Menopause & perimenopause

Bridging the gap — talking with your partner about menopause

by Dixie Mills, MD

Menopause is a time when many women start asking questions — about ourselves, our lives, our changing bodies, and our relationships. But a lot of times, we do this kind of work by ourselves, in private. In fact, our partners may be unaware of how profound the inner emotional and physical changes caused by menopause can be: he or she may think everything is normal, when in reality, we could be feeling physically or emotionally off-center a lot of the time. And if your menopausal symptoms involve your mood, libido, or sense of personal equilibrium, you may be acting in ways that confuse or hurt your partner — completely without intending to.

No matter how long they’ve been with us, our partners are not mind-readers. And neither are we! Even if you feel confident about going through your menopause without support, that doesn’t mean your partner necessarily feels the same way. And unless our loved ones have been through menopause themselves, they might not have the faintest idea about what lies in store. Or they may have picked up all the wrong ideas from friends or the mass media about the “Big M”! It can’t hurt to have at least one conversation about it to keep the lines of communication open. So let’s talk about talking — how to begin or continue a conversation with your partner about what menopause is, the emotional and physical changes caused by menopause, and how you can help each other along the way.

Our differing perspectives on menopause

Our partners (usually men) are often completely clueless about “The Change.” Even though they might not come right out and say it (and probably shouldn’t), they could be harboring hidden fears based on stereotypes about menopause — that the woman in their life will awaken one morning transformed into a “mean old witch” who’s in a terrible mood that will last for the next ten years. They may worry less about how you feel, and more about how menopause will affect your behavior. They’ll wonder if you will no longer desire intimacy (or them), or if you’ll have mood swings — some who are particularly in the dark actually believe that during menopause, women go “crazy.” They may have heard of a wife of a friend of a friend who up and left her husband of 30 years and wonder if “the change” means a complete rearrangement of not just their partner, but also their partnership.

It’s true that when our hormones are out of whack, we more often find ourselves asking to be left alone, becoming instantly tearful, anxious, or hot-headed over the tiniest things, or even saying things that intentionally push our loved ones away. This is difficult for our partners — especially when they’re just trying to help us — and it’s not healthy for us either.

Menopause doesn’t have to mean strife and massive emotional upheaval — that’s just a stereotype (one of many). But it’s still a major life transition, and many women feel genuinely intimidated by the emotional and physical changes of menopause. Women may fear a “bleak period of sudden change, loss of beauty, immediate aging, and a sexless existence” that is a common misconception of what menopause means. They worry about how this change in hormones will affect their emotions. They also have real concerns about whether the people they love will provide the kind of emotional support they need. Women tend to be worried that their partners will abandon them — yet many of us treat our partners as if they had already fled!

For many couples, this emotional “gap” between one another can feel more like the Grand Canyon: astonishingly wide and utterly un-crossable. But it doesn’t have to be. The more we allow our fears and concerns to build up in silence, the greater tendency we have to overreact when they do (or do not) come true. As long as you and your partner approach menopause openly, with a sense of curiosity but without inflated expectations, the span between you will be half as wide and not nearly so deep.

Remember that at the central concern for both of you is the desire not to lose each other — to maintain closeness, attraction and intimacy. Secretly imagining Doomsday scenarios isn’t going to help anyone. What might help is for you and your partner to look at menopause in a way that defies the stereotypes — as a transition that has a brilliant light of freedom and fulfillment at the end of what might seem like a dark tunnel. So as you begin to define menopause for your partner, you can let him or her know that menopause is not something to fear, that its more difficult aspects are temporary — even when symptoms seem to last forever, they will eventually go away. But there’s a lot more to share about what menopause is as well.

Defining menopause for your partner

It’s important for both of you to know that menopause is not the end of life. It’s not a disease, handicap, or any kind of “marker” on women. It’s a natural body process that happens when menstruation ends, and women’s hormones (most notably estrogen, progesterone and testosterone) begin shifting. Hormonal imbalance can cause physical reactions, but these are not symptoms of an illness. And each woman’s menopause differs widely, based not only on personal history but on a variety of genetic and cultural factors, too:

• Japanese women report fewer hot flashes and sleeplessness.
• Greek women have more hot flashes.
• Thai women experience more headaches.
• Scottish women have fewer severe symptoms.
• Rural Mayan women report no symptoms.

