You’d expect that a book about menopause would be directed at women. It would also be fair to assume that, given my nature, it might contain a couple of acerbic asides aimed at men. But what my book Cracking the Menopause (and the title was conceived by my husband) acknowledges is that menopause very much affects family and friends, and that we need to educate men as well as women.
The impact of menopause on men is far too often overlooked. They need to be told about the subject because it affects their lives too. ‘The Change’ jokes are firmly off the menu. In today’s new, improved, embracing environment, it’s all about understanding, education and respect… and then you can go back to the comedy potential, which we all know is bountiful.
As marriage or a partnership is (ideally) a long term commitment, it’s worth appreciating the biology and psychology of this time of life, and asking what you can usefully do to help rather than turning a blind eye and hoping it will go away. Knowing about menopause is likely to help sustain a happier relationship and therefore make your life a better place.
It’s hard not to sound patronising when writing a guide for the opposite sex, but this isn’t the goal. It’s biological facts, not womansplaining the offside rule. I can’t tell you how appreciated it is when a man genuinely wants to understand women’s bodies (and not just in a ‘is it nice when I do this?’ sort of way).
The above is not to say my personal experience was a festival of roses. When I recently asked my husband whether I changed during my pre-HRT perimenopause years, his answer was blasphemously rude. From the age of 49 to 51, I vaguely recall him displaying an infuriating lack of interest or sympathy as I unknowingly suffered the first signs of hormonal turbulence that signify the perimenopause, with such vague symptoms as sleeplessness, anxiety and fury. (Of course, long-standing couples will be familiar with all of these emotions, and not necessarily identify them with significant life events.)
Relationship-wise, they were not the happiest years in the Frostrup household. Now, aged 58, with the menopause firmly under my belt and living in a happy and HRT-filled hinterland, I realise that part of the problem was that I didn’t really know what was happening. With two of us ignorant about cause and effect, it’s no wonder we found navigating the period quite a challenge.
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How, if I wasn’t aware I was suffering a catastrophic loss of oestrogen, could a partner with a body largely fuelled by testosterone possibly understand? This has been a problem throughout the centuries. I delved back thousands of years, and the entire history of the menopause was largely written by men. In addition, the menopausal experience is unique to every woman, meaning that those in same sex partnerships may also struggle because their experiences are totally different.
It’s no exaggeration to say that most reading I did around the subject of menopause and relationships wasn’t positive. The majority of the data I ploughed through made it perfectly clear that most women were not clued up while men are often completely left in the dark.
For example, in a 2020 survey of 1,500 menopausal women and 500 male partners, 77 per cent of the men said that they’d noticed a change in their partner’s moods, and 50 per cent that she had gone off intimacy. A further 40 per cent noticed she was always tired. But the overwhelming feeling on their part was of being shut out and pushed away.
Another recent piece of research by Avon found that 26 per cent of UK women feel either uncomfortable or very uncomfortable discussing menopause with their partners. Looking at the centuries of mythology around menopause, it’s clear why that might be. Until recently, a woman admitting to menopause was tantamount to saying you were now going into retirement as a sexual being. So it’s not so much because we think men don’t deserve to know, but that it’s too embarrassing to share with you. No wonder you’re left floundering in a thick mist of incomprehension.
So – all men – listen up. The menopause is but a fleeting moment, occurring exactly 12 months after our final period. As our ovaries stop producing eggs, the three key hormones made by them – oestrogen, progesterone and testosterone – fluctuate and then fade (if you must, think of the ovary as a car engine running out of petrol and gradually puttering to a stop. And HRT as refuelling.)
There are oestrogen receptors all around the female body; from the brain and skin to the heart. If the hormones are going up and down like a yoyo, then so – metaphorically speaking – is your wife or partner.
The years before that final moment are known as the perimenopause and the subsequent decades are post-menopause. Around 80 per cent of women experience symptoms, which can begin up to a decade before and last for years after. On average we go through menopause at the age of 51.
There are said to be 34 symptoms, which can be as specific as a hot sweat or as utterly vague as insomnia, irritability, anxiety, itching, headaches and dryness (vaginal or otherwise).
Anger is a key one. I’ve spoken to many women (and yes, I have experienced this myself) who have found themselves transformed into heat-seeking missiles furious over such seemingly minor misdemeanours as teaspoons in the sink, not saying we look nice or buying the wrong washing powder. It can be confusing and infuriating for everyone.
My advice, for what it’s worth, is to buckle up and enjoy the ride. It’s not often you’ll find the full spread of human emotion available on tap in your own home. That sense of trepidation about who you’re going to encounter each morning, rather than a negative, could add spice to your relationship. I am of course being slightly facetious here, but truly, any long-term relationship is about riding a rollercoaster together through life. If you’re armed with the facts, you can make this stomach-lurching dip a far easier one for the woman you love.
Laugh together at the crazier moments, and show kindness and support for someone who’s probably already balancing two jobs (paid and unpaid) and is now having to navigate her busy life while her body is playing hooky.
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There are many and much-debated solutions. HRT, where you replenish the lost hormones, is (in my opinion and that of all the experts to whom I spoke) an obvious choice, but it's still as hotly argued as the new cabinet line-up regarding breast cancer risk (actually very low). Cognitive behavioural therapy, meditation and mindfulness can all provide relief, and so might some supplements - I swear by magnesium for my restless legs. And, boringly, less alcohol, a better diet and more exercise are all likely to improve symptoms and mood. Whatever your wife or partner decides she wants, support her. You don’t know how it feels when your hypothalamus becomes over-sensitive, or how a lack of sleep and a deficit of oestrogen might make you feel as though you’re suffering from dementia. Empathise but do not advise.
Sex is another tricky topic. Many women suffer from such discomfort as dryness and increased UTIs, as oestrogen affects lubrication. The psychological effects and tiredness that may occur through menopause can mean that libido drops like a stone in a well.
I know it’s excruciating, but don’t be offended if we resist your amorous advances (or don’t appear to make an effort ourselves). There are solutions, which can be quite cheerfully explored together – outercourse is one (think about it) and the wonders of a tube of lube must not be dismissed! Local, or vaginal, oestrogen, applied directly to the area, is hugely helpful (and no breast cancer link at all). The importance of maintaining intimacy is vital. I personally recommend what I call appointment sex, whereby you schedule it, just to make sure it’s still present in your relationship.
Although these thoughts are genuinely meant to be loving and empowering, they come with a side dish of caution. The clichéd image of midlife is that of men roaring off in their fast motors with a busty younger woman, but the reality is that we older women are far more likely to instigate actual divorce than men.
Released (whether reluctantly or not) from our fertility, we are far more likely to be seeking pastures new. Honestly, it’s worth putting in a bit of effort to make sure you’re grazing in the same field for the rest of your years.
Cracking the Menopause by Mariella Frostrup is available from Telegraph Books for £20. To order, visit books.telegraph.co.uk or call 0844 871 1514