Menopause Is a Team Sport: What Every Man in Her Life Needs to Know

If you're reading this, there is likely a midlife woman in your life who seems a little different lately. You might have noticed that she is more tired than usual, maybe she's not sleeping, maybe she's more emotional, more forgetful, or just doesn't seem like herself. Maybe she even has been giving you some dirty looks. 

You could be wondering what happened. However, the truth is, she's probably wondering the exact same thing. Men, this one is for you.

Perimenopause and menopause are some of the most significant biological transitions a woman will ever experience, yet most people still know very little about them. In this day and age, information is becoming more available, but women are still often left trying to figure it out on their own.The men in their lives are usually given even less information and have no idea what to do.

That can be a large problem, because menopause doesn't just affect women. It affects relationships, families, friendships, workplaces, and communities. Nearly one in three women have thought about quitting her job because of menopause symptoms. A UK survey found that seven in ten women blamed perimenopause or menopause for the breakdown of their marriage. In the US, the divorce rate for women over 50 has nearly tripled since 1990.

One of the things I hear most often from women is not that they want someone to fix what they're going through. They want the people around them to understand it, and oftentimes they don’t have the energy to do the teaching or explaining. Here is a basic rundown.

First, What Is Perimenopause? 

Perimenopause is the transition to menopause. Menopause itself is simply one point in time: the day a woman has gone 12 months without a menstrual period. 

The years leading up to that can vary from woman to woman and last anywhere from four to ten years. Yes, I said four to ten years. 

During this period, estrogen and progesterone are shifting and fluctuating oftentimes in a dramatic way. These levels can look like that of an earthquake seismograph. Another analogy I often use is to think of it less like a dimmer switch slowly turning down and more like a flickering light that never seems to settle. (That can be quite irritating). 

Since estrogen affects far more than reproduction, those fluctuations can affect sleep, mood, memory, body temperature, joints, skin, metabolism, sexual health, and overall wellbeing.

There are estrogen receptors throughout the body, which is why hormonal changes can affect so many different systems. This is why understanding menopause matters. Whether she is a friend, coworker, sister, partner, or mother, how you respond can make a woman feel supported, understood, and a little less alone while she's going through it. 

Why Men Sometimes Pull Back 

Most men seem to genuinely want to help. It sounds cliche, but many men like to fix things. The problem is that this isn't something that can be solved with a quick fix. When the woman you care about is struggling and you don't know what to do, it's easy to change the subject, pull back, or assume she'll figure it out. On the other hand, sometimes symptoms are taken personally. Your partner seems irritable. A sister seems withdrawn. A coworker seems frustrated. As humans, it’s natural to wonder if you've done something wrong. Most of the time, you haven't. It is truly a biological transition that affects how the brain, body, and nervous system function. Most women do not need a solution from you. They need someone who is willing to listen, learn, and stay engaged. 

Mood Changes, Irritability, and Emotional Ups and Downs 

One of the symptoms that people notice most is mood changes. Estrogen plays an important role in serotonin and dopamine, two brain chemicals involved in mood, emotional regulation, and stress response. When estrogen fluctuates, emotional resilience suffers. Women often tell me they feel more reactive, emotional, and easily overwhelmed. 

This is not a personality change. There is a biological reason. That doesn't mean women aren't responsible for how they treat others. But it does mean there is often more going on beneath the surface than people realize. Patience and understanding go a long way during this phase of life. 

Brain Fog Is Real 

Brain fog is another common concern I hear in perimenopause. Women tell me they lose words mid-sentence, walk into a room and forget why they're there, reread the same sentence over and over again without taking it in, reading emails multiple times before sending them, just to name a few. 

Many start wondering if something is seriously wrong, but these are all symptoms of estrogen fluctuations in the brain. Estrogen plays an important role in how the brain uses energy. Changes in estrogen can affect memory, focus, and mental clarity. What women need most in these moments isn't a joke about getting older. Instead, they need the reassurance that they're not losing their minds. 

Hot Flashes Are More Than Feeling Warm 

A hot flash isn't simply overheating and hot flashes are not benign.

