Client Populations Psychoeducation

Supporting Partners Through Menopause

The life transition of menopause can be challenging for partners. This article shares statistics and support tips for therapists working with clients whose partner is going through menopause.

By Mental Health Academy 2023-11-17 05:03:59

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The life transition of menopause can be challenging for partners. This article shares statistics and support tips for therapists working with clients whose partner is menopausal.

Related article: Supporting Women Through Menopause.

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Introduction

If you have ever received into your therapy rooms anyone who expresses a mixture of exasperation and bewilderment, feeling like they have “lost their partner”, who hasn’t “been the same person they used to be” lately, your first line of enquiry – especially if the person is in their middle years – might be that of whether the partner could be going through menopause.

Menopause – defined as menstrual cycles and fertility having ceased at least 12 months prior due to declining levels of hormones (estrogen and progesterone) – tends to happen between ages 45 and 55. The average age is around 51, although some women experience it much earlier than that. It typically lasts 7 years, although some women experience uncomfortable symptoms for as long as 14 years(Mayo Clinic, 2023; Bracy, 2023).

In a companion article, we examined how therapists can support women going through menopause. In this article, we look at what a partner can do to help support their loved one through this natural but frustrating transition. Before proceeding, you may wish to view the many symptoms we noted in our first article. Today we first offer some surprising statistics on the subject, and then some tips on how a partner (whether male or female) can support a woman beset by menopausal symptoms.

When the bleeding stops: Surprising statistics about menopause

This this section we cover several sets of statistics on the topic. First, some general facts:

  • In 2021, women aged 50 and over (thus, postmenopausal) accounted for 26% of the world population of women and girls
  • By 2025, an estimated 1.1 billion women will be postmenopausal, and by 2030, that number will rise to 1.2 billion
  • There are more than 30 recognised symptoms of menopause (see Supporting Women Through Menopause for a list)
  • Symptoms last, on average, 4-8 years
  • 1 in 4 will experience very few symptoms
  • 3 in 4 will experience symptoms
  • 1 in 4 will experience debilitating symptoms (Meno Martha, 2023; Danzebrink, 2023).

A “shocking lack of support”

It would be nice to think that a phenomenon occurring to half the population would not only be well-known, but also well supported. Sadly, that is not the case. A 2022 study based on the largest-ever survey of menopausal and perimenopausal women in the U.K. showed that the symptoms are widely experienced and troublesome. The survey also revealed (according to the Menopause Support website who summarised the findings) a “shocking lack of support for menopause by healthcare providers and in the workplace”. The survey found that:

  • 77% [of respondents] found at least one menopause symptom ‘very difficult’
  • 84% experienced trouble sleeping
  • 73% experienced brain fog
  • 69% of women experienced difficulties with anxiety and depression due to menopause
  • 44% of women experienced three or more severe symptoms (Danzebrink, 2023)

Moreover, 45% had not spoken to their G.P. about their symptoms, and of those who did, 31% said that it took numerous appointments for their G.P. to realise that they were experiencing symptoms of menopause. This percentage rose to 42% of those who were experiencing severe symptoms. Though official U.K. guidance notes that hormone replacement therapy (HRT) should be offered to women struggling with their symptoms, only 39% reported being offered HRT, even after health and medical professionals knew that they were experiencing menopause. Over half the respondents (54%) reported that their loss of interest in sex was “difficult”, but even though testosterone has been shown to help with this in research studies, only 33% of women had heard of its use in HRT.

Hassles in the workplace were reported, too, with 41% of women saying they had seen menopause or its symptoms treated as a joke by people at work. And among those who had taken time off because of menopause, 39% had told their employers that anxiety or depression was the main reason they were off sick rather than share their menopause status (Danzebrink, 2023).

What men know about partners’ menopause

The above statistics are either facts or come from research into what women are experiencing. The 2019 MATE Survey administered a 35-item online survey to which 450 men with a female partner aged 45 to 64 responded. When asked to choose from a list of symptoms their partners could be experiencing, they most often identified difficulty sleeping (54%), followed by lack of energy (49%), and low libido (48%). When asked open-ended questions about symptoms women typically experience, hot flashes/sweating topped the list (55%), followed by mood swings (44%), and low libido (18%). Interestingly for your consultation with such a partner, the men in the study only attributed the symptoms to menopause about one-fourth of the time (26%).