(For more about how the experience of menopause differs for women around the globe, see my article on menopause across cultures.)

There are no guarantees with menopause — your menopausal transition could be easy, average, or somewhat difficult, depending on any number of factors, so let your partner know that flexibility here is key. And there are no guarantees you’ll have physical symptoms at all — up to 20% of American women experience no symptoms during perimenopause other than irregular periods, and while 60% of American women have hot flashes and dizziness, only half of those still experience symptoms after two years. And for some women, menopause offers benefits like increased energy and creativity!

It’s also interesting that menopause appears to be unique to the human female — female monkeys only live a couple years after their last pregnancy. Some experts think it developed in our species as a natural mechanism for protecting the gene pool, by freeing up older women from childbearing to help with the care and nurturing of the tribe. This is a good thing! So if you haven’t talked about menopause with your partner before, here are a few concepts you can use to open the conversation:

• Menopause can’t always be seen.
• Menopause is a transition — not a final destination.
• Menopause is different for every woman.
• Menopause is a good thing — it makes us more available to the ones we love in the long run.

But if you do have a longer or more difficult perimenopause, it’s important for both of you to come together and discuss a strategy for supporting and nurturing each other’s needs. That’s why I recommend setting a menopause date.

Making a menopause date

What’s a menopause date? It’s a day or night (or both!) when you carve out a little time together to talk about what menopause is all about for both of you, what you’re expecting from it and what you are worried about. You can make it a positive conversation over a glass of wine, or enjoy a favorite meal together, or you can make the time to do something your partner loves to do afterwards. That way it gives both of you a chance to exchange information and share in the experience.

But I’ll say it again: your partner is not a mind-reader, and there’s just no way for him/her to know really how you feel unless you find a way to express yourself in a way they can hear it. So this should be a time to focus on communication. You can also make it a talk about just getting older together — discuss health and aging issues for both of you, your money concerns and goals and thoughts about retirement. Or you can even frame it in terms of caring for the parents, and bring up how your partner’s mother went through menopause and whether he or she remembers anything about that.

Menopause is a developmental milestone

Sharing with your partner about what’s going on with you will help you understand it yourself. Menopause is a major developmental milestone in women’s lives. It is a transformation not only of your body, but of your complete self — your physical, emotional, and maybe even spiritual identity. After years of taking care of children and family, you may suddenly find yourself in a position to take care of yourself. That can be both liberating and intimidating — maybe both at the same time!

Some women in menopause find themselves evaluating everything in their lives, from the big things like their career, marriage or relationship, to little things like a change in hairstyle or the way they dress. They find themselves questioning, maybe for the first time, whether they still want to be the person they’ve been all these years, whether the things they’ve acquired at this point in their life are the things they really want, whether the beliefs they’ve held all these years are even serving them. These questions can be painful and all-consuming at times. But be assured, you haven’t gone crazy and there’s nothing “wrong” with you — it’s a natural part of any major life transition, much like asserting individuality is for teens going through the transition from puberty to adulthood.

It’s no accident that many of the patients I’ve seen use the words “I feel like myself again” when we help them regain hormonal balance during or after menopause. The hormonal shifts that go along with menopause can sometimes make women very uncomfortable in their own skins, literally as well as figuratively. Yet your partner may not realize just how earth-shaking this transition is for you unless you can communicate it (or that old stereotype of menopausal craziness might be the full extent of his/her understanding). Sometimes just stating openly that your world is upside-down right now, but that you want your partner to hang in there with you, can help guide your relationship through these sometimes rough waters.

Then there may be other times when your relationship needs a little more help than that. If there are longstanding issues simmering below the surface, menopause might be the best opportunity to address them with a professional marriage or couples counselor.

