A Man’s Guide to Helping His Wife/Partner on Her Menopause Journey

If you’re new to my Substack I’m a former prostate cancer patient that was receiving treatment with drugs that cause side effects that mimic those of perimenopause, menopause and sometimes post menopause. I’m in the unusual position of being a biological man who understands the life challenges that many women experience in their menopause journey. I have experienced nearly every symptom of menopause, including hot flashes, memory loss, brain fog, fatigue, loss of sleep, muscle wasting, weight gain, depression, and low libido. In an effort to learn how to cope with my symptoms, I educated myself on menopause to see how women work through them. I have read countless books and articles by noted women health experts including doctors Lauren Streicher, Kelly Casperson, and Mary Clair Haver just to name a few. I’ve taken the time to learn about how changes in estrogen, progesterone, and testosterone levels affect women. In the process I have come to realize that women get treated like second class citizens even when it comes to women’s specific health issues. Women often get great care and attention during pregnancy but the quality of care they receive is clearly not up to the same standards once their reproductive years are over. It’s as if they no longer matter.

In this post I hope to inform men how they can and should support their female partners from peri-menopause through post-menopause. I have attempted to write this “Support Guide” in such a manner that readers can copy the text, paste it into a Word document, print it out and use it for your reference or if you’re one of my women readers, print it out and give it to your partner/husband.

A MAN’S GUIDE TO MENOPAUSE

FATIGUE - often times, women going through menopause and are postmenopausal have serious problems getting a good night sleep resulting in significant fatigue. So what can a husband/partner do to help? The answer is fairly straightforward. Ask what you can do to help relieve some of her workload. Don’t cherry pick what you think is easiest to do and gives the appearance of help without actually helping. Real help might involve cooking dinner, making lunches for the kids, running errands, whatever. The term “whatever” covers a lot of territory.

SLEEP PROBLEMS - This might be caused by a hot flash that wakes your wife/partner up, soaked with sweat and having to put on fresh dry clothes. By the time that happens, it often takes a long time to go back to sleep. Even if she doesn’t experience a hot flash while sleeping, just getting to sleep might be difficult and staying asleep might even be more challenging. So what can you do to help? Well, the answer might have to do a lot with the cause of the sleep problem. If the problem is hot flashes and it’s Summertime, set the AC to a lower temperature then you yourself find comfortable. Use a ceiling fan too. If you don’t have a ceiling fan, put one in or have one installed. If it’s Winter time, set the heat to a low temperature for the night. This might mean you have to wear pajamas or light sweatpants to stay warm. Trust me, whatever you have to do for your partner/wife is worth it. If you happen to snore and your wife is a light sleeper, you might need to find another place to sleep now and then. Sometimes nothing will help, but trying something is almost always better than doing nothing.

BRAIN FOG - low levels of estrogen and testosterone may make your wife/partner feel like she’s mentally in a fog. I’ve experienced this personally as the result of the cancer drugs I was on and let me tell you, it’s disorienting on a level that’s hard to explain. Simple things like: making a grocery list, remembering where you parked the car, trying to understand cooking instructions printed on the side of the package, or even just remembering cooking instructions for something that you’ve made a hundred times seems impossible. I had severe brain fog at times during cancer treatment. My doctor called it “chemo brain”. I cannot relate how many times I had to ask my wife if the spaghetti noodles went into the pot before, or after the water boiled. No joke. Brain fog can leave the affected person feel disoriented at best and worthless at worst. I recall having brain fog so badly that I couldn’t comprehend the humor in the Sunday comics. Nothing made sense. Imagine looking at the comic strip, “Peanuts!” and not being able to appreciate the simple humor. So what can you do to help? First of all, don’t “throw fuel on the fire” by pointing out the problem or making fun. Don’t tease and don’t joke. That’s cruel. The best place to start is to ask “Can I help?” You might have to learn something new and you’ll be better off for it.

MOOD SWINGS - low levels of estrogen and testosterone, combined with fatigue and sleep problems can lead to mood swings. Sometimes this may manifest itself as irritability. Sometimes it may manifest itself as feeling sad or hopeless with no apparent cause. Women who often would benefit from estrogen therapy are instead often treated with antidepressants which don’t solve the problem; only turn down the severity of the mood swing. Mood swings are not a mental problem. They are not imaginary or a bid for attention. They are the result of a hormone shortage. When my testosterone level plummeted to three, (300 is normal for a man my age), I suffered with severe mood swings, irritability, and depression. I was not in control of my emotions. I thought I was going crazy. I was overly sensitive and emotionally brittle. What I needed to fix things was more testosterone, which was out of the question while being treated for prostate cancer. Some women going through menopause experience the same thing. Partners need to be supportive and patient. Words matters so think before you speak. This is not the time to tease your significant other or give unsolicited advice. The best thing you can do is listen and be supportive.

HOT FLASHES - Hot flashes happen when the body’s biological thermostat, called the hypothalamus, malfunctions. Low estrogen levels cause the hypothalamus to behave as though the affected person is overheating. It tells the body to reroute blood through the veins and capillaries closest to the skin to dissipate heat. While the internal temperature of the human body is roughly about 98°F, skin temperature is typically lower by a few degrees. I did some research on this and it seems as though normal skin temperature varies from 91°F to 95°F. When a hot flash happens and blood is routed towards the skin, the temperature at the skin may raise to as high as 98.4°F. This happens in a matter of seconds, which is why a hot flash is also sometimes called a hot “flush”. I’ve as many as 30 hot flashes in a single day and believe me when I say they suck. When skin temperature rises, sweat glands get activated in an attempt to cool the body down. It’s a thermal tug of war and the woman experiencing them is stuck in the middle. If your wife/partner suddenly starts removing clothing items while experiencing perimenopause, she’s probably just trying to cool off from a hot flash so get any other ideas out of your head Bucko. My wife used to get the worst hot flashes in the middle of Winter when she had a heavy coat on and we were driving somewhere. When a hot flash hit, she was racing to get her coat off and the windows down. I’d be freezing and begging her to put the windows back up because I didn’t understand what she was going through. When I experienced hot flashes as the result of cancer treatment, I understood. Our roles were reversed, and I became far more sympathetic. Here’s how you can be supportive: If it’s Winter time and your wife has a hot flash and needs to put down the windows in the car, don’t complain. She’s worth the inconvenience. If it’s Summertime and she needs to keep the house set a cooler temperature to avoid hot flashes from starting in the first place, be supportive. Dress more warmly if you need to.

