My Changing Valentine

Often times men begin noticing changes in their partners when they are in their forties. Many of these changes are misunderstood and effect relationships.

Men are unclear about the changes that are occurring, and don’t have a clue about what the experience is like. They are also uncertain as to how to support their changing valentine.

The emotional and physical changes (symptoms) are a direct result of the ovaries beginning to shut down – estrogen, progesterone and testosterone levels fluctuating, and changing. As a result of this biological process, many women feel irritable, anxious, forgetful, fatigued and may also experience lack of sexual desire and painful intercourse.

The kindest thing you can do for your changing valentine is to talk to her about how she is feeling emotionally and physically, and take her needs seriously. In addition, take the advice of our medical expert, Bruce Bekkar, MD and read his article below.

Menopause for Men: What every guy should know!

By: Bruce Bekkar, MD

What is menopause?
The menopause, or "change of life," is defined by our medical textbooks as the end of a woman's menstrual periods. The periods stop because the ovaries no longer respond to the hormonal commands coming from the Pituitary gland in the brain. Menopause occurs, on average, at the age of 51- but the best indicator for any woman is the age at which it occurs in her own family. See Chapter 1 of our book, Your Guy's Guide to Gynecology, to learn what causes menstrual periods in the first place, and other useful information about women's anatomy and physiology.

How do I know if my partner has reached menopause?
It may be difficult to know- even for us as gynecologists- but women often will report the following:

• Absent menstrual periods: as explained above
• Hot flashes or flushes: sudden, intense sensations of heat in the skin of the upper chest and face, which reoccur without warning and often awaken women from sleep
• Vaginal dryness: less natural vaginal lubrication, often making intercourse uncomfortable
• Psychological symptoms: many women experience none of these, but others note nervousness, anxiety, forgetfulness, depression, irritability and difficulty concentrating.

What else happens as a result of menopause?
Even though no symptoms are present, a woman's risk of heart attacks and strokes doubles shortly after menopause. In addition, her bones begin to thin out, resulting after several years in a condition known as osteoporosis. These conditions, although silent, are very significant. For instance, many people are unaware that ten times more women die each year from heart attacks and strokes than from breast cancer! Osteoporosis, and the fractures that often result, is a leading cause of nursing home admissions.

What can women do for themselves when they reach menopause?
Menopause is not a disease, but it is a "call to action"; the consequences of a woman's behavior increase at this time. The most important step that all women can take is to make a commitment to living a healthy life. We recommend to our patients that they assess their own particular health risks- due to conditions they have, habits they've adopted, and familial traits- and then really make an effort to improve their odds. It's time to lose weight, aggressively manage their diabetes or high blood pressure, or quit smoking. Many women decide to take hormone replacement therapy or "HRT," a partial replacement of the hormones estrogen and progesterone, lost as a result of menopause. Much evidence exists of benefit, not only in terms of symptom relief (e.g. hot flashes), but also protection from long-term risks like bone loss and cardiovascular disease. Considerable controversy exists around this treatment, and it's not for all women; conversation with her doctor is important. Alternative hormonal medications are showing promise- the so-called "designer estrogens" like tamoxifen and raloxifene. These drugs and those to come in the next few years will have many advantages for certain women who aren't candidates for standard HRT. Botanicals and phytoestrogens, including yam creams, dong quai, and soy products may find a lasting place in menopause management, but more research is needed. Dangerous side effects are no less likely because these chemicals come from "natural" sources.

What can you do to help?
Get informed and get involved! Educate yourself by visiting web sites like the North American Menopause Society or reading No It's Not Hot in Here, by Dick Roth. Your Guy's Guide to Gynecology provides information about a wide range of women's health topics- from birth control and planning for pregnancy to hormonal issues like menopause and P.M.S., and includes suggestions for helpful behavior from caring spouses (like you).

Set an example! If she's going through "the change," guess who else needs to take a look at his "lifestyle"? The best way to inspire her to take great care of herself and look good is to do the same. Lead by example and not by lecturing. Ask her how she's feeling. Menopause can be a difficult time for women, even if they don't have a lot of physical complaints. This major change in her body may make her feel less like a woman, she may be worried about some particular problem of aging- like Alzheimer's disease, or she may even be depressed because her kids are leaving home. If she's having a bad day, it is amazingly therapeutic for her if you simply ask, "How are you feeling today?" The key is to listen to her entire answer without interrupting and trying to "fix" her or make it better. This takes most of us guys a little practice, but watch how she responds. When women- or men- talk about feelings, we mostly want to be heard, to have someone really know how we're feeling.
Overall, the most important thing for you to learn is that you can make a real difference in your partner's menopause. Don't withdraw from her! Even if you don't understand much of what she's going through, your participation in her process will lighten her load and bring you closer together.