Perimenopause symptoms that signal the beginning of the menopause transition for women happen a lot earlier than many of us expect and not the way we often anticipate. The average age of menopause (the day after a woman has gone a full year without her period) is 51. Everyday after is considered postmenopause.
But the average age for perimenopause is 45 and symptoms can start as early as mid-30s. They tend to be earlier and more severe for women of colour and people with unresolved trauma and can last up to 7-10 years.
For me, it wasn’t the typical irregular or heavier periods or hot flashes that I noticed. First it was joint stiffness and what I later discovered was frozen shoulder. Then came increasing pain, headaches and insomnia during my menstrual cycle that felt debilitating at times. This was followed by brain fog, weight gain, anxiety and then depressive thoughts and significant dips in my libido. I’ve never struggled so much with finishing writing, something that has always come naturally to me, or felt so fatigued. This invoked fear as a solopreneur and shame for my lack of productivity and need for so much more rest.
Unexpected Struggles
Like many women I’ve talked to, it’s been a much bigger struggle than expected and we’re still having to navigate a range of surprising symptoms and varying, sometimes contradictory recommendations. For example, there’s been hesitation by some health care providers to prescribe vaginal estrogen cream which can help with painful intercourse from thinning and dryness and other genital urinary symptoms such as frequent urinary tract infections,
And men are changing too in midlife. Some men go through something known as andropause; symptoms caused by a slow reduction in testosterone. You can learn more about it here.
Midlife can be a time of increased stress from juggling work, aging parents and youth/young adult children while often experiencing decreased capacity and sleep challenges. Grief and loss can also bring up questions about life and our relationships.
Why Education and Prevention Matters
Shame is isolating but information is empowering. Remember, “It’s not you/me, it’s the situation” to stay connected even when you’re feeling less than, rejected or exhausted.
Lifestyle and relationship changes in midlife can not only reduce symptom severity and protect against divorce but they can save lives.
Estrogen affects systems throughout the body but lifestyle changes can help reduce the the risks of cardiovascular conditions, dementia, osteoporosis, diabetes and suicide.
Change and getting help is not easy but a supportive partner can make all the difference. Take an invitational approach and either help your partner protect time for exercise and sleep by lightening their load (more on that below) or join them for walks or working out. Be mindful that female partners might be feeling more self-conscious as weight gain is a common symptom. So validate the struggle and put emphasis on long term benefits and improved energy, focus and mood over expected changes in weight or appearance.
Recognize warning signs of mental health struggles specific to perimenopause. Did you know women between 40- 59 in Canada are at the highest risk for suicide? This is likely similar in the States. Depression is especially common for those with a history of clinical depression, postpartum depression or PMMD. Try to reduce alcohol consumption or consider getting sober together and seek support for underlying issues, especially unprocessed grief, loss, trauma or infidelity.
A Necessary Shift to Protect Your Relationship – Me to We to Support Sharing the Load
“It’s not just hormones.”
A partner’s irritability and sometimes rage can feel surprising to men in a heterosexual relationship when a partner has generally been more quiet or agreeable. It’s easy to blame it on hormones and get defensive. While some women find themselves lashing out at supportive partners, more often than not, there are underlying issues.
Many women have been socialized to please and appease but as estrogen declines, so does their tolerance. A common complaint for women in heterosexual relationships is partners not making the shift from “me to we,” leaving women carrying the weight of the load, including the mental and emotional load.
To protect the relationship, instead of waiting for her to ask for help and making decisions based on wants without considering the partner’s needs or household responsibilities, the Gottmans encourage this important shift:
ME TO WE:
Recognizing one’s time is no longer our own
Preparing for being away by arranging for other help or outsourcing to lighten the partner’s load.
Equally sharing household and childcare responsibilities
Taking initiative instead of waiting to be asked
Sharing the load as described by Eve Rodski in “Fair Play” as ”taking ownership from conception to completion” has the benefits of:
Protecting the relationship from resentment and often relationship breakdown
Valuing women’s time and energy protecting against burnout
Ensuring partners feel supported instead of alone or abandoned
“The secret to lasting passion is actually a strong friendship.”
In the beginning of all relationships, feel good neurotransmitters help keep us attracted to one another. But those don’t last and fluctuating hormones in midlife can lead to distance or disconnection. Fortunately, the Gottman’s Fondness and Admiration system can help you maintain a close connection as you weather the storms of midlife together.
