How to support your wife when she is going through menopause

Menopause can affect a woman's mood, memory, alcohol tolerance, and libido, requiring supportive partners. Photo / 123rf

As Dr Samantha Wild, BUPA Health Clinics’ women’s health clinical lead, says: “For many years we’ve just been told that menopause is all about hot flushes and maybe night sweats, whereas oestrogen affects every single body function so women can experience the multitude of physical symptoms and a lot of psychological symptoms as well.”

My wife, Stephanie, is 45 and going through perimenopause, the transition stage leading to menopause. We already have a hormonal history. During unsuccessful IVF treatment she was put through a reversible chemical menopause, which served as a prelude to the biggie. I am fortunate. She has been a good teacher for me. The business she founded, Laughology, was also one of the first to offer menopause awareness workshops to organisations. With an expert navigator at the helm, I understood what the hell was going on when, in the middle of a shop, she suddenly started taking off her clothes and panting. I know (now) not to frown or laugh, but to patiently take her handbag and hold the layers as they peel off.

I also know that when I’m asked to sleep in the spare room, it’s no reflection on our relationship, she just wants a good night’s sleep. And that on the very rare occasions when she is angry with me for a minor infraction that would normally fly under the radar, the best thing I can do is roll with the punches. Do not react.

As the years roll on, I know what’s coming down the track for her, and I have nothing but empathy. The mental and physical toll is profound. The best thing a partner can do is understand and support.

If like many men you’re not as educated about menopause as you could be, here are some pointers that might be useful.

Her mood might fluctuate

During perimenopause, oestrogen and progesterone, the hormones that control the menstrual cycle, start to fluctuate. These hormones are also thought to influence serotonin and GABA, the neurotransmitters that promote feelings of well-being and happiness. When hormone levels drop, serotonin levels also fall, which contributes to increased irritability, anxiety, anger, irritability and sadness.

Many women also have problems sleeping during perimenopause and menopause, which amplifies these symptoms.

Dr Louise Newson is a GP, menopause specialist and a member of the parliamentary UK Menopause Taskforce. She says: “Women can also ruminate and catastrophise. They can worry about things they wouldn’t worry about normally.

“In perimenopause, PMS symptoms can also get worse and last longer, and even though you might understand that this is caused by hormones, you can’t stop yourself feeling the way you do. You can’t take a step back and depersonalise yourself from it.”

As a supportive partner, it is your job to understand this and make allowances. Sometimes, you might get both barrels for no apparent reason. Man up and live with it, don’t react back.

And when it comes to discussing hormones and the possibility of hormone replacements, women do not want to be mansplained to.

“On a simple, practical level, women want to hear ‘what can I do to try to help you?’,” says Dr Wild. “Be supportive, encouraging and kind. Try not to take things personally and recognise that your loved one may have changed but this is not because of you or anything you’ve done. But equally, try not to attribute everything to the menopause. It’s a tricky time.”

When the dust has settled, do say: “That was really out of character for you, do you think maybe it could be related to hormones?”

Don’t say: “Calm down, love.”

Menopause is marked by decreased oestrogen and progesterone levels, impacting mood and health. Photo / 123rf

Memory loss is common

Research shows that, during perimenopause and menopause, a reduction in a hormone called estradiol, which is a potent form of oestrogen, causes a reformatting of the brain cells that regulate memory, causing forgetfulness and brain fog.

According to Dr Newson’s research these are the most common menopause symptoms reported. “Women describe it as like thinking through treacle,” she says. “It might sound funny when you find your car keys on the fridge, but when you start to forget names, birthdays, anniversaries and why you left the house, it can have a serious impact on relationships and on work.”

A government report found that 900,000 women in the UK had left their jobs because of menopausal symptoms while the Chartered Institute for Personnel Development (CIPD) found that around one in six women (17 per cent) have considered leaving work because of a lack of support in relation to their menopause symptoms.

“That’s not good for relationships,” says Dr Newson, “it puts an extra financial strain on households, which can then lead to pressures and arguments. In some cases we know that domestic violence increases during perimenopause and menopause, which is something that’s often not spoken about.”

Wild recommends offering greater reassurance to your partner. “Do what you can to help out,” she says. “Women can often worry that they may be developing Alzheimer’s, so reassure them and let them know this is normal. Forgetting names can be an issue if you’re in a social situation, so help if you can without making it really obvious.”

Do say: “You remember Brian, don’t you dear?”

Don’t say: “Duh!”

Alcohol tolerance nosedives

Liver function declines naturally with age in everyone and in the perimenopause, menopause and postmenopause stages of life this is exacerbated for women because levels of enzymes that process alcohol also reduce, leading to an increased intolerance of alcohol. And booze can also amplify symptoms, such as hot flushes, mood swings and insomnia.

Dr Newson says: “Our metabolism changes when we don’t have hormones and so does the metabolism of our liver. A lot of people find that they can’t tolerate alcohol in the same way and that they get worse hangovers or get drunk quicker. But conversely, we did a survey on addictions, and found that some women are drinking more because they want to numb their symptoms.”

For partners, quiet vigilance is the key. “If someone is drinking more or participating in risky behaviour, recognise it’s a warning that could be related to their hormones in some way,” recommends Dr Newson.

Do say: “Just a quick one and then we’ll go home.”

Don’t say: “Let’s do shots.”

During menopause, women often experience reduced alcohol tolerance due to enzyme changes. Photo / 123rf

Sex changes

Intimate relationships often change profoundly when a woman goes through perimenopause and menopause. Declining oestrogen levels cause physical and psychological challenges for couples, ranging from vaginal dryness, which makes sex painful, to trouble achieving orgasm, low self-esteem and loss of libido.

“The last thing you want to do is hop into bed,” says Dr Newson. “Sex can be painful, and if you can’t orgasm, you don’t enjoy it. A lot of women I see tell me they love their partner, but just don’t want sex with them.”

Libido does often return, and hormone replacement therapy can help as can treatments such as vaginal hormones to help with physical symptoms.

The experts agree that, for partners, the most important thing to do is to talk and not to presume that your partner doesn’t love you anymore.

“Over a third of women report a loss of sex drive,” says Dr Wild. “They may also be suffering with aching joints and loss of sleep. Men should try not to take it personally if they do not want sex, while understanding what your partner is going through. Remember that intimacy is not all about penetrative sex. It can be cuddling, kissing, even just spending time together.”

Ultimately, there is no one-size-fits-all approach because symptoms are individual. “You’ve got to find out what works for your partner,” says Dr Wild. “And that is best done through open, honest conversation.”

Do say: “I understand and I am here to support you.”

Don’t say: “What about me?”