How to communicate what’s going on physically in menopause

Once your partner has gained a better sense of what menopause is, then you can start filling in the details about what is happening with your body. It’s really up to you to teach your partner about the specifics. He or she might be wondering why a mutual friend doesn’t have the same symptoms, or why you keep saying “Don’t touch me,” and keeping your distance when you “appear” fine, or why you burst into tears over the kinds of things you used to handle with no trouble. Or maybe menopause, for you, means a burst of unusual energy and creativity — which sometimes can be just as disconcerting to a partner as the more unpleasant symptoms!

Either way, the confusion about what’s going on with you could add stress to your relationship. And while we’ve known for some time that a lot of emotional stress can weaken our immune systems, making us more susceptible to colds and other illnesses, studies are now showing that relationship strain, especially in marriage, actually “accelerates” adverse health effects as we grow older.

At Women to Women, we’ve known for a long time that how we feel is connected to our physical health, and that hormonal upheaval during menopause can put extra pressure on our bodies. In some respects, keeping our partners at a distance during menopause can make what we’re going through that much more difficult. Opening up about your physical symptoms, or even asking your partner to come along when you talk with your healthcare practitioner about menopause, will give them a closer look at what you’re going through, enabling them to be more sympathetic and understanding.

What follows is a short list of physical symptoms of menopause that some women experience. Some of these are related to aging rather than to the menopause transition, and both men and women can experience them. It might be helpful to show this list to your partner, and let them know that if you fully support your body’s needs, most of these symptoms will decrease or resolve in time.

General

• weight gain, especially in the abdomen, buttocks and thighs

Menstrual cycle changes

• heavier periods
• spotting between periods
• irregular periods or skipped cycles
• worsening PMS or PMDD

Vasomotor instability

• hot flashes or cold flashes, including night sweats
• sleep disturbances, poor quality sleep, insomnia

Urogenital/vaginal atrophy

• itching
• dryness
• bleeding
• watery discharge
• urinary frequency, urgency, incontinence

Skeletal

• joint pain
• muscle pain
• back pain

Skin, soft tissue

• skin thinning and becoming drier
• a sensation of pins and needles, or ants crawling on or under the skin
• hair changes

Psychological

• mood disturbance
• irritability
• fatigue
• memory loss, and problems with focus and concentration
• depression and/or anxiety

Whether you experience all or none of these symptoms, perhaps the most important thing is to let your partner know that menopause is not “all in your head.” You are not choosing to feel sad, or choosing to wake up drenched in sweat. You can sit down together and talk about the symptoms you are having or the ones that concern you or your partner the most. You can develop a point system for how you feel each day, which will help you identify patterns and better communicate to your partner the nature and severity of your symptoms.

The best time to talk about this might be earlier than you think, perhaps before you even enter perimenopause, but reaching out at any time is better than silence! It is also critical, if you can, to bring a sense of humor to the subject — laughter can heal most anything, and there is a lot of funny stuff out there about menopause.

Talking with your partner about your libido

Communicating is especially important if you have been not been intimate with one another for longer than what’s normal for you. Here’s some good news: the myth that a fulfilling sex life is over at menopause is just plain wrong. Your sex life might change, and you might try other ways of loving each other physically that don’t include intercourse, but I know so many women who feel sexy and desirable during and long after menopause. But again, there are no guarantees, so you can let your partner know ahead of time that any of the following could influence how you feel about having sex:

• Difficulty with sexual arousal
• Inability to have an orgasm, or decreased orgasmic sensations
• Vaginal dryness and thinning of the vaginal walls, causing pain during intercourse
• Hot flashes
• Mood swings
• Decreased sense of sexual attractiveness

Again, when you provide your body with the support it needs, these symptoms should pass in time — and there are plenty of women who don’t experience them. In fact, there are some women who find their libido and enjoyment of sex increase in menopause, particularly since once periods end, the concern about becoming pregnant is gone.

One thing that’s so important to understand about low libido is that it may be related to changes in your relationship with your partner. Recent studies are showing that hormonal fluctuations during menopause don’t affect our sexual response as much as the way we feel about our partner, our partner’s own sexual health, and our own overall feelings of contentment and well-being.

