Signs and Symptoms of Perimenopause and How Your Husband Can Provide Support

When we make a marriage covenant, we vow “in sickness and in health.” We are committed to being by each other’s side through the highs and lows of life. Perimenopause can be a difficult time in a woman’s life, and it can unexpectedly cause tension and stress in the relationship.

Perimenopause is the “multi-year phase before menopause.” Signs and symptoms of perimenopause usually begin from ages forty to forty-seven and can last from four to ten years. There are drastic changes that occur in a woman’s body and brain.

This is not an exhaustive list of signs and symptoms of perimenopause, but here are some of the changes that a woman can experience to varying degrees of intensity.

• Hot flashes – a rush of heat from the inside
• Mood swings – fluctuations in mood
• Irritability, anxiety, and depression
• Night sweats – excessive sweating during sleep, causing clothing and bedding to be wet, and not caused by a hot room
• Insomnia – trouble falling and/or staying asleep
• Brain fog – change in ability to think, focus, concentrate, and remember
• Changes in libido – changes in desire to be intimate and feeling attractive and wanted
• Weight gain – due to hormone changes, a woman burns 200-250 fewer calories per day, making it harder to maintain and lose weight.
• Increased UTIs and other bladder problems
• Fatigue – deep exhaustion beyond just feeling tired
• Joint pain – body aches and other pains
• Changes in skin – acne, dry skin, increased sensitivity and changes in pigmentation

The age range when signs and symptoms of perimenopause typically occur often happens at the same time in life as other major life changes in a woman’s life. These can include an empty nest, caring for aging parents, losing parents, job changes, and/or starting to have grandchildren.

These major life changes, combined with changes in her body and brain, make stress management, communication, and connection more difficult, causing division and strain in a marriage.

Hormones control metabolism, growth and development, stress response, reproduction, sleep, and mood. Examples of hormones are insulin, adrenaline, estrogen and testosterone, melatonin and cortisol. Hormones control and contribute to many different aspects of a woman’s health.

She may find herself experiencing increased anxiety around everyday tasks – driving, getting ready for the day, sleeping, or simply managing the day-to-day responsibilities that never seemed particularly difficult before.

She may begin to wonder, “What is happening to me?” and even feel like she is going crazy because she cannot understand what is happening in her body and brain. What once felt familiar and manageable can suddenly feel overwhelming, leaving her confused and frustrated, wondering why she no longer feels like herself.

Sometimes perimenopause is missed by doctors and counselors as a major contributor to a woman’s symptoms either because of her age, because she doesn’t meet “enough” of the criteria, and/or because they are not knowledgeable about the extent of its effects. Many women are diagnosed with mood disorders, anxiety, depression, and other mental health diagnoses.

A mental health diagnosis may still be accurate. Still, when it is noted that she is experiencing perimenopause, it helps her doctors and counselors to provide resources and treat it specifically. In doing so, the symptoms of anxiety and depression can decrease.

Some Common Myths of Perimenopause

Hot flashes are the main sign Even some professionals still have this idea that hot flashes have to happen for a woman to be considered perimenopausal. Different women experience different symptoms with varying intensity and frequency.

You can’t get pregnant during perimenopause This is not true, but it can be more difficult to conceive during this time. Symptoms of perimenopause and early pregnancy are similar. The chance of pregnancy doesn’t drop to zero until a woman has not had a menstrual cycle in twelve months.

It’s just physical Husbands can say, “I don’t know what happened, but she has changed over the last few years.” Wives can say, “I don’t know why I am so irritable and miserable. I don’t feel like myself.” Doctors can help with medications but basically say, “It’s just part of menopause. It will be over eventually.”

The ripple effect goes way beyond the physical. When it affects the physical, mental, and emotional, it then affects the woman’s view of herself, her view of her husband, and their relationship.

Love is patient, love is kind and is not jealous; love does not brag and is not arrogant, does not act unbecomingly; it does not seek its own, is not provoked, does not take into account a wrong suffered, does not rejoice in unrighteousness, but rejoices with the truth; bears all things, believes all things, hopes all things, endures all things. – 1 Corinthians 13:4-7

This chapter on love does not say to love when others are nice or love when it is easy, but “love is patient, love is kind…”

Communication is key

Before you realize it is perimenopause, you may think, “This is just a stressful time in my life.” It is, but it is compounded by what happens in perimenopause. It needs to be communicated how you both feel and what you are struggling with.

Instead of “You don’t understand me,” say, “I know I have not been myself lately. I am figuring out how to navigate some major changes as a female and really need your patience and support.”

Instead of “What is wrong with you?” say, I have noticed you haven’t been acting like yourself. Is there anything I can do to support you?”

Ways For Husbands to Support Their Wives

First, acknowledge she is going through major changes in her body and brain that are not her fault and are not enjoyable. Just like pregnancy, she is going through changes that make her feel unattractive, insecure, emotional, and irritable. She may feel “old” or like she is “falling apart,” and it came out of nowhere.

Second, communicate with her by asking her how she needs you to support her both physically and emotionally. Work to understand what she is experiencing. Ask for specifics. Ask, “How well did you sleep last night?” “What can I do today to take some weight off of your shoulders?” “What is something that would help you to relax more every week? “

Third, be observant. Asking for what she needs is great, but observing will communicate love to her at a deeper level. Watch for signs of her mood changing, feeling overwhelmed, extra tired, or just feeling “off” and not knowing why. Instead of immediately getting defensive when she is irritable and emotional, realize she may not be feeling well and may need some time to relax physically and emotionally.

Fourth, find ways to relieve her of duties and give her more time alone, with girlfriends or with you, to whatever capacity is doable and makes her feel loved and supported even when she is not acting lovingly.

Fifth, but not least, increase your patience. She may seem so different than the woman you married years ago, but she is still your wife. Take this time to strengthen your communication and affection. If she had a heart condition, cancer, or other medical illness, you would not expect her to “push through it” and do it all anyway.

In addition to patience, be willing to adapt your “normal” way of doing things while she is experiencing the intensity of these symptoms. For example, if her anxiety is higher or she is now experiencing anxiety where she didn’t really struggle with it before, be willing to spend less time at a friend or family member’s house, spend less time away from home so you are with her more, and/or provide more reassurance during other stressful times.

Treatment and Resources

Speak to your gynecologist and/or a menopause specialist about your symptoms. Tell them everything, because what you think might not be connected might be, or be closely related. Counseling can help address your depression, anxiety, stress, and marital tension. You are not falling apart, and you’re not crazy.

The more you know about what is going on in your body and brain, the more you can learn and find ways to manage it healthily. Counseling can and does help. It provides an outlet and can provide you with tools to manage the changes you are experiencing in your relationships and become more aware of your mental health. The more support, the better.

Gynecologists and menopause specialists can assist in developing a plan to treat the most troubling symptoms. There are several medical options. Ask your doctor for all the options so you and your doctor can make the best decision for your health and situation.

The Menopause Society website provides information, including a list of menopause practitioners, and can be searched for your area.

Remember:

• This is not forever.
• It is beneficial to reach out for support.
• Use this time to strengthen your communication of deeper and more personal things with your husband and with God.
• Your emotions fluctuate, but God’s character does not, and He promises us to “never leave us nor forsake us.” (Deuteronomy 31:8)
• Your value and worth have not changed.