The survey also asked about whether and how men were being affected by their partner’s symptoms, to which an overwhelming majority responded affirmatively. The symptoms negatively impacted the men themselves in 77% of cases, where 70% believed their partners were affected, and 56% reported negative impact on their relationships (most often identifying the emotional strain on relationships and reduced intimacy). While the survey showed relatively low knowledge about options partners (menopausal women) might have for relief of their symptoms (only 46% reported knowing that there were ways to reduce the symptoms), the men did mostly believe (75%) that they were at least somewhat influential in their partner’s decision to seek treatment or make lifestyle adjustments (Parish et al, 2019).

Menopause is real, it’s pervasive in a woman’s life, and it’s often tough for both the woman and her partner – usually for an ongoing period. We see that, even though both health professionals and lay persons know about many of the symptoms, menopause is widely underacknowledged for its impact on women’s wellbeing, their health care, their sexuality and relationships, and even their career. So, what do you say to their partner? What can they do to be supportive, to safeguard the relationship, and to help their partners get their “old selves” back? Let’s look at some useful interventions, and some strategies you might encourage them to try.

How to support the partner of a menopausal loved one

You are likely to have a receptive audience to your suggestions, given the high percentage of couples where both are affected by menopause. Some of the helping things the partner can do are practical tips. Others reside in the arena of relational/communicational strategies. Let’s tackle those first.

Relational/communicational strategies

Become informed

The partner’s psychoeducation about menopause is a fruitful area for enquiry, especially given that in the above-mentioned MATE Survey (Parish et al, 2019), the woman’s symptoms were attributed to menopause only 26% of the time. You can provide the partner with lists of symptoms; this article lists both early and later symptoms of menopause.

Mood swings are due to hormones; don’t take it personally!

Several expert commentators have keyed in on a major misery-making dynamic: menopausal loved ones can get “snappish” or bad-tempered because they are feeling lousy, and when their partners take it personally, things escalate. Instead, you can advise the partner to keep trying (it can be hard in the heat of the moment) to remember that the loss of libido, frustration over bodily changes, and/or prevailing angst are the culprit, not them. Even if comments are directed the partner’s way, you can remind them: “It’s not that the relationship is falling apart or that they don’t love you anymore. It’s just the hormones” (Schwartz, 2010; Bracy, 2023).

Express your feelings in a healthy way

The above points do not mean that a partner should tolerate abusive behaviour, on any level. If a partner is acting unreasonably, the other partner may need to speak up (assertively but not aggressively) about how the mood/behaviour is affecting them. As the therapist, you may be instrumental in helping them generate some statements that they can use for such occasions. You can suggest that, if things get rough, they may need to step away and come back to an issue later because of how they are feeling, not because of what the partner is doing. It’s important for the partner to be understanding and patient, but it’s never ok for them to accept abuse (Schwartz, 2010; Bracy, 2023). These tips from the Gottman Institute are useful for managing such conflict.

Express positivity, approval, praise, feelings of affection

Never mind if your client protests that they are the “strong, silent type”. There’s no time like the present to learn to be expressive. As we noted in our other article on menopause, menopausal women often feel old, fat, and like they’ve lost their sex appeal. Given that they’re “one down” here, the partner’s efforts to bolster sagging self-confidence or self-esteem will not go amiss. Genuine compliments about how their smile lights up the room, or how the partner loves that outfit on them can go a long way toward compensating for a negative bias in their self-perception, as do appreciative comments about how much they do for the partner/household, how much they are loved, and how much the partner values the relationship. They will need to be told more than once!

It goes without saying that negative, critical comments – especially about appearance – are likely to be more damaging at this time. Ditto any jokes about, for example, bladder leaks or other aspects of bodily functions that are now less able to be controlled. The worst “sin” of all may be to doubt or minimise what they are experiencing; it’s not “all in their head” (Bracy, 2023; Perry, 2017).

Use this time to fine-tune relational and communicational skills

You can remind the partner that not knowing what their loved one wants is not a sin; it’s likely to be changed now in any case. Thus, encourage the partner to ask their spouse what they want. How can the partner help? Are there any mundane household or “executive” tasks that can be taken off their plate for now (a perennial favourite for overwhelmed or tired loved ones)? Can they clarify when they want to be alone and when they want support? Patience is key (Bracy, 2023).

