World Menopause Awareness Day 2024 and World Menopause Month

Highlighting couple-pause

World Menopause Day is held annually on the 18th October to raise awareness, break the stigma and offer support for all those going through the menopause. This year at Health & Her we are using this event to highlight and focus on the concept of the couple-pause.

Why did we choose to turn the spotlight on the couple-pause? It is an emerging and exciting area of research which should help to open up a new dialogue for couples in their 40s and 50s to address their hormonal changes together. Quite frankly, as a concept you wonder why nobody has thought about this before given that people are not experiencing periods of hormonal transition, such as the perimenopause, menopause or andropause, in a vacuum but usually in the context of a relationship. This couple-centred approach then becomes a potential game-changer in that it acknowledges that hormonal disruption can have a significant effect on the health of a relationship and that the needs of both partners should be taken into consideration. In short, it should help to create more openness and understanding around the menopause and andropause.

What exactly is the couple-pause?

The term was coined by two Italian professors¹ to specifically highlight how hormonal shifts experienced by both female and male partners during mid-life can cause problems around sex and intimacy - but as a concept it can also be expanded into trying to foster a greater understanding of a partner’s hormonal health generally. (It should also be pointed out that both sexes can experience age-related changes and same-sex and opposite-sex couples may be equally affected). Typical menopause symptoms include tiredness, low mood, irritability, sleeplessness, weight gain, vaginal dryness, recurrent urinary tract infections and low libido and common side effects of andropause include lethargy, mood swings, depression, weight gain, lack of motivation, erectile dysfunction and low libido - all of which can potentially have a huge impact on any relationship. The couple-pause can also be a time when you, quite literally, take a pause to reflect and take stock of what you both might be going through – physically, psychologically and emotionally - at this mid-life point.

Sharing hormonal experiences

If you are part of a couple in your 40s and/or 50s, acknowledging the existence of the couple-pause can hopefully help you develop increased empathy, understanding and provide practical help for your partner. The menopause might manifest itself differently to the andropause but there is plenty of evidence to show there are hormonal changes going on for many men at around the same age that women are going through the perimenopause and menopause. These can equally cause unsettling physical and psychological changes and then any frustrations that may be felt by one partner due to these hormonal upheavals is clearly going to impact on the other and vice versa. The idea of sharing hormonal experiences can also divert attention from seeing one partner in the relationship as ‘the problem’ and frame any challenges as something to be faced by you both. This isn’t to assume that all the issues a midlife couple encounter are automatically down to your hormones. There are very likely to be a myriad of other stresses going on in your lives at this point (ageing and ill parents, ‘empty nest’ syndrome, work insecurities, worries about middle age and time running out, to name but a few) but everyone over the age of 40 will experience some hormonal decline and disruption, the physiological effects of which can also make it harder for your body to respond to that stress.

What it means for you both

Understanding how your hormones can affect you in your 40s and 50s should, however, help you to build a more rounded and informed picture of what might be going on with either of you at this life stage. For women perimenopause usually starts in her 40s caused by fluctuations in oestrogen levels, leading to possible insomnia, brain fog, weight gain, hot flushes and mood changes. Then as we head into our 50s², and periods stop, we transition into menopause, where oestrogen levels are less chaotic but head into a more into a rapid decline additional signs include low self-esteem, lack of confidence, vaginal dryness and low libido.

Andropause, on the other hand, involves a slow and steady decline in testosterone levels in men from the late 30s onwards. It doesn't mark the end of fertility like menopause, or have a noticeable physiological ‘end’ as with women when their periods stop, but testosterone deficiency can potentially lead to symptoms in some men such as low energy, depression, decreased libido, erectile dysfunction, difficulty sleeping, fatigue, an increase in body fat, loss of muscle mass, mood changes, irritability, lack of focus and dips in confidence and motivation. Estimates vary but according to research³ up to 82% of men aged 40-55 experience at least one sign of andropause,

These hormonal shifts during menopause and andropause also mean both of you may be dealing with disconcerting changes to your body, (the so-called ‘meno-belly’ and breast changes for women and a bigger gut and ‘moobs’ in men); mood swings (irritability and depression are common symptoms for both women and men at this life stage); plus changes in libido – all potentially happening at the same time. You don’t need telling that all this can then put a strain on communication, intimacy and make your life together tougher and that’s not including whatever else might be going on in your life at the time. But by taking on board the couple-pause concept you address new ways to understand each other and do more to protect your relationship.

