In sickness and in health, and through the menopause years
Menopause symptoms can have a serious impact on partners. A new book aims to inform and support them as their other half navigates this significant transition
Soon after Pauline turned 53, she started having hot flushes and night sweats. Mood swings, low energy, fatigue, and anxiety were to follow.
“Pauline suspected menopause straightaway, as some of her friends had similar symptoms,” says John. “She went to a doctor, who confirmed her suspicions. We talked things through and knew it could take time to adjust. But we had no idea how long it would take or how tough it would get. There were times I despaired, thinking we’d never again be the couple we were. There were times I didn’t recognise Pauline as the woman I married. I wish I’d known more about menopause, as it would have prepared me more for what happened.”
A new book, , offers men like John information to support their partners through this hormonal transition.
The author, Michelle A Hardwick, is a Cork-based therapist specialising in hypnotherapy, and many of her clients are menopausal. “The idea for the book came to me while I was attending an online networking event,” says Hardwick. “In one of the breakout rooms, I told my fellow attendees what I did, and one of the men sighed and said his marriage might have survived if he’d known more about menopause.”
Hardwick was inspired by his words. “A lightbulb went off in my head,” she says. “My focus until then had been on women, like myself, who found menopause difficult. I hadn’t thought about their husbands and partners. If women are struggling, their partners are usually right beside them, but can often feel helpless. So, I decided to write a book that contains insights from more than 40 men, as well as practical tips and tools to help couples navigate menopause together.”
Menopause can take a toll on relationships. In Ireland, a survey of 461 men carried out by the Menopause Hub clinic in 2024 https://www.themenopausehub.ie/menopause-blog/men-and-menopause-survey found that 60% said their partner’s symptoms had affected their relationship, half said it had a detrimental effect on their sex life, and 8% said they had considered ending their relationship. This tallies with a 2019 American study, in which 77% of men said they were negatively impacted by their partner’s menopause and 56% who said their relationship had suffered.
Men’s lack of understanding about menopause can leave them isolated and confused. Dr Genevieve Ferraris, from the Menopause Hub, gives an overview of what both men and women can expect. The average age at which women become menopausal — meaning 12 consecutive months without a period — is 51, she says, adding that changes in the menstrual cycle, known as perimenopause, occur in the years before menopause. This is caused by a decline in oestrogen levels and can be accompanied by a wide range of symptoms.
Ferraris says: “There are physical symptoms, such as hot flushes, night sweats, poor sleep, joint aches, weight changes, breast tenderness, and headaches. Psychological symptoms can include anxiety, low mood, irritability, overwhelm, and loss of confidence. Cognitive symptoms range from brain fog to poor concentration. And genitourinary symptoms resulting from falling oestrogen levels affecting the tissues of the vulva, vagina, bladder, and urethra can cause women to experience vaginal dryness, burning, itching, discomfort, and pain during sex.”
Ferraris likens menopausal symptoms to dominoes, “with one triggering or worsening the others”. She gives night sweats as an example. They interrupt sleep, leading to exhaustion, low mood, and irritability that can strain intimacy.
“If she’s tired and overwhelmed, sex may be the last thing on a woman’s mind,” says Ferraris.
A woman’s libido can wane even more because she has been taught to believe that it is inevitable at this time of hormonal transition. Ferraris says that “menopause was long framed as decline: The end of fertility, the beginning of ageing, and the loss of attractiveness and sexuality. That narrow, outdated view still influences how some women feel about themselves. They can feel embarrassed, ashamed, or reluctant to talk about what’s happening, even with someone they love. That silence can create distance in relationships.”
Emily Power Smith, a clinical sexologist and psychotherapist, says men often interpret their partner’s diminishing interest in sex as a rejection. “If the couple aren’t communicating well and the woman is showing less and less interest in sex, men often jump to the conclusion that she doesn’t fancy them anymore,” she says. “They take it very personally.”
The situation can be further complicated by the fact that men may also be experiencing a hormonal change. “Their testosterone levels fall in middle age, although that decline is more of a gentle slope, whereas a woman’s oestrogen levels can fall off a cliff, which can drastically reduce her libido and interest in sex,” Power Smith says.
This combination can cause marital or relationship strife. “Falling testosterone can mean that men’s erections aren’t as reliable as they once were, and men can react defensively by turning away from their partners,” says Power Smith. “If they do this when she is feeling sweaty and unattractive, then she can feel rejected by him. Damage can be done to their relationship if they don’t talk about the changes in their bodies and how these changes are making them feel.”