So nurturing your relationship becomes even more important that we thought! Many women keep journals during menopause, and as part of your journal, you can keep track of how often you share a physical moment with your partner. It’s easy during menopause to become so absorbed in our own healing that we can barely notice as the weeks (or even months) fly by without much in the way of close contact. And this can leave your partner feeling confused or unwanted, if not unloved.

This isn’t just difficult for them, but as you’ll see below, it doesn’t help to decrease your symptoms, either.

A healthy relationship supports a healthy body — and vice versa

The health of your relationship has a direct impact on how much you both can enjoy your sex life — menopause in and of itself actually has little to do with it. Research shows that women’s sexual desire is more closely related to whether their partners were “available” — physically and emotionally capable of intimacy — than to menopausal status. Perhaps what this shows is that as we grow older, we don’t always work as hard to keep our relationships close and connected — but if we want to maintain an active, enjoyable sex life, that’s exactly what we need to keep doing.

At the same time, if we’re not feeling good due to hormonal fluctuations or other factors of menopause, our relationship can suffer as a consequence unless we make it clear that any lack of interest we might have in sex is due to our need to take care of ourselves. Sometimes the best thing we can do for the well-being of our relationship is to pay attention to our own health! So don’t neglect your nutrition, sleep, and other health needs, as these might be the key to supporting your partnership as well as your body.

But it’s also important to distinguish “sex” from just intercourse. The small gestures we receive from or offer to our partners (a longer-than-usual kiss, a finger gracing your cheek, even just a loving look) can do wonders. And there are many other ways to be physically intimate with each other. Tell your partner that you’re interested in sensuality, not necessarily “sexuality.” This can include:

• Hugging, cuddling, kissing, spooning
• Leaving “suggestive” notes or symbols around
• Touching, stroking, massage, sensual baths
• Manual stimulation
• Checking out a sex manual together or visiting a high-end sex store together
• Oral sex

Men, too, go through sexual changes in midlife, and aging reportedly affects men’s sexual response more than women. Educate yourself about your body and have fun exploring new ways to enjoy each other physically (see our articles on rekindling desire, the health benefits of sex, and the health benefits of self-cultivation). Above all, let your partner know that you still need and appreciate their attention. And this begins with talking.

“How do you feel today?” — communicating your emotions

During menopause, we might genuinely be feeling hopeful and strong one moment, and completely lose it the next. It’s vital that your partner understand that these fluctuations can be a part of the experience for women, and not to take it personally. Menopause sometimes makes us “uncensor” ourselves, which can be both good and bad: we may rejoice at finally being able to share our thoughts and emotions more openly, but at the same time we may find ourselves “flying off the handle” as we vent pent-up feelings in ways that are hurtful. This weakens our partner’s ability to help and support us. So what follows are some healthy ways to communicate how you feel:

• Be honest with yourself, and each other. Before you instantly react, try to identify the honest source of your emotion. Lying to each other, even white lies like saying you feel fine when you don’t, only widens the gap between you.


• Ask questions. Make a point to inquire how your partner is feeling, not just what they’re doing. But you may need to experiment a bit with wording to find an approach that works to open them up. Sometimes people send up walls when you start a conversation about feelings, so you may want to open with some questions about what they’re doing and then lead into how they feel about what’s been going on.


• Be aware of your own emotions. We know they are powerful, so it serves us to handle them responsibly. Tell your partner when you’re feeling bad, so he/she can gauge how to respond. Something like, “I’m feeling off-center, so please don’t press me. If it’s something we really need to talk about, write it down, and we’ll discuss it later.”


• Check in with each other every day. Find a time when the two of you can reach a common emotional place each day, whether it’s first thing in the morning, or maybe a special time to talk in the afternoon. Knowing you can rely on your partner for that positive time during the day will help you both support each other. Giving your partner a positive comment or compliment at least once a day — the more the better — has been shown to be a key ingredient in lasting relationships.


