Menopause is called “the change of life” for a reason. But a more accurate nickname would be the changes of life—as in changes with an “s.” That’s because a woman changes dramatically in many, many ways during perimenopause, which are the years leading up to menopause. These myriad changes can affect both the body and emotions for decades, from the 30s through the 50s and beyond. And the shifts in a woman’s overall presence may also affect her romantic relationships.  

Communicating clearly about what you’re feeling physically and emotionally can help your partner understand what you’re going through. The problem is, most women don’t share the gory details of menopausal symptoms with their male partners (perhaps because so many women don’t fully understand what’s happening to themselves!), and that gap can create confusion and misunderstandings.  

Why is menopause so hard to discuss?

Our grandmothers and mothers suffered through menopause mostly in silence. A few brave gals may have shared their struggles in hushed whispers, but back then, polite society just wasn’t ready to converse in normal tones about hot flashes, mood swings, and (ahem) vaginal dryness. The thought of talking with a man about menopause symptoms might have made your grandmother faint.

It’s only in the past few years that women are tossing cultural bias aside and talking to each other about menopause in loud, clear voices. Now we’re celebrating ourselves, taking steps toward wellness throughout the transition, and taking control of how we experience it. Thank goodness for that!

But ladies, leaving men on the outside of the discussion can leave them feeling confused and frustrated. In the interest of preserving our romantic relationships, it’s time to open up to our guys about menopausal secrets. They need to know!

Explaining menopausal symptoms to your male partner

One way to help your partner understand what you’re going through is to tell him how it feels. Explain exactly how each symptom is affecting your body and emotions.  

If you’re still a little nervous about what to say, here’s some help. For each symptom, there’s a quote or two to use as conversation starters and a bit of factual info to share.

Hot flashes

     “Did you ever bite into a hot pepper, and you broke out in a sweat and felt like your mouth was on fire? A hot flash feels like that—but it’s your whole body that’s sweltering.”

If your man doesn’t dabble in hot peppers, maybe try saying something like this instead:

     "Imagine you're sitting in an important meeting, trying to look professional, when suddenly your body decides it's time for a surprise trip to the surface of the sun. Your face turns bright red, sweat starts trickling down your back, and you're desperately hoping nobody notices the damp circles forming under your arms. Meanwhile, everyone else looks perfectly comfortable. Fun times."

About three-quarters of perimenopausal women have hot flashes, and the symptoms can continue into postmenopause. Sometimes a hot flash occurs in response to stress, caffeine, or a warm room, but often there’s no apparent trigger. You feel a sudden flood of warmth, then you start to sweat, and your heart may race. Each hot flash can last up to five minutes.

Sleep disturbances

     "Every night starts with so much promise. I slide into bed tired enough to fall asleep standing up. Then menopause says, 'Not so fast.' Suddenly, my brain is hosting a late-night TED Talk on every problem in my life. If I finally manage to fall asleep, I'm wide awake again at 3:47 am, staring at the ceiling and contemplating whether it's too early to start the coffee maker. And all this happens while you’re sound asleep and snoring like you’re mowing down trees!

     Other nights, I bolt awake, drenched in sweat, wondering who turned my bed into a crockpot. I kick off the covers, peel my pajamas off my skin, and try to cool down—only to be shivering five minutes later like I’m camping in the Arctic. Then I’m up changing clothes at 3:00 am, because apparently menopause comes with costume changes. By the time I get back in bed, sleep has left the building, and I start the morning feeling like I spent the night wrestling a swamp monster."

Insomnia is common in midlife women. It may manifest as trouble falling asleep, night sweats disrupting sleep, or waking up in the wee hours and staying awake. The end result is that 40-60% of perimenopausal and menopausal women struggle with frequent insomnia. Not getting 7-8 hours of quality sleep may lead to daytime fatigue and brain fog. Chronic insomnia has been linked to serious health troubles like insulin resistance, diabetes, and even heart disease.

Mood swings

     "One minute, I'm perfectly fine. The next, I'm ready to throw hands because someone loaded the dishwasher wrong. Then I'm crying because a stranger reunited with their lost cat on Facebook. Then I'm laughing at a meme. Then I'm irritated again because the thermostat is set to 72 degrees. Honestly, it feels like my emotions are being controlled by a toddler with a remote control and no adult supervision."

From 40-70% of perimenopausal women struggle with mood instability. While sleep-deprivation plays a big role, mood swings are also linked to hormonal changes. When estrogen declines, a mood-regulating chemical called serotonin may also drop, which has been associated with shifts in a woman’s mindset. Progesterone, which is a calming hormone, also typically declines during perimenopause.  

Normal stressors during midlife can pile on too—job woes, relationship struggles, transitioning to an empty nest, losing a parent, or caring for a parent with health problems. These can cause strong emotions to bubble up and make a woman feel on edge.

Intimacy challenges

“Can I tell you something? My vagina’s on fire (no honey, not in a good way). It feels so dry and irritated that sex isn't just uncomfortable—it's downright painful. Imagine having a paper cut on your penis and then rubbing it repeatedly with coarse sandpaper. Not exactly a recipe for romance, right? I've been pulling away, not because I don't love you or find you attractive, but because I've been dreading the pain and didn't know how to explain it."

Menopause can take a toll on intimacy in multiple ways. Battling fatigue due to sleep disturbances can make you too tired for sex. And body shape changes, like a puffy tummy and thicker thighs, can make you feel less sexy. Libido can drop—or disappear completely.  

But vaginal dryness is especially tricky, and it catches many women by surprise. Sometimes using a lubricant can help. But lack of estrogen causes vaginal tissue to become thin and fragile, so a lubricant may not always soothe the irritation.

Sadly, many women don’t share what they’re experiencing with their partners. In a survey of 4100 menopausal women, 28% of them did not tell their partners when they first encountered vaginal discomfort because they were embarrassed or felt it was just a natural part of aging. Some who used vaginal lubricants even hid that from their partners.

Sharing the details creates opportunities for understanding

Your partner may feel rejected or frustrated when you seem uninterested in physical intimacy due to your menopause symptoms. Sharing details about how you’re suffering physically and emotionally can reassure him that you’re not rejecting him. And it gives him a chance to be there for you with support and compassion.

It seems like men are very open to learning about menopause, even the really nitty-gritty stuff like vaginal dryness. In fact, in the survey mentioned above, 4 out of 5 men wanted their partners to talk about how vaginal symptoms affect them.

Menopause is a women’s issue, but it affects our male partners too. If we’re open about our struggles, it helps our men understand what we’re going through and may avoid misunderstandings that can lead to serious relationship issues.

Have you considered hormone therapy?

No matter which menopausal symptoms you’re battling, replenishing your hormones with bioidentical hormone replacement therapy (BHRT) may help. At Belmar Pharmacy, our pharmacists can customize the delivery method to match your needs, with under-the skin, topical, and oral options.  

For vaginal dryness, your provider could prescribe a cream to apply to the external and internal vaginal areas. In studies, vaginal estrogen therapy has been associated with less painful sex in a significant portion of women. Imagine being able to have comfortable and enjoyable sex again!  

You’ve suffered in silence long enough. Talk about your menopause symptoms with your partner—and your provider.

Note: If you’re a man, read, “What NOT to Say to a Woman in Menopause (and Other Lifesaving Tips)” for ideas on ways to show up for your wife or partner who is experiencing midlife changes.