Perimenopause and Men

For those of you who don’t know, I host Ask Me Anythings in my Instagram Stories several times a week.

I get asked about a wide variety of topics by women and men, and a man recently asked me the question below about his wife, who is going through perimenopause.

I normally respond to questions with one or two Instagram stories, but this man’s Instagram DMs annoyed me so I ended up responding in a series of 14 stories.

My stories are sort of their own ecosystem, with a community that is aware of the context of what I post regularly, so I was very hesitant to post this on other platforms or as a post because I don’t want to be seen as speaking over women or anything of that sort.

But after a number of women who follow me asked me to share this on Substack and on my Instagram grid, I decided to do so.

This will seem slightly disjointed, as it was in a series of Instagram Stories, and I have also left the typos intact intentionally.

Question: “My wife going through perimenopause. saw your post. I can’t keep up. Advice?“

My Response:

I’m obviously not a woman, an OB-GYN, or an expert on women’s health in any respect.

But having had lots of women friends over 45 since I was 21 years old, I do think I’m an expert on how the external world — including a woman’s family members — reacts when she’s going through perimenopause.

I’m often one of the first to hear about what a woman in my life is frustrated with when it comes to her husband, boyfriend, children, etc.

And at this point, I think I’ve heard every type of reaction to perimenopause, from the utterly shocking and cruel to the most empathetic support.

So my advice is to understand what’s happening, and given some of your DMs to me on this topic, I don’t think you fully grasp the complexities of what she’s going through, not just on a biological level but also an emotional one.

And if you have any empathy, you’ll shift from a state of confusion to one of support and understanding.

When someone is dealing with a destabilizing event in their life — no matter what the event might be — confusion, when there is information available, is one of the most frustrating emotions, especially from a spouse.

I read all the DMs you’ve sent me in the last week.

Saying “I don’t know what to say” or “I don’t know what to do” when there is a huge amount of information out there that will likely lead you to know exactly what to say and do is an abdication of your duty as her husband.

If aliens invade Earth, then you’re welcome to act confused.

But you’re not allowed to act confused and helpless when your wife is going through a process that hundreds of millions of women are going through right now and that many billions of women have gone through since you were born.

You don’t have the excuse that a husband in the 1950s did — when information was limited and often incorrect and soaked in misogyny.

From your Instagram I can see you play fantasy football…. that requires you to be online looking up stats, projections, injury reports, matchups….

That has complexity to it.

You can use those same fingers you used to check the injury report before Sunday’s game to look up perimenopause.

Given what I see on your Instagram, I cannot imagine that you don’t know down to a T what to do during a flood in your home, a home invasion, a fire, etc.

You seem very diligent!!

Your wife and children benefit from that diligence — just as you benefit from her diligence — so why are you robbing her of that diligence when it comes to perimenopause, something that has taken over her life in the most erratic and unpredictable ways.

Again, from your Instagram posts, I learned that you know how to play golf and it appears you play it well.

So you understand the complexities of the game.

You know how to hit with different clubs. You understand grip, stance, and possess the mental discipline required to play well.

You have learned an entire technical language for a game.

So what this all tells me is that perimenopause should not be too confusing for you.

It is only confusing to you by your choice!

Your wife is going through a major full-body hormonal transition that can affects every part of her body and thus every part of her life.

The most important thing you can do is stop treating it like a mystery that annoys you.

You cannot pound your chest and say you will protect your wife from a robber or an attack and then not offer the same support to her when she’s dealing with what can feel like a terrorist attack on her body from within.

I’m guessing, like many women, your wife wasn’t prepared for the realities of perimenopause.

Every woman knows that at some point menopause is coming — and that is something that already still is undersupported, under-researched, etc.

But perimenopause, which often lasts longer and for many women can be a much more disruptive process, is barely understood and mentioned.

Now that you’re beginning to understand how challenging perimenopause is for your wife, can you think of anything health-related in your life that you have been unprepared for or not knowledgeable about to this degree?

And I’m not talking — God forbid — about cancer or age-related diseases, but something that every man has to go through.

Imagine that, starting in your 40s or 50s, your testosterone did not simply decline slowly.

Instead, your body started randomly surging it, dropping it, surging it again, then cutting it in half for no obvious reason.

One week you feel like yourself.

The next week, your sleep collapses, your body temperature regulation goes haywire, your mood changes, your sex drive changes, your skin and hair change, your joints ache, your focus gets worse, and your body suddenly feels unfamiliar to you.

Then, right when you think you understand the pattern, it changes again.

They used to call perimenopause and menopause “the change of life.”

What a gentle, inadequate phrase for what so many women actually experience.

It’s not a change of life.

It’s more like a biological earthquake.

And then women are expected to keep functioning like nothing happened.

And to call it a change is false — because that has the connotation of the flip of a switch, when perimenopause is, in fact, a process that flips the light switch repeatedly on a woman for years at times and at hours of its own choosing.

Think of when a kid comes into a room and suddenly flips the light switch off and on again repeatedly as a joke.

And he keeps doing it throughout the night despite being told not to. That is the reality of perimonause for many women - an erratic process on their entire body that has no rhyme or reason.

And you told me she works outside the home?

In most workplaces, a person can talk openly about something that is impacting their body in terms of a cold, flu, cancer, etc.

With rare exception, women go through this destabilizing force without the ability or the comfort of sharing.

And what’s even more difficult is that perimenopause hits when a woman in the workplace is hitting her peak professional power.

This doesn’t mean women are fragile and weak and shouldn’t be considered for jobs - quite the opposite.

It just means it’ll help you understand how frustrating this time is for her.

You also mentioned that she gets annoyed and irritated when she forgets things.

Most women, and especially mothers, are in a position where they are required to juggle so many things that their memory and focus are not luxuries…they are essential infrastructure.

So to have that memory and focus suddenly and unexpectedly disrupted by perimenopause can be deeply painful and frightening.

It is not just brain fog.

It can feel like losing access to the very tools you use to keep your life, work, and family functioning.

So when perimenopause suddenly starts affecting focus, memory, it is not some minor inconvenience.

It can feel like the system they rely on to keep their entire life functioning is suddenly coming apart.

And that is painful in a very specific way because it can feel like a loss of competence.

It can be very scary and humiliating.

Which is why some women in my life who haven’t been prepared think they may be dealing with early-onset dementia.

I don’t know your wife or understand fully what she’s dealing with with respect to perimenopause, outside of what you’ve shared with me in DMs, but I’m willing to bet she doesn’t expect you to have the knowledge of an OB-GYN, and acting as if she does is probably your way of putting up a barrier that will justify your not supporting her in the way she needs.

I think you should think really hard about whether that’s what you’re doing — whether it’s conscious or not.

And once you understand the full picture of what she’s dealing with, all of it won’t seem so complicated, confusing, and crazy.

You’ll realize that if it were happening to you — especially if you hadn’t been educated about it in advance and weren’t supported while you were going through it — you’d be reacting the same way, and likely worse.

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