By Dr. Mary Jane Minkin, Clinical Professor, Department of Obstetrics, Gynecology and Reproductive Sciences, Yale University School of Medicine
In so many of my daily conversations with patients, colleagues, and friends, there is almost always a moment when someone exclaims “I wish men knew how to support their female partners better when it comes to menopause.” From those conversations, I’ve discovered a constant theme: women living through menopause just want to know they are not alone, that they can speak about their experiences openly with their partners, and that they will be supported and loved. Normalizing menopause is the most important way a man (or anyone, really) can support a partner or the women in their life going through it, and there are myriad ways to treat many of the infamous symptoms caused by menopause that have unnecessarily and unjustly shrouded mid-life women in silence and shame.
For too long, the word menopause was whispered or quietly referred to as “the change” or “the m word”—a phase of life when women were said to be irrational, irritable, cold, and sexless, some of the worst of the false stereotypes. Archie Bunker famously referred to menopause on national TV as “Edith’s Problem.” It was certainly groundbreaking material for the 70s, but attitudes haven’t changed enough with the times. Recent studies show that despite plenty of progress, only 30% of women report talking about their menopausal symptoms with their healthcare provider, and 50% of women feel that the topic is taboo. It often takes women – and their partners – a while to acknowledge that changes to their mental health, sex drive, and body as they reach mid-life may be due in large part to the menopausal transition and not necessarily the relationship.
Little research has been done around men’s attitudes or understanding of female menopause but studies are emerging. A 2019 survey, published in the Menopause: the Journal of the American Menopause Society, found that 63% of survey respondents reported that their partner’s menopausal symptoms had affected them personally, including emotional strain (34%), reduced frequency of sex/intimacy (33%), and trouble sleeping (10%). This proves male partners are aware of their female partners’ menopausal transition, but they are less aware of how to be supportive. In the same survey, less than half of the respondents knew there were treatments available for menopausal symptoms.
Destigmatizing menopause starts with knowing the facts. According to the Mayo Clinic, “menopause is a natural biological process” that a woman officially reaches when she has gone 12 months without her period, signaling the end of her reproductive years. In the years leading up to menopause, called perimenopause, the ovaries produce less and less estrogen, the hormone that regulates the female reproductive system, until the ovaries are no longer active. As a result of declining estrogen and other biological changes, women in perimenopause may experience a range of uncomfortable symptoms like hot flashes, difficulty sleeping, brain fog and other cognitive challenges, depression, and loss of sex drive. Women also often experience vaginal dryness, pain with sex, and other changes to their pelvic health. They will also be at higher risk for osteoporosis, heart disease, and other health problems.
The good news is that there are many safe hormonal and non-hormonal treatments and lifestyle changes that can mitigate menopausal symptoms and help women and their partners maintain a healthy relationship. The biggest barrier to these treatments is STIGMA. For a start, men can tell their partners that they love them unconditionally and will support them as they speak with their doctor or medical providers about treating their symptoms. They can also offer to join their partner for an appointment or telehealth conversation or help them develop a list of questions to ask. Regular exercise; holistic practices like yoga and meditation; eating a healthy and balanced diet; and taking calcium and vitamin D can also help to ease menopausal symptoms and create mutually beneficial opportunities for partners to spend time together and reconnect.
And yes, aging will change sex for both partners—regardless of gender!—but there are many ways to keep things vibrant. Most importantly, men should let their partners know how much they love them and keep the lines of communication open. Be aware that intercourse may become painful or uncomfortable for a perimenopausal or menopausal woman through no fault of her own. Reassuring your partner that it’s okay is crucial to her self-confidence. A woman’s medical provider can recommend hormonal and non-hormonal treatments, medications, and devices to help with arousal and desire, and potentially refer her to a pelvic floor specialist if the pain is severe. There are many over-the-counter lubricants and vaginal moisturizers available as well.
Most importantly, find ways to have amazing sex that honor your partner’s body where it is. Most women—age notwithstanding—have their best orgasms without intercourse. And remember, it does take two to tango—men will endure changes to their sex drive as they age too. There is increasing evidence that men go through their own menopause of sorts. Both partners need to be open with their doctors for guidance on how they can address aging-related issues like erectile dysfunction and decreased energy and desire.
Menopause is not a time to check out and be afraid to broach the topic or become resentful. Ideally, a man who is involved and supportive can make a big difference for his partner going through the menopausal experience and in the relationship. Reducing the stigma about menopause and normalizing the conversation and the experience will go a long way.
Dr. Mary Jane Minkin is a practicing gynecologist, with a special interest in menopause. She is a North American Menopause Society Certified Menopause Clinician. Dr. Minkin is also the co-director of the Sexuality, Intimacy and Menopause for cancer survivors program at the Smilow Cancer Center. She has taught at Yale University School of Medicine for over 41 years, and is a clinical professor of obstetrics, gynecology and reproductive sciences.