If your partner is going through menopause, here’s a brief guide for survival.

Menopause isn’t just a challenging time for the person going through it, but it can also be difficult for partners, friends, and children. Hormones are very real, and they have a very real-life impact on our bodies and our relationships.

Dr. James Simon, Medical Director and Founder of IntimMedicine Specialists in Washington, DC, shared his expertise with True Women’s Health on how to best survive menopause as a partner, and we’ve distilled that for you here.

(Note: Not all women have a uterus so not all women go through menopause, and not all people with a uterus are women, so we will be using gender-neutral language throughout this guide.)

Step One: Understand What’s Going On

The first step in understanding what’s going on with your partner is to know exactly what menopause is. Here is a quick guide to help you understand a bit more of what’s happening before, during, and after menopause:

1. Perimenopause—This means “around menopause” and refers to the time when someone with a uterus is making the transition to menopause, usually age 45-50.

At this time:

• • Periods become more irregular and/or heavier.
  • Ovaries begin producing less estrogen, and as menopause becomes closer, the drop in estrogen increases, causing symptoms like hot flashes, night sweats, disturbed sleep, lower sex drive, weight gain, and mood swings.

It’s important to note that during perimenopause, pregnancy is still possible.

2. Menopause—This is the time when the last spontaneous menstrual period occurs. Once a full year has gone by without having a period, the date of that last period is the moment of menopause. This usually occurs, for most people, around the age of 50.

Your partner might experience the symptoms listed above, as well as other symptoms, like vaginal dryness, pain with sex, and decreased sexual desire.

3. Postmenopause—This is the time after your partner has gone through menopause. In other words, after an entire year without a period, postmenopause has officially begun. For some people, menopausal symptoms, such as those listed above, may become less frequent and less intense. However, sometimes those symptoms can last for many years after the menopause transition.

Step Two: Listen to Your Partner

It can feel really bad when your partner is tired and cranky, and it might even feel like you did something wrong. You might even feel rejected romantically and physically, and that lack of desire and touch can lead to something called skin hunger – where you crave touch, and begin to feel lonely without it. But your partner is also going through all of this. And it is nobody’s fault. You can’t support your partner and your relationship if you don’t really understand what’s going on. And sometimes, your partner won’t understand what’s going on either.

The easiest thing to do is to ask what your partner needs, and what would feel good. And when it comes to sex, it’s about thinking outside of what’s “normal” for you in your relationship.

Dr. Simon has done significant research on the impact of painful sex after menopause, and nearly two-thirds of people experienced painful sex after menopause, causing them to avoid sex and lose interest in sex. This shift in desire can have a large impact on relationships.

First, consider different ways to connect intimately. Perhaps penetrative sex isn’t a viable option right now. What about mutual masturbation? Or oral sex? What kind of touch sounds good to you and your partner? These conversations can be difficult if we aren’t used to having them, but communication is one of the most important aspects of sex.

There are treatments for painful sex, and that will be different for each person, but may include:

• Vaginal lubricants or moisturizers
• Vaginal estrogen
• Vaginal dilators
• Sex therapy
• Pelvic floor physical therapy

Dr. Simon has found that nearly 60% of couples who went through post-menopause treatment for painful sex felt that their sex life (and their relationship) was significantly better than even before menopause!

Step Three: Count Sheep

Sleep is imperative for all humans, especially for those going through menopause. The constant night sweats cause more than disturbed sleep: weight gain, mood swings, and decreased sex drive are all results of a change in sleep habits.

If you’re in a relationship with someone who is currently experiencing these changes, then you probably know what I’m talking about. If you think it’s difficult for you, just imagine what your partner is going through. And, if you’re concerned about your partner, it’s okay to seek professional help individually or as a couple. Menopause can feel so isolating, especially when dealing with sleep deprivation.

If you see that your partner is isolating by setting up barriers, it will be especially important to work together to create a support plan with professional help. Mood swings, for example, may be related to PMS or heavy bleeding, and taking birth control can actually help lessen these symptoms. There are answers, but your partner may need that extra understanding and a gentle push from you to take the steps to get help.

Step Four: But, What Can I Do?

• Take Initiative to Learn—There are so many books, articles, and podcasts  with good information on the topic of menopause. This is a great place to begin educating yourself. Asking your partner to do the emotional labor to educate you about menopause generally will be just as exhausting, and you want to help, not hinder. That doesn’t mean that you shouldn’t ask questions about what your partner is going through, how things feel, and what support would look like—questions like these can be really validating.Websites like menopause.org and isswsh.org have so much information that can help people navigate the struggles of menopause. You can also make an appointment with IntimMedicine—we often setup meetings with individuals and couples to better grasp how to handle menopause with a bit more ease. Having basic information before you talk with your partner will convey that you are really trying to understand what’s going on.

• Have Compassion—This can be a difficult time for everyone, and hormones are fierce. Reminding yourself and one another that no one is at fault can be helpful. Take a beat before responding during heated conversations, and remember that, again, hormones are real and they actually alter the chemical state of the brain. If you’re feeling hurt, confused, or lonely, consider talking with a therapist or journaling about what you’re going through.
• Use “I” Statements—When discussing your emotions around this whole menopause experience, try to use “I” statements. For example, saying “I feel _(hurt, rejected, sad, lonely)_ when I initiate intimacy with you and you turn away” is much better than saying, “You never want to have sex anymore.” Having an intentional conversation about your experiences of emotions can be really productive.

What’s Next?

Menopause isn’t easy for anyone involved. As a provider who specializes in caring for people who are at this stage of their life, this is Dr. Simon’s best advice: Understand what’s happening with your partner and know why it’s happening. This can help you navigate your way through the challenges of menopause—together. Now that you know more about menopause than perhaps you ever thought you would – use that information like a tool to work together with your partner to foster a healthy, compassionate relationship, even when things feel tough.

And if you and your partner are looking for hormone balancing or menopause treatment options, Dr. Simon and the IntimMedicine staff are ready to help.