Menopause for Men

The last time I took a pregnancy test, my partner sat next to me on the edge of the tub and we held our collective breath waiting for that blue line to give us a verdict. We had been screwing like bunnies for months and, despite being told in the distant past he was infertile, he’d sired two children in quick succession with his former wife.


“If you’re pregnant, we keep the baby, right?” he asked.


“Well, yeah, ‘cause it’ll be a bloody miracle.” I was 50 years old.


I suspect a lot of women over 45 are going to be in a similar bathtub position when their periods become less regular. I couldn’t get pregnant ten years earlier without a lot of help from a lab. Even so, at 50 I had fantasies my body could perform miracles. After all, my orgasms had improved exponentially after my periods stopped. But pregnant? Could I be? Is it possible? No. It wasn’t. But don’t let me convince you to give up your birth control.


Before going through menopause, about the only thing I really understood about it was that I might, without benefit of exercise, suddenly combust at any time of the day or night. But what I learned during the thick of things was that menopause was a constellation of symptoms otherwise associated with puberty or dementia. And wouldn’t it have been nice if I’d known this beforehand? So if you’re a man loving a woman about to get to this stage, or a woman too busy with work and life to spend hours looking up, “Why can’t I fucking sleep?” here’s my personal guide to what I wish I’d known before I became an infertile, raging bitch. (Which, rest assured, eventually resolves. The bitch part, not the infertility.)


There Will be Spontaneous Rage (and Tears): I dated a man who said he used to track his girlfriend’s periods and bring her flowers right about the time she’d hit her monthly PMS. I told him if our partners could do something this thoughtful during menopause, they might make it through unscathed and, more likely, cherished. Guys, chuck the daily latte habit and budget for weekly flowers.


Why rage? It could be the indignities of age; the bladder incontinence while trampolining with the kids (start your Kegals now, gals), the bank breaking cost of keeping grey hair disguised as cute highlights, or the photo that captured her reading face as a horrifying cascade of chin folds. Though they say ‘most’ women go through menopause without a significant mood disorder, I suspect that’s because, instead of presenting to the doctor for an evaluation, we’re roaring through our days like Charlize Theron in ‘Fury Road’ and don’t give a rat’s ass what ‘most’ of you think. The fact is, over 70% of women going through menopause will report irritability as their first symptom of hormone shifts, along with depression, anxiety, crying episodes and insomnia. I suspect if we could just solve the insomnia, all this other shit might go away. No one, menopausal or not, can be a decent human on two hours of sleep. Start there. Melatonin, hormone replacement, Magnesium, whatever it takes. And flowers.


She Will (Temporarily) Lose Her Mind: After my son was born, I experienced the typical ‘baby brain’ (yes, they actually shrink) as evidenced by the number of things that flew off the roof of my car during the first six months of his life. But it didn’t matter because I was on maternity leave and the only thing more taxing to my brain than getting his mouth latched onto my breast was figuring out what to cook for dinner. Everyone tells you about baby brain when you’re pregnant. “Oh honey, you will feel like a dumbass.” But when menopause hits we’re at the top of our game, seasoned professionals, accomplished mothers. No one tells you menopause feels like you just had a baby. Suddenly, the complex steps required to do your job, manage the household and schedule your bikini wax become wholly insurmountable. It’s as though the luge tracks of your brain have been blanketed with rocks.



Around the time I was losing my menopausal mind, I saw the movie Still Alice where Julianne Moore is diagnosed with a rare form of early onset Alzheimer’s. Avoid watching this movie at all costs between the ages of 48-54. Otherwise you will run to your doctor demanding a brain MRI. This article does a good job of helping you distinguish between menopausal brain fog and dementia. But more ominous is recent research speculating a woman’s higher risk of Alzheimer’s (two-thirds are women) is the result of estrogen depletion to the brain. So even if we exercise, get good sleep, and eat well, our brains may become toast eventually anyway. Which is another reason why I slap an estrogen patch on my hip every week.


For the most part, the menopausal brain fog dissipates after the first year or so. Whatever you do, don’t make her feel bad about her sudden inability to recall common words or find her cell phone. See above: There will be spontaneous rage.


She Might Want to Sleep with Other Men: In the run up to menopause a woman’s body will be screaming at her to get knocked up one last time before the ovarian DNA shuts down. Her androgen levels will go wonky and right after she rages she’s going to want to fuck. At first, my partner thought this was really cool. Until I told him I wanted other men involved. Whatever you do to work with this libido overdrive, don’t expect it to be easy. If the menopausal woman is suddenly asking for things that were heretofore absent from your sexual lexicon, be gentle with your assessments. It doesn’t necessarily mean she is bored and done with you. (Although she could be. See below: She Might Stop Wanting Sex) If you want your relationship to survive you need to be the bigger man and not take anything personally. Of course, this woman will be so pissed off during menopause that she will want you to take her very personally, but do so in a way that allows her to be the degenerate…and forgive her. If you keep your own cool when hormone shifts are kicking her ass, you’re going to have some damn fine golden years. And probably a lot of great sex.