Sex may be problematic

The male respondents in the MATE Survey (Parish et al, 2019) seemed to know that sex changes as women come into menopause, in that they identified low libido/less desire for sex as the third most frequent/common experience that women have.  Here we emphasise that genuine education about the vaginal changes will most greatly help your partner-client understand why sex becomes not just difficult, but unbearably painful. Totally apart from hormonal changes lowering sex drive, dryness and decreased flexibility in the vagina, bladder and urethra means that they may tear and bleed more easily upon penetration. There can be a sense of burning as the tissue becomes more easily damaged and prone to infection. What to do? Here you can encourage the partner to explore ways that they can be physically close without having intercourse. Spouses should be encouraged to talk to their health provider and/or gynaecologist about vaginal and other creams or lubricants to reduce friction. Sex therapists may have advice on how to explore the use of sex toys or do tantric sex, and couples counselling can sometimes be indicated (Perry, 2017).  

Practical tips

Keeping things cool and dry

Those pesky hot flashes and concomitant sweats mean that allowing menopausal partners to cool down the bedroom or open the window/turn on the fan will be much appreciated. If your client has not been with someone going through menopause before, they may not know how wet the sheets or pyjamas can get, so keeping dry replacements on hand may work wonders. As regards a related issue, you can invite your partner-client to explore (with their spouses) solutions to the highly typical sleep challenges. This could include discussions about what to do for insomnia, how to reduce sleep apnoea, and what can happen differently in order to enhance sleep hygiene (Bracy, 2023; Cornforth, 2023). For a range of science-backed tips to sleep better, read this article.

Journeying with them on lifestyle/health adaptations

We noted in our companion article how most expert commentators are quick to point out how a few lifestyle adaptations, such as cutting down on alcohol, nicotine, and caffeine and maintaining regular exercise can accomplish miracles for both mood and some of the physical symptoms. Your role here may be to explore with your partner-client how they may be able to support their spouses by joining them in their journeying toward greater health (Bracy, 2023). If the spouse decides to start going to the gym, can the partner go, too? If they give up that six-o-clock wine for a sparkling water, can the partner follow suit? You can remind the partner that choosing the healthy option is so much easier (and often, more enjoyable) for the spouse if they can do it with them. By the time menopause ends, the now-healthy couple may want to keep their good habits going!

Help for them

You can remind the partner that they’ve done the right thing by reaching out to you; the more resilient they are through their spouse’s changes, the better support they can be for them, and the better then for the relationship. Part of the partner’s job may be to discern if/when their spouse’s symptoms are seriously disabling and they need more help. Whether that help is needed in the realm of psychological support, such as in counselling, or health/medical support, the important thing is that the partner is not embarrassed to talk about menopause and their loved one’s needs during it. The MATE Survey (Parish et al, 2019) found that 72% of men had spoken with their partner about their menopause, although in 72% of those cases the woman had initiated the conversation. You can help your client find ways to begin such a conversation and to normalise reaching out for help for whichever aspects are most challenging (Schwartz, 2010).

Menopause is a unique process for each woman, and because it affects everyone in their life sphere, especially their partner, it is also a journey that couples take together. Your client will appreciate hearing what they may be able to do to make the travelling less uncomfortable. Ultimately, their supportive behaviour will reap significant rewards of enhanced relationship.

Key takeaways

  • A 2022 study based on the largest-ever survey of menopausal and perimenopausal women in the U.K. showed that menopausal symptoms are widely experienced and troublesome.
  • By 2025, an estimated 1.1 billion women around the globe will be menopausal, with surveys indicating that most (77%) will find at least one symptom quite difficult, and many will experience some version of health/medical professionals either not taking their symptoms seriously or not attributing them to menopause.
  • Surveys of men with menopausal partners have found that most men know about the main symptoms of menopause and at least three out of four have been negatively impacted by their partner’s menopause.
  • Therapists can help partner-clients through both relational/communication skills enhancements and also practical tips. An example of the former is encouraging partners not to take a spouse’s irritable moods personally. Examples of the latter include supporting the spouse’s efforts to keep the bedroom cool, implement healthier lifestyles changes, and seek professional help.

References

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