Understanding the Change: Menopause Basics

Menopause is technically defined as one year after a woman’s final period. It marks the point when the ovaries stop producing eggs, leading to a permanent decline in key hormones: estrogen (estradiol), progesterone, and testosterone.

The transition itself is a process with four key stages:

1. Pre-menopause: The time before any menopausal symptoms begin.

2. Perimenopause: The period when hormonal changes begin and symptoms occur, but periods are still happening (even if they become irregular). This phase can last from a few months up to around 10 years, often starting when a woman is in her early $40$s. Many women don't realize their symptoms—like fatigue or brain fog—are due to perimenopause, often attributing them to stress.

3. Menopause: The point marked by 12 consecutive months without a period.

4. Postmenopause: The time after menopause has been reached.

In the US, the average age for menopause is 52 [1]. If it occurs before age 45, it is considered early menopause, and if before age 40, it is called Premature Ovarian Insufficiency (POI). Medical treatments like having ovaries removed, chemotherapy, or radiotherapy can also trigger an early menopause.

What Symptoms Might Be Impacting Your Partner?

When estrogen, progesterone, and testosterone levels fluctuate and then decline, the effect can be systemic, impacting nearly every cell and organ in the body. While some women experience very few or no symptoms, 75% to 80% of all women experience several symptoms, and about 25% of those women have severe symptoms [2].

Symptoms often include:

• Emotional & Mood Changes: Your partner might be irritable one minute and tearful the next. Mood changes are extremely common, with over half of women with symptoms reporting them [9]. Irritability is a frequent mood complaint [10], and the emotional toll can be particularly pronounced if she has a history of PMS or postnatal depression.

• Sleep and Energy Issues: Hot flushes and night sweats can wake her up drenched, leading to fatigue and poor sleep during the day.

• Cognitive Issues: "Brain fog," including memory lapses and poor concentration, is a frustrating common symptom.

• Physical Aches: Low hormone levels can cause joint pains and muscle aches as these hormones are important for joint lubrication and preventing inflammation.

• Sexual Health: Declining testosterone can lead to a lack of libido (interest in sex). Lower estrogen levels can cause the vaginal tissues to become thinner and drier, leading to painful sex.

• Urinary Changes: Thinning of the bladder lining can cause a frequent urge to use the toilet or recurrent UTIs.

• Period Changes: Periods often become heavier or much lighter, usually occurring more irregularly before stopping altogether.

How Menopause Affects Your Relationship

If your partner is experiencing symptoms, they will affect you—either directly (like being woken up by night sweats) or indirectly (like dealing with a lowered mood).

The emotional toll is significant. Menopause also frequently coincides with other major life transitions, such as children leaving home, caring for elderly parents, or career changes. Your partner may be in a period of reflection or even reinvention. If she embraces new changes that seem sudden, try to understand she may be embracing a new stage of life.

Treatment and Health: Why Seeking Help Matters

Nobody should have to wait until symptoms are unbearable before seeking help.

The most effective treatment is Hormone Replacement Therapy (HRT), which works by replacing the three key hormones (estrogen, progesterone, and testosterone) that the body has stopped producing.

Seeking medical advice is also vital because low hormone levels are linked to an increased risk of developing other health conditions, including:

• Osteoporosis (bone weakening) [3]

• Cardiovascular disease (heart and blood vessel issues) [4]

• Type 2 diabetes [5]

• Dementia and cognitive decline [6]

• Auto-immune diseases [7]

• Some cancers [8]

Health guidelines emphasize an individualized approach and shared decision-making when considering treatment options.

How You Can Be Her Champion: 7 Ways to Support Your Partner

Your support is critical. By having an understanding of what she’s going through, you can support her through these physical and emotional changes.

1. Learn About Menopause: Read up! Offer to go with her to medical appointments—she might appreciate having an advocate or note-taker. Even just offering shows you care. You can find evidence-based information on this topic and on the balance app.

2. Be Patient: If she starts HRT, don't expect an instant "cure." It can take time to find the right dose and type, and full symptom relief often requires a holistic approach (diet, exercise, stress management). Be a stable presence, not a "fixer."

3. Don’t Take It Personally: It can be hard when your partner is irritable or angry. Try to understand that her mood swings are a common hormonal complaint [10], and not about you. Have coping mechanisms ready for when you feel hurt, and try not to snap back.

4. Go With the Flow: Many women feel overwhelmed. Don't put too much pressure on her, and offer to help with decisions, even trivial ones. If she withdraws from social events due to fatigue or self-confidence issues, be her safe space.

5. Factor in Libido: A lack of sex drive or painful sex (due to lack of lubrication) is common. Your reassurance is huge; tell her you love her and appreciate her. Conversely, some women feel liberated and gain confidence once periods stop.

6. Make Time for Each Other: You don't always need a "big talk." Try building in small, regular habits, like a 10-minute evening walk where you can be side-by-side. Many people find it easier to talk when they are outdoors and walking together, holding hands, which is a powerful way to stay connected.

7. Be Her Champion: Encourage her to seek advice and treatment from a clinician who is experienced in hormone therapy. You can be her advocate as she navigates treatment options like HRT, including the use of testosterone.

Sources (US References)

1. The statistic that the average age of menopause in the United States is 52. (Source: National Institute on Aging)

2. The estimate that 75% to 80% of all women experience menopausal symptoms, with a significant percentage experiencing them severely. (Source: Johns Hopkins Medicine and general medical consensus in the US)

3. The acknowledgment that low hormone levels are associated with an increased risk of health conditions, specifically the increased risk of osteoporosis (bone weakening disease). (Source: Mayo Clinic and Osteoporosis Canada)

4. The acknowledgment that low hormone levels are associated with an increased risk of health conditions, specifically cardiovascular disease (conditions affecting the heart and blood vessels). (Source: American Heart Association and Women's Health Initiative studies)

5. The acknowledgment that low hormone levels are associated with an increased risk of health conditions, specifically type 2 diabetes. (Source: Diabetes research consensus)

6. The acknowledgment that low hormone levels are associated with an increased risk of health conditions, specifically dementia and cognitive decline. (Source: Observational studies and Women's Health Initiative Memory Study (WHIMS))

7. The acknowledgment that low hormone levels are associated with an increased risk of health conditions, specifically auto-immune diseases. (Source: The Menopause Society)

8. The acknowledgment that low hormone levels are associated with an increased risk of health conditions, specifically some cancers. (Source: Breastcancer.org and National Cancer Institute)

9. The finding that many women experience a negative change in their mood and emotions, with a significant portion reporting mood changes as a symptom. (Source: YouGov/US-based polls state 56% of women with symptoms experienced mood changes)

10. The finding that irritability is a common mood complaint for women during perimenopause. (Source: American College of Obstetricians and Gynecologists (ACOG) notes about 40% of women in perimenopause experience mood changes similar to PMS, including irritability)