A hot flash starts in the brain's temperature regulation center (the hypothalamus) and can cause sudden flushing, sweating, a racing heart, and intense discomfort. What many people don't realize is that a hot flash is actually a vascular event. Blood vessels rapidly widen and then constrict, sometimes multiple times a day and night. For some women, this happens dozens of times a day. 

Night sweats can be even more disruptive. When sleep gets interrupted night after night, everything becomes harder. Mood, concentration, patience, energy, and stress management all suffer. Exhaustion is often as difficult as the hot flashes themselves. 

The Symptoms Nobody Talks About 

There are also symptoms that don't get talked about nearly enough. Women will tell me: "I have this constant feeling that something bad is about to happen." "My anxiety is through the roof." "I don't feel like myself anymore." "My skin is itching and nobody can explain it." "I feel disconnected from who I am." 

These symptoms can sound unusual if you've never heard of them before, but they are real. In reality, there are more than 40 documented symptoms of perimenopause and menopause, and I suspect there are many more that women experience but never connect back to hormones. 

That's because there is almost no part of the body that isn't influenced by estrogen. Estrogen receptors are found throughout the brain, heart, bones, muscles, skin, blood vessels, bladder, and reproductive tissues. When estrogen starts fluctuating, women can experience symptoms that seem completely unrelated, but often have the same underlying cause. So, if a woman in your life tells you she's experiencing something that sounds strange, don't dismiss it because you've never heard of it. She needs you to believe her. 

Changes in Intimacy 

This is often one of the hardest topics for couples to discuss. Changes in libido and physical comfort during sex are extremely common, and are often physiological, not personal.

Declining estrogen affects vaginal tissue, lubrication, blood flow, and comfort. For some women, sex can be uncomfortable or painful. That can create distance in a relationship, especially if neither partner understands what's happening. Each partner thinks it is something they are doing wrong. It is not. 

By midlife, many couples are juggling a lot: work, kids, aging parents, schedules, and household responsibilities. Connection can slowly get pushed aside, and it is not anyone’s fault. It's just life. It often becomes more apparent during perimenopause when sleep is disrupted, stress is high, and symptoms are affecting how a woman feels in her own body. 

Sometimes reconnecting starts with something as simple as a walk, a conversation, or spending time together without an agenda.

You Don't Have to Fix It 

This may be the most important thing I want men to understand. Please don't try to fix this. You can't fix a hormonal transition. However, what you can do is learn about what is going on, stay curious, listen, stay engaged. Sometimes, with genuine empathy, saying something as simple as, "That sounds really hard." "I'm sorry you're dealing with that." "How can I help?" 

Those simple responses often mean more than you realize. 

Be Her Advocate 

Unfortunately, even today, many women still spend years being told their symptoms are stress, aging, anxiety, or simply something they need to learn to live with. Having someone who believes them and supports them can make a tremendous difference. Sometimes being an advocate means helping her write down symptoms before an appointment. (Her brain fog often gets in the way of remembering). Sometimes it means attending an appointment with her. 

Sometimes it simply means reminding her that what she's experiencing is real, worth addressing, and not something that should be dismissed. Showing up for her can mean the world to her. 

Let's Talk About Rage 

There isn't enough conversation about the rage and anger that many women experience during perimenopause. Women will often tell me, "This isn't me." Some women are very afraid of this rage. The important thing to understand is that this is a symptom, not a character flaw. Understanding that doesn't excuse hurtful behavior, but it can help everyone approach these moments with more compassion and less blame. For many women, the intensity is just as surprising and upsetting to them as it is to the people around them. 

This Is Not the End. It's a Transition. 

All of this can sound daunting. It may seem like perimenopause and menopause would put a strain on any relationship, whether that's a friendship, work relationship, or romantic partnership. However, it does not need to be that way. We have come a long way in talking about what we're feeling and experiencing instead of pushing it under the rug and simply carrying on. We know that does not work and will eventually come back to bite us. We also now have access to education surrounding this transition. The more men and women understand what is happening during this transition, the less likely they are to blame themselves or each other. 

Menopause is a turning point for many women, and it can be very positive. Women don't have to simply suffer through this transition. With the right support, education, and medical care, they can navigate this stage with confidence and set themselves up for a healthy, active, and rewarding second half of life. 

To all the men out there who care about a woman, just keep showing up. Listen. Learn. Choose curiosity over judgement. That will matter more than you know.