I wrote a book about menopause, but it’s for men — here’s why

“I feel like I’ve lost my best friend.”

 “She’s really struggling and I don’t know how to help.”

 “I feel like this knowledge is going to really help us both.”

These are just some of the things men have said to me about menopause, either in general conversation or at the end of a workplace training session.

As a women’s health and fitness coach and menopause educator, I’ve dedicated myself to improving women’s health during midlife, and heard countless accounts from women of the profound impact the menopause transition has had on them. And of course it makes sense that the recent increase of menopause awareness, discussion, and education over the last few years started with supporting women to better understand what was happening to them.

But I’d been increasingly feeling that we were missing half the picture.

Time and time again men were telling me they felt out of their depth in how to understand and support their partners and colleagues. Several men told me lack of understanding of their partner’s struggles during menopause had cost them the relationship. Men said they wished they’d realised ahead of time how profoundly women could be affected by perimenopause and menopause, and how early it could start. And during workplace training men frequently said they’d initially been reluctant to attend but were now so glad they had, and that they felt the information would help at home as well as in work.

Because although menopause happens to women, it doesn’t occur in isolation; it affects relationships, families, and workplaces. By educating men we don’t just foster a more supportive environment for women, we’re also supporting men.

I believe by helping men better understand the physiological and emotional changes women are experiencing, we make them more able to empathise and less likely to take things personally. This can reduce strain on relationships. And although the information on biology, signs/symptoms, and treatment options is of course the same regardless of who it’s written for, men who told me they’d researched information about menopause on the internet said because it was obviously written for women it had felt a little like they were peeking rather than that they were meant to read it – so I wanted to change this.

Menopause is a complex physiological and emotional transition experienced by all women – and it commonly starts far earlier than we expect. The average age of natural menopause (the day someone hasn’t had a menstrual period for a year) is 51 but perimenopause (the years leading up to menopause where hormones are fluctuating and declining) can start up to 10 years before, and perimenopause is often the time when symptoms are most pronounced and confusing. Surgical menopause (hysterectomy removing the ovaries) and medical menopause (mostly due to oestrogen blockers in cancer treatment) can occur at any age, and 1-3% of women experience natural menopause under the age of 40 – so we’re talking about a profound change to female physiology that starts a lot earlier and lasts a lot longer than many of us expect.

The significant drops in oestrogen, progesterone and testosterone during the menopause transition affect virtually every system in the body and can lead to almost 50 symptoms ranging across hot flashes, mood swings, sleep disturbances, cognitive changes such as brain fog, and memory issues. 

Symptoms can be bewildering, distressing, even frightening for the woman experiencing them, and for her partner too.

Because symptoms can vary, and many could potentially be due to other things, women often have to play detective to figure out what’s happening and why. And although there’s some evidence that lifestyle factors such as movement, exercise, nutrition, stress, and smoking can play a role in symptom occurrence and severity, there’s no predicting who’ll experience which particular symptoms, or who’ll experience severe symptoms – you could be doing everything ‘right’ and still be floored.

Trying to work out what’s going on can be exhausting, not to mention the exhaustion caused by the actual symptoms. And it’s unfortunately really common for women to repeatedly seek medical help only to be told ‘you’re too young’, ‘have some antidepressants’, ‘do more exercise’ – leaving them struggling on alone feeling like a broken record trying to get help.

Women may not understand or feel equipped to explain to partners/colleagues what’s happening – they often just don’t feel like themselves any more, and get dragged down by the exhaustion of dealing with symptoms. This can lead to partners feeling isolated and misunderstood, and women struggling at work with managers not knowing how to effectively support them.

I felt it would help men (and women) to have a kind of ‘Haynes Manual’ (remember the car guides?) which explained everything about menopause from causes, signs/symptoms, diagnosis, treatments, how lifestyle can help, work, intimacy issues, and practical advice on how to effectively communicate, support, and talk about things.

I thought it was really important to cover topics women may not themselves feel comfortable discussing, for example the stigma associated with women’s aging and menopause, including what that means for our self-image and perceived relevance and attractiveness. Additionally I felt it was important to dedicate a whole chapter to sex, intimacy and libido as this can often dramatically change and impact relationships in midlife.

I also wanted to empower men with knowledge and skills to effectively support women emotionally and practically. Men who’d effectively navigated menopause with their partners told me they thought understanding concepts such as holding space, active listening, open questions had really helped. But these concepts aren’t familiar to all men, so I wanted to outline what they were, how to use them, and compassionately explain why immediately going into ‘fix it’ mode can be counterproductive.

Another potentially new concept which I explain in my book and in my sessions for men on menopause is unequal ‘mental load’ – that in addition to paid work there’s an often-invisible cognitive burden associated with running a household, and that invisible burden is unequally borne by women. Perimenopause can seem to be the straw that breaks the camel’s back – but in reality, previously unacknowledged unequal mental load can also be responsible. It’s not to say that men don’t also bear mental load, just that women typically bear more, and that recognising and changing this can benefit both female and male mental health. But this concept needs to be explained to men in a way that doesn’t feel like criticism.

I was also conscious that having a partner in menopause can leave men feeling isolated, and wanted to encourage men to recognise the importance of their own self care, including where to get support. I’d heard some incredibly moving stories from men, some of which I recount in the book, and it was important for me to be balanced and empathetic.

I believe it’s vital to support both men and women to understand menopause, to encourage better communication, to help people understand and support each other, and to improve – maybe even save – relationships. I really hope that’s what my book achieves.