Or…She Might Stop Wanting Sex: I’ve heard a lot of stories, mostly from men, about their wives or partners losing all interest in sex. I didn’t have the forethought to ask these men how much effort they were putting into being good lovers or if their idea of good sex was just sticking it in her.


From my own experience, taking new lovers just as I was entering menopause was a terrific reignition of my interest in sex, probably made better by the fact that these men were trying to be good lovers because we hadn’t been together for 25 years. Now that I’m 54, my interest has waned a little but not a lot, probably because I keep cycling through new lovers. But having been a medical provider, I’ve seen a lot of women who admit that sex hurts now. With estrogen depleted after menopause, the vaginal tissue becomes fragile, it’s harder to lubricate and often sex simply doesn’t feel good. But there are all sorts of ways to treat this condition, one of my favorite being the Estring, an insertable device that provides localized estrogen, considered safe even for women with a family history of cancer. Other ways to treat vaginal atrophy, and everything you need to know about the vagina, can be found in Dr Jen Gunter’s Vagina Bible.


There’s also hormone replacement therapy (HRT) which is gradually coming back into common use despite a few studies claiming inappropriate risks associated with using it. But those risks have been equivocal over the past decade and usually associated with going on synthetic hormones after age sixty. This new report in The Guardian highlights that a regular habit of wine is likely to increase your cancer risk more than synthetic hormones. Personally, I love being on HRT. Systemic estrogen can treat insomnia, hot flashes, irritability and pretty much fool your body into thinking menopause hasn’t really happened. And it will treat the vaginal changes that cause painful sex.


If a woman is insisting that menopause is incompatible with a good sex life, because of the physical changes, ask about her actual interest in sex and what might make it better. Because if Daniel Craig propositioned her, chances are she’d run for the lubricant. Menopause might just be her excuse for giving up sex with you. As Wednesday Martin writes in her excellent book on female sexuality Untrue, “Understanding what turns women on might turn back the tide of low female desire that plagues an otherwise happy marriage.” This has a lot to do with a woman’s sense of her erotic self and feeling desired. Which is a tough nut for the man who has been farting in bed next to her for a few decades. This will require a lot of bald-faced, scary conversations.


Menopausal women are fearless. While being given a warning on a Thameslink train after purchasing an improper fare, the bald and burly conductor squatted to my eye level and, after explaining the repercussions of encountering a fare enforcer less lenient than himself, I asked him point blank if he wanted to go out. He was totally flattered and very married. But I didn’t feel an ounce of regret or embarrassment. This is the time of life when risk taking feels effortless, when our bodies are still limber enough to survive bungy jumping and our brains have lost the prevaricating habit of thinking we don’t have the right to ask for what we want.

As any number of wise people have said, we never go to our graves regretting the things we did over a lifetime, only the things we didn’t do. Whether it’s line dancing or tantric sex, menopause makes it easier for her to say, ‘Yes!’. There’s an urgency to getting things done, especially if she played it safe in her 20’s. Now is the No Stone Left Unturned time of life. I, for one, have not squandered this. And though there are many things left on my bucket list, discreetly removing my knickers and passing them across the table to my date in a crowded restaurant is not one of them.


She may want to go her own way: In conjunction with being fearless, a lot of menopausal women I know have lost their patience for bullshit. If this applies to the relationships she’s having, it’s a precarious time for a marriage or marginal friendships. Over 60% of divorces are initiated by women between the ages of 40-60. I’ll say it again, men who can be empathetic, supportive, and good natured while a partner is going through a disorienting menopause will be deeply valued after the storm passes. If you got your kids through puberty without completely alienating them, you’re probably going to survive menopause. Until then, buckle up, Buttercup.


Things Will Eventually be Better than Good: Once through menopause, it’s the first time in an adult woman’s life when she’s no longer plagued by uterine cramps, migraines, menstrual blood heavier than a severed artery, or the inexplicable desire and ability to devour a pound-sized bag of M&M’s. We no longer cycle through interludes of crippling self-doubt and the anxiety associated with hormonal shifts. We’ve spent most of our lives, two or three weeks of every month, feeling ‘not normal’. When a woman gets through menopause and feels ‘normal’ every single day, it’s like waking up to a world free of Donald Trumps, Harvey Weinsteins and Anne Coulters.


If I were in charge of the National Science Foundation, I’d have doctors create an equivalent menopause in men and have it be mandatory that they too live for a year or more of mood swings, hot flashes and debilitating insomnia. Until then, show us some love and recognize all the shit we get done despite this caterwauling time of life. We will love you (even more) for it.


Love, Karin

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