How the couple-pause could help you both

Sharing what you’re going through. Nobody should feel pressurised into sharing details of their hormonal health, and it can make you feel vulnerable doing so, but if you can discuss your concerns within your relationship it should lead to greater understanding between you and your partner and make you stronger as a couple. It should also lead to increased empathy and hopefully being more supportive of each other's struggles.

Increased knowledge. Taking time to educate yourselves about menopause and andropause and the associated symptoms can help you to understand why your partner might be acting out of character and help to reduce common misconceptions (for example, thinking he/she just doesn’t fancy me anymore when it could be that one, or both, of you is too tired, stressed or self-conscious about your changing body shape to want sex; you don’t want sex because it has become uncomfortable; you are increasingly worried about not being able to ‘perform’ or your libido is temporarily AWOL). Interestingly, the professors who conceived the idea of couple-pause have written about how during the course of their research it became apparent that there were big gaps in knowledge and misinformation in how women and men viewed age-related changes in the other. Understanding more about the two ‘pauses’ (andro and meno) can also potentially help you to recognise symptoms and signs in other people around you in their 40s and 50s such as work colleagues, friends and relatives who may be experiencing similar symptoms.

Knowing when to ask for outside help. In an ideal world, sharing how your hormones might be affecting you within the confines of your relationship should be helpful but it might not be the resolution you were hoping for. If symptoms are significantly impacting your quality of life or relationship this should be your cue to get help from a healthcare or relationship professional. They might initially recommend lifestyle adjustments and/or they might possibly prescribe antidepressants, medication for erectile dysfunction, hormone replacement therapy/testosterone replacement therapy, a talking therapy such as CBT or even couples counselling.

It can encourage you to do more together. Often making simple lifestyle changes can help to effectively manage your hormones so encouraging each other to do things which should lead to improved physical and emotional well-being generally should be a big help. Ideally, do them together. These can include regular exercise (losing weight and exercising can boost testosterone levels naturally) and evidence shows it can reduce typical menopause symptoms like hot flushes and mood swings); eating a healthy balanced and hormone- regulating diet such as a Mediterranean-inspired one; practising relaxation techniques like meditation and finding ways to effectively manage stress.

References

1. https://academic.oup.com/jsm/article/21/Supplement_2/qdae002.070/7618321
2. https://www.nhsinform.scot/healthy-living/womens-health/later-years-around-50-years-and-over/menopause-and-post-menopause-health/menopause/#:~:text=Perimenopause%20and%20menopause%20are%20a,to%20reach%20menopause%20is%2051.
3. Censuswide, 2024. Survey of 1006 males in the UK aged between 40-55, July 2024. [Research conducted for Health & Him]

How to know if you’re experiencing perimenopause or menopause

Women’s health expert and GP, Dr Shilpa McQuillan, shares what to expect:

“During perimenopause, some women may continue to have regular periods but experience symptoms of menopause. Many women may find these symptoms distressing and confusing as they are not aware that you can experience menopausal symptoms whilst still having periods.

Menopause is diagnosed once a woman has no menstrual periods for 12 months in a row. For many women this occurs between the age of 45 and 55, with the average age in UK being 51.

Some women do not experience any symptoms, but the majority of women will, and this can really impact on both physical and mental aspects of your life including relationships, work, and activities.

Speak to your GP if you feel this could be you and you would like more information on how to manage this. Some women also find it helpful to keep a diary of their periods and the symptoms they are experiencing."

Read Dr Shilpa’s full article here: Menopause, perimenopause and post-menopause – A GP’s overview

When is World Perimenopause Day 2024?

World Perimenopause Day (launched in 2019 by Health & Her) is an annual awareness day that takes place on 11th October  – one week before World Menopause Day. World Perimenopause Day 2024 aims to raise awareness around the lesser known stage prior to menopause, where hormone levels fluctuate and as a result, women experience an array of menopause symptoms while still having periods.

What are the signs of menopause and Perimenopause?

There are more than 30 recognised symptoms of menopause, and on average, women will experience nine of these*.

The top 9 symptoms of perimenopause are:

• Period Changes
• Hot flushes & Night Sweats
• Stress & Anxiety
• Sleeping Problems
• Brain Fog & Poor Concentration
• Skin & Hair Changes
• Mood Changes
• Low Energy
• Joint & Muscle Aches

The top 9 symptoms of menopause are:

• Sleeping Problems
• Hot flushes & Night Sweats
• Stress & Anxiety
• Weight Gain
• Low Energy
• Brain Fog & Poor Concentration
• Skin Changes
• Mood Changes
• Urinary Changes

For many women, Perimenopause and Menopause can be a life changing and isolating experience. But by raising awareness and education we hope to support women in joining the dots as they understand the connection between their symptoms and midlife hormone fluctuations.