• Exercise restraint. If you don’t know why you’re angry, do your best not to unload on your partner — there are many ways of coping with stress and anxiety, and no one appreciates being a dumping-ground. Once you’ve calmed down, counted to 10, and become aware of the source of your emotion, then you can better communicate with your partner.


• Apologize when you cross the line. If you said or did something that hurt your partner without meaning to, express your regret right away — don’t let it fester or gloss it over so it winds up becoming yet another barrier to communication. It’s a way of letting your partner know that you respect his or her feelings in this difficult time.


• You may have to decide on some other ways to communicate in front of young children, if you have them. You can come up with your own hand signals to convey “That’s enough…” when the youngsters are around. Or on the other hand, you can have a sign for “You’re hot!” too. Stay tuned for another article about talking to your children about menopause — we will create an entirely new way for the youth of today to see this generation.


• Exercise release. If you really need to vent to someone, put your words into a framework that’s helpful for them: “Is it okay if I just vent for a minute?” or “Do you have a second to listen?” or “I’m freaking out, and I really need to get this off my chest.” Tell them that you’re not looking for a cure, you just need to clear the air. That will prepare them for what’s to come!


• Choose your battles. Ask yourself if what you’re upset about is really a big deal — couples who bicker constantly may become desensitized to one another. Then when a more urgent issue arises, they’re less likely to be able to listen to each other or find resolution.


• Give each other breathing room. Again, no matter how much our partners would love to “fix what’s wrong,” sometimes you just aren’t always looking for solutions. Saying there’s nothing he or she actually can do for you but give you the space and time you need to restore balance is one approach. “I just need a little breathing room” is a great, kind way to let your partner know you need this space.


• Find the humor whenever possible. The strongest couples are the ones who can laugh together. If you both find yourselves struggling to communicate, it’s easy to change the “air” with a joke or two — go easy on each other!


• Find alternative forms of communication. In the immediate moment of a heated exchange, sometimes it works to write how you feel instead of talking. You can take the time you need, and he/she can put frustrations down on paper. Then the issue also isn’t forgotten. Some couples have developed a numeric system together to try and identify how each is feeling — especially if you or your partner feels that someone is overreacting or pushing buttons. Rather than having to articulate how upset you are, you can say, “Careful, I’m an 8 out of 10 right now,” and your partner will know exactly what that means! Then later, when you’ve let go of the strong emotions, you can bring up the problem and discuss it more effectively.


• If things don’t get better... Sometimes you can work very hard at all of the strategies we suggest and still it doesn’t seem to work out. That may be time to get help from a couples counselor or therapist. There may be hidden issues that need to be resolved before you can successfully connect and communicate.


• If it still doesn’t get better... You should understand that you’re not a failure if you decide you need to end your relationship. Not every partner is willing to be supportive or even to meet you halfway when you try to connect. Sometimes menopause, the “change of life,” signals far-reaching changes in every aspect of your life, not just in your reproductive life. Menopause can make women less fearful of life transitions as well as less tolerant of behaviors in a partner that they used to simply accept. And if your partner isn’t interested in changing with you, then it may be time to cut your losses, give yourself time to grieve, and then start over.

What you both have to look forward to after menopause

Menopause is an entirely natural life transition and, for the most part, the symptoms too will pass with time — even though some might last for what seems an eternity. Once the periods don’t come back and those rocky monthly cycles disappear, women often become much more comfortable with their true selves. There’s a place of centeredness and fulfillment that many women reach as they exit a lifetime of hormonal fluctuations. Truly, there’s a lot to love about menopause — for instance, what couples often don’t realize is that many postmenopausal women report a much stronger union with their partner after menopause, both physically and emotionally.

It may not be easy (or even possible) for your partner to fully understand what you’re going through. But with a little bit of work from the both of you, you can bridge the gap — or even avoid it completely. Find a peaceful and supportive middle ground. Remember that menopause is not the end of a woman’s life; it is a totally revitalizing transition that can change the way you both live and love — together.

Related to this article:

References & further reading on talking about menopause

 

Original Publication Date: 06/23/2008
Last Modified Date: Last Modified: 02/16/2010
Principal Author: Dixie Mills, MD