The fact that midlife can be challenging enough on its own can place additional stress on couples. “Many people, especially women, are carrying a heavy load, juggling careers, children or teenagers, ageing parents and caring responsibilities, as well as financial commitments and sometimes major life transitions, like bereavement,” says Ferraris. “When menopausal symptoms are thrown into the mix, it can become overwhelming.”
It starts with open communication, says Power Smith.
“People who are good communicators tend to be able to communicate themselves out of trouble,” she says. “If they have always proactively solved problems together, menopause doesn’t have to be a huge issue for them.”
Having accurate information helps. “Men need to know what’s involved in menopause, so they can support the women in their lives going through it,” says Power Smith. “My advice is to check out reliable sources, like the HSE website or the British Menopause Society, not influencers or unqualified people online.”
Ferraris adds that women need to be educated, too. “They should know that help is available in the form of lifestyle measures, psychological support, vaginal oestrogen, and hormonal replacement therapy (HRT), where appropriate,” she says. “Women shouldn’t feel they have to struggle on in silence.”
Nor should women shy away from discussing what is happening to them, says Power Smith. “Traditionally, men and women have struggled to talk to each other about bodies and sex. It starts in schools, when boys and girls are separated for sex education classes, so that boys can learn about erections and girls can learn about periods. This mentality reinforces the idea that bleeding, menstruation, and women’s hormonal stuff should be kept from men. It doesn’t make it easy for boys and girls to share. This mentality isn’t helpful for men or women and can become an obstacle to real closeness and intimacy in relationships.”
Men and women would benefit from learning that “penetrative- penis-in-vagina sex” isn’t the only option, Power Smith says. “It might be a lot of people’s favourite option, but just because it’s off the menu doesn’t mean you have to leave the restaurant hungry. You might just need to expand your repertoire.”
For couples who don’t know where to start, she recommends “slowing down and starting to play. Get naked and snuggle, cuddle, and stroke each other without expectation of any kind of action. It can be a beautiful starting point for reconnection.”
She says: “From my own experience of menopause and from working with women going through it, that lack of interest could be due to physical discomfort or the fact that the changes in women’s bodies make them feel disconnected from themselves to the extent that it’s hard for them to connect with anyone else.”
She says. “When women aren’t interested in or able for sex, then things like holding hands, dancing, going for a walk, or even just making her a cup of tea can help maintain a sense of closeness.”
John says that one of the biggest lessons he learned was that “menopause wasn’t something a woman can manage on her own. My wife needed me to help.”
Doing so wasn’t always easy. He now sees it as “a true test of our love for one another. As a man, I had to learn a new love language. As a couple, the journey took us to places that weren’t always comfortable. But with patience and understanding, we came through it together, and it’s made us stronger.”
Hardwick hopes that her book will help more couples emerge on the other side of menopause with a strengthened relationship. “The men I spoke to shared how menopause put their relationship under pressure and the tips and tactics that helped them cope, as well as the lessons they learned that they wished they had been aware of at the very beginning,” she says. “There is a lot that men can do to help the women they love through menopause, but, essentially, it’s all about being open and honest and making her feel seen, supported, and loved.”
“That’s why I’ve given so many different suggestions in my book,” says Michelle A Hardwick. “Men should take a trial-and-error approach to find out what works for their partner and their relationship.”
“And listen without dismissing,” says Genevieve Ferraris. “Menopause symptoms can have a massive impact on women. Symptoms like brain fog can affect professional confidence. Anxiety or low mood can affect social confidence. Having someone to talk to about this can make a big difference.”
“Listening can often be a fix in itself,” says Emily Power Smith. “Any time a person comes to you to tell you something, it’s a good idea to ask them if they want an ear or a solution. Don’t offer a solution if all they want is to be heard and maybe a hug.”
“There are times when it can help to joke about things, but you need to be careful she doesn’t feel you’re laughing at her,” says Hardwick.
“Tell your partner if you don’t understand what she is going through, but ask her to help you understand,” says Hardwick. “That opens the door to connection.”
“Menopausal women may not have the energy and bandwidth they used to have,” says Power Smith. “Pick up some of the slack by planning and cooking meals or taking care of children’s extracurricular activities.”
“You can’t pour from an empty cup, so be sure to replenish your own energy,” says Hardwick. “Whether it’s exercising, listening to music, or hanging out with friends, it all helps you be a better wingman.”
“Women don’t need to put up with painful sex, recurrent urinary symptoms, or loss of sexual wellbeing as an inevitable part of ageing,” says Ferraris. “Sexuality, intimacy, confidence, and vitality do not have to end at menopause. Women deserve good medical care, and it is available.”
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