Use our perimenopause and menopause symptom checker to help determine if you might be experiencing symptoms.

Track your symptoms with the NEW Health & Her Menopause app

Here is everything you need to know about the Health & Her menopause app

Campaign with us

From campaigning to help women get access to expert information, to sharing your own personal story – your support can help millions of women from around the world to join the dots and take on the change together.

Tell your story

Email us at contact@healthandher.com or find us on Facebook and Instagram, and use the following hashtags to get involved:

#worldmenopausemonth
#worldperimenopauseday
#worldmenopauseday

References and sources

• [1] https://www.bhf.org.uk/informationsupport/heart-matters-magazine/medical/women/coronary-heart-disease-kills
• [2] https://www.bhf.org.uk/what-we-do/news-from-the-bhf/contact-the-press-office/facts-and-figures#:~:text=Heart%20and%20circulatory%20diseases%20cause,men%20and%203.6%20million%20women.
• [3] https://www.hriuk.org/health/learn/cardiovascular-disease/women-and-heart-disease#:~:text=Heart%20disease%20is%20the%20leading,in%20the%20UK%20and%20globally
• [4] https://www.bhf.org.uk/informationsupport/conditions/heart-attack/women-and-heart-attacks#:~:text=chest%20pain%20or%20discomfort%20in,headed%20or%20short%20of%20breath.
• [5] https://www.leeds.ac.uk/news/article/4328/estimated_8000_women_die_due_to_unequal_heart_attack_care
• [6] https://www.ceu.ox.ac.uk/news/women2019s-age-at-first-menstrual-cycle-linked-to-heart-disease-risk
• [7] https://www.escardio.org/The-ESC/Press-Office/Press-releases/Premature-menopause-is-associated-with-increased-risk-of-heart-problems
• [8] https://www.bhf.org.uk/what-we-do/news-from-the-bhf/news-archive/2023/february/reproductive-factors-in-women-increase-cardiovascular-risk
• [9] https://www.nhs.uk/health-assessment-tools/calculate-your-heart-age
• [10] https://www.nice.org.uk/guidance/ng23/ifp/chapter/benefits-and-risks-of-hrt#:~:text=Heart%20disease%20and%20stroke%20(cardiovascular%20disease),-Studies%20show%20that&text=If%20you%20start%20HRT%20before,of%20dying%20from%20cardiovascular%20disease.

Additional resources:

• https://www.bhf.org.uk/informationsupport/heart-matters-magazine/medical/women/coronary-heart-disease-kills
• https://www.bhf.org.uk/what-we-do/news-from-the-bhf/contact-the-press-office/facts-and-figures#:~:text=Heart%20and%20circulatory%20diseases%20cause,men%20and%203.6%20million%20women.
• https://www.hriuk.org/health/learn/cardiovascular-disease/women-and-heart-disease#:~:text=Heart%20disease%20is%20the%20leading,in%20the%20UK%20and%20globally
• https://www.bhf.org.uk/informationsupport/conditions/heart-attack/women-and-heart-attacks#:~:text=chest%20pain%20or%20discomfort%20in,headed%20or%20short%20of%20breath.
• https://www.leeds.ac.uk/news/article/4328/estimated_8000_women_die_due_to_unequal_heart_attack_care
• https://www.ceu.ox.ac.uk/news/women2019s-age-at-first-menstrual-cycle-linked-to-heart-disease-risk
• https://www.escardio.org/The-ESC/Press-Office/Press-releases/Premature-menopause-is-associated-with-increased-risk-of-heart-problems
• https://www.bhf.org.uk/what-we-do/news-from-the-bhf/news-archive/2023/february/reproductive-factors-in-women-increase-cardiovascular-risk
• https://www.nhs.uk/health-assessment-tools/calculate-your-heart-age
• https://www.nice.org.uk/guidance/ng23/ifp/chapter/benefits-and-risks-of-hrt#:~:text=Heart%20disease%20and%20stroke%20(cardiovascular%20disease),-Studies%20show%20that&text=If%20you%20start%20HRT%20before,of%20dying%20from%20cardiovascular%20disease..

*Health & Her Symptom Tool Research conducted with over 50,000 women