body responds.

Your body, your choice, your toolkit.

Share this article. Sometimes an article can say what we are too tired, frightened or medically complicated to explain. Send this to the woman whose new symptoms keep being put into one old bucket.

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Join the conversation: Has menopause made an existing illness harder to interpret, or has an existing diagnosis made menopause easier for clinicians to miss?