WEIGHT GAIN - Weight gain, particularly in the abdomen area, is common starting in peri-menopause and extending through post-menopause. Estrogen regulates fat distribution. Estrogen undergoes a decrease during menopause, resulting in enhanced fat accumulation and redistribution particularly in the tummy and lower abdomen. If thats not enough, metabolism slows down resulting in making weight loss quite difficult even with dieting and exercise. If you’re a man reading this you need to be sensitive. Embrace the change. Unless there is a genuine physical concern like diabetes or obesity, don’t comment, or worsesuggest that she do something about her appearance. Your wife / partner may be struggling with feelings of low self esteem due to her changing body and doesn’t need you adding to her internal stress. Besides, you could probably stand to lose a few pounds too!

PAINFUL SEX - Many men have the misconception that the onset of menopause is a good thing. No more risk of an unwanted pregnancy. No week off from sex each month during her menstrual cycle. I remember speaking with one of my male friends who admitted to me, “I thought menopause would be a good thing and my wife and I could have sex all the time! Man was I wrong!” What he didn’t expect was that his wife was going to experience vaginal dryness caused by low estrogen. To paraphrase what my Substack friend Dr. Lauren Streicher wrote in one of her posts, a bathtub full of lube isn’t going to alleviate the pain from the resulting genitourinary symptom of menopause or GSM for short. Sex is supposed to feel good and if pain gets in the way, that can be a showstopper for a couple in love, at least until the root cause can be addressed and the pain eliminated. At the risk of being overly graphic, imagine how your penis would feel if it were stroked with 100 grit sandpaper. You probably wouldn’t be in the mood for sex for long. If you and and your partner/wife enjoy worthwhile intimacy together you may have to pivot and take intercourse off the menu for some period of time. It might be time to try something new or something old for that matter. Making the pain go away might require an appointment with a gynecologist and seek either hormonal or non-hormonal help. The decision to pursue medical help is up to her, not you.

LOSS OF INTEREST IN SEX - Libido in women is affected by factors too numerous to list. Suffice it to say that both estrogen and testosterone play a significant role in a woman’s interest in sex. Testosterone, combined with estrogen affect libido, arousal, and even orgasm for BOTH women and men. Levels of estrogen and testosterone can fluctuate wildly during perimenopause and crash to near undetectable levels post-menopause, causing many women to ask themselves “Where did my libido go?” I can relate. Cancer treatment including surgery, radiation and very powerful drugs derailed my libido for several months and there was nothing I could do about it. After over four decades of marriage, my wife and I found ourselves in unfamiliar territory. As a result , I understand firsthand how some women feel when their libido goes missing due to hormone changes. It felt unnatural to me; like something was missing. I bet it feels the same way to women experiencing issues with desire and arousal because of menopause symptoms. The challenge for you both in the situation is to stay emotionally connected if this happens. I think the natural tendency is to avoid situations that would normally lead to intimacy which quite frankly only makes things worse. It’s a great time to work on non-sexual intimacy. Hugs, cuddling and maybe kissing without an expectation that it will lead to sex. Without some amount of intimacy it’s all too easy to drift apart. This can result in feelings of anger, resentment, and maybe even abandonment for either partner/spouse. Assuming that your wife doesn’t need help in the form of HRT which in this case stands for “husband replacement therapy” there is hope and clinical help available to get your sex life together back on track. In the meantime, you’ll need to be patient and understanding. Dr. Lauren Streicher has a Substack dedicated solely to this subject called “Come again”. If your wife /partner subscribes to this ask to listen to the podcasts too so you can understand in detail what’s going on and possibly what you can do to help.

DEPRESSION - Depression can be a serious issue for anyone at any time in one’s life. I know personally because I personally went through a bout of moderate depression during cancer treatment. For women T here can be an increased risk of depression particularly during the perimenopause and early postmenopausal stages. This may be linked to fluctuating and declining estrogen and progesterone levels, which can affect brain chemicals like seratonin and dopamine that regulate speed and mood. There also can be associations with issues with sleep and stress.

So what can you do if your wife/partner exhibits symptoms of depression? The answer to this is quite complex because depression itself is complex. I’m not sure I can tell you what to do beyond being supportive and LISTEN, but I can tell you what not to do. Don’t encourage self medication. Treating depression with alcohol and or THC Gummies is a BAD idea. Don’t try to psychoanalyze. Don’t use phrases like “You’re acting crazy” or worse “You’re driving me crazy.” That’s not helpful and can be downright harmful. Don’t be judgemental. You don’t know what or how she is feeling. DO use phrases like, "I've noticed you haven't been yourself lately," or "I'm worried about you and I'm here to listen if you want to talk." I’ll wrap up with this. Here’s another thing you can say if you think her depression is serious. “I love you and want to see you feel your best. You might need to talk to someone that knows how to help in ways that I can’t. I’m happy to help you find someone if you’d like.”

Well, that sums up what I know about how men can help their wife/partner through the life challenges that menopause may cause. I hope it helps!

Bob Mizek