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Research involving married couples found that women with a positive attitude towards the menopause struggled with fewer symptoms. Women also said that their menopausal symptoms were fewer if their partners had a positive attitude. Research on men’s impressions, experiences and attitudes towards their wives going through a natural menopause found that if men had a better understanding of the changes women were experiencing, they were able to provide more emotional support. This, in turn, helped to improve marital relationships. So what do men need to know about the menopause so that they can help and support their partners?

This article was included in issue 78 (autumn 2018) of The Menopause Exchange newsletter

What is the menopause?
The menopause is a natural event that heralds the end of the reproductive phase in women. This is when women can no longer have children. A woman is classified as post-menopausal once she has been naturally free of menstrual periods for a year. A natural menopause usually occurs at the age of 50 to 51; but it can happen at any time between 45 and 55.

Around one in four women sail through the menopause with no troublesome problems. But others struggle. Classic symptoms include, for example, hot flushes and night sweats, erratic period or bleeding patterns, low moods, problems with sleep, a loss of libido and urogenital (bladder and vaginal) symptoms. A sexually active woman under 50 who is naturally bleed/period free for two years can stop using contraception. Women over 50 should use contraception until they’re period free for a year. Women using HRT should stop contraception after age 55.

Women going through the menopause may have to deal with other life stresses, as well as accepting the ageing process and the fact that they’re no longer able to have children. They and their partners may have other medical conditions and be on medication with side effects. They may be part of the sandwich generation, looking after elderly parents as well as their children and grandchildren. This may impact on their own ‘me-time’, and their ability to take part in and enjoy lifestyle choices, such as exercise and a balanced diet, which are important for stress relief. Increased stress and worrying can increase menopausal symptoms or make them worse.

Common symptoms
In a study, the four most common menopausal symptoms reported by women were hot flushes (seven out of 10 women), sleeping problems that could be related to night sweats (seven out of 10), and low moods and irritability (five out of 10). The women struggled with more menopausal symptoms if their partners had health or sexual (e.g. premature ejaculation) problems. Support that helped to reduce menopausal symptoms included using HRT, religious practice with spiritual guidance and a partner who was faithful.

In November 2015, National Institute of Health Care and Excellence (NICE) published guidelines on the diagnosis and management of the menopause. NICE says that for women between 50 and 60, and particularly those with good lifestyle interventions in place, the benefits of using HRT may outweigh the risks. Each woman is entitled to a personalised risk-benefit assessment and discussion with her GP or menopause specialist. Women may appreciate and feel supported if their partners accompany them for these assessments and help them make this decision. Some women may prefer to try herbal or alternative medicines; these may help them if their menopausal symptoms aren’t too troublesome.

Long term effects
As women approach the menopause, their female hormone levels fall. Oestrogen helps to maintain bone density in women. After age 50, one in two women is at increased risk of osteoporosis. For men, the osteoporosis risk after age 50 is one in 10. Women may have other risk factors as well, such as genetic or medical factors, that increase their risk for osteoporotic fragility fractures (broken bones). This is on top of their age and the menopause. Fragility fractures are painful and can cause disability and a poor quality of life. For bone protection, it’s important to eat a balanced diet with calcium-rich foods and vitamin D, take weight-bearing exercise, and not smoke or have too much alcohol. HRT can protect bones from osteoporosis and is a useful treatment option for women aged 50 to 60. Once the decision is made not to use HRT, women and their healthcare professionals can discuss non-hormonal options.

After the menopause, a woman’s heart risk increases, and becomes the same as for men. Lifestyle measures can help to reduce her overall heart risk. There’s a decline in sexual functioning with age, and this is further affected by the menopause. In an Australian study, it was seen that the number of women going through the menopause and suffering from sexual problems rose from 42% (this was for women just starting to go through the menopause) to 88% (in women who had been going through the menopause for some years ). Postmenopausal women said that they had low sexual arousal and interest and a lower number of sexual activities. Women complained of vaginal atrophy (vaginal dryness), dyspareunia (pain with sex) and of partners’ problems in sexual performance. For vaginal dryness and dyspareunia, women can try vaginal oestrogen hormone treatments or vaginal lubricants and moisturisers. For partners’ problems, psychosexual counselling can be helpful.

How a man can help:
There are many ways that men can help women going through the menopause. Having a positive attitude to the menopause and having good lifestyle interventions are important. By understanding the changes that occur during the menopause, and being emotionally supportive, men should also benefit from the good marital relationship that will result from this support.

About the author
Dr Nuttan Tanna is a pharmacist consultant at The Northwick Park Menopause Clinical & Research Unit at London North West Healthcare NHS Trust, Harrow, Middlesex.

Created Autumn 2018

Copyright © The Menopause Exchange 2019


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