How well do you really know your partner? To stay connected, you need to turn towards your partner’s bids for connection and show genuine interest in their inner world by building love maps.
Are you taking your partner and all they do for granted or are you expressing appreciation for the big and small ways they make your life a little easier, a little richer or more fun?
Speaking of fun, this article highlights the importance of maintaining a sense of playfulness to transform your love life. Laughter and lightheartedness are good for our nervous system. How can you bring more playfulness into your relationship?
While midlife can bring many challenges, couples can grow together by using Gottman practices to strengthen the foundation of their friendship and engage in healthy conflict to create a more equal relationship.
Growing Together, Instead of Growing Apart
“When done in safe and healthy ways, conflict has the ability to bring you closer together.”
Let’s use a hypothetical couple Bill and Jane to illustrate the antidotes for the 4 Horsemen (Criticism, Contempt, Defensiveness and Stonewalling) or predictors of relationship breakdown. Instead of criticizing Jane for lashing out at him lately, which will only put her on the defensive, Bill uses a softened start up to express his complaint and need without blame:
“I love when we find time to spend together. Lately I’ve been feeling confused and hurt when you lash out at me. I don’t know what I’ve done wrong and I’m worried you don’t want to be with me anymore. I find myself pulling away. I need to know what’s going on and for us to be kinder to each other.”
Importance of self soothing
Instead of rolling her eyes in contempt or stonewalling due to flooding, Susan takes a few deep breaths to self-soothe. Although she’s been silently fuming for years over how uneven things feel, she realizes she needs to work on expressing her needs more and also wants them to treat each other with more kindness and respect.
She uses self-compassion to protect against shame. She never used to lash out. Sometimes the mood swings feel out of her control. Sometimes the sound of his chewing makes her want to scream. She validates Mark’s feelings and expresses appreciation for his bringing up his concerns in a loving way.
It’s Jane’s turn to share using a softened start up:
“I’m really struggling with how much I’m doing and the weight of the mental load. When I have to do all the planning and delegating, I feel exhausted and can’t relax. I’m feeling frustrated and alone. I need us to divide things up more evenly.”
Instead of being stuck in traditional beliefs or getting defensive and saying something like “But you always seemed so capable and besides, if you really wanted my help, you would just ask,” Bill is willing to accept influence and listen as Susan begins to share about her experience, common to many women in the menopause transition years:
“I don’t have the same energy I used to have. Half the time I wake up and then can’t fall back to sleep. My body aches and I know exercise would help but there’s too much to do. I also hoped that now that the children are older, I would have more time for my book dream but I can’t focus long enough to finish a sentence. I’m so frustrated.”
Difficult Conversations
These aren’t easy conversations, especially if Jane has repeatedly tried to bring up the lack of equality to Mark and was met with indifference or defensiveness. If Mark can take responsibility for his part and use breaks of at least 20 minutes to self-regulate and both use repairs to get things back on track, there’s still hope. Conversations about the dreams within conflictcan help couples move beyond issues that feel gridlocked and ultimately come closer together.
If a partner turns against or is abusive, safety needs to be the first priority. Resources for safety can be found here.
Statistics show that more women than men are likely to initiate divorce in midlife, usually after years of feeling unsupported, unheard or undervalued. Instead of avoiding conflict, the Gottmans provide a roadmap for restoring and deepening connection.
Midlife Reflections
Navigating perimenopause and all the changes and stressors of midlife can feel overwhelming. It can bring up a lot of emotions and increase conflict. But it’s also an opportunity for couples to improve their lifestyle and relationship.
Some questions to support you are:
How active are we?
How well is our sleeping and eating?
How safe – emotionally and physically do I feel with my partner?
How equally divided are the family and household responsibilities, including care for aging parents and the mental load?
How appreciated do we each feel?
Do we make time to connect, have fun and be silly together?
How well are we supporting each other’s dreams and career ambitions?
Do we feel better or worse after conflict?
Remember, there’s no such thing as a perfect relationship and it’s normal to go through ebbs in flows in libido, energy and mood. But by using the Gottman practices to cultivate friendship and healthy conflict along with regular State of the Union meetings to not let resentment build and deepen connection, midlife can be an opportunity to grow stronger together.
