I don't understand my partners struggle, (A men's guide to the menopause and POI)

Imagine that you have shared your life with your partner for what seems like a lifetime. You've seen her exhibit powers that almost appear superhuman. Perhaps she has managed to balance work and family obligations without ever missing a beat. Perhaps she has always been your rock—the basis of your relationship—but lately you have noticed she is struggling with everyday tasks. She seems distant and withdrawn; she doesn't have the energy for life she usually has, and maybe she has become very forgetful. Despite leading an active lifestyle and maintaining a healthy diet, she doesn't appear to be sleeping well and is gaining weight.

It is possible that your partner is experiencing "the menopause." You may be thinking, Well, it's just the end of her period; it can't be that big of a deal. The menopause is much more than just the end of her period. As her hormone levels fluctuate and lower during perimenopause, she could be experiencing a whole cocktail of physical symptoms. Then there is also the impact it can have on her mental health; maybe this is all happening earlier than anticipated and you haven't finished raising your family. Perhaps she doesn't trust her body to keep her safe and well because she feels like it is betraying her. It's possible that she believes discussing it would also cause you stress. 

So how can you help her during the transition that is menopause?

The key components are understanding and communication. Understand what is happening and why it is happening. Communicating is vital, identifying everyone's needs and how you can work together to ease the strain of everyday life.

A woman's body can seem complicated, especially if you do not identify with it, but there are four main stages to a woman's hormonal cycle:

1. Puberty is the time when she starts her reproductive cycle; on average, this is at age 11.

2. Pre-menopause is the time when her reproductive cycle is stable and her hormones usually run like clockwork.

3. Peri-menopause is the time before menopause when her hormone levels will fluctuate. This is the time when menopausal symptoms may start to present; this can start 10 years before menopause, so around the mid-40's. A woman can still be fertile during these years, but her periods may become irregular.

4. Post-menopause is the time after her periods have stopped for 12 months. Eventually, the symptoms experienced in perimenopause will stop.

Menopause is the day that marks a woman not having a period for 12 months. For many women, they will not know when this day happens. This is on average at age 51.

Approximately 1 in 10000 women under 20, 1 in 1000 women under 30, and 1 in 100 women under 40 are diagnosed with premature ovarian insufficiency (POI), formerly known as premature ovarian failure. That represents about 3.7% of all women worldwide. Because of POI's striking similarities to menopause symptoms, medical professionals often treat it as such. It is a challenging diagnosis and can make some young women feel very lonely, as it isn't being discussed in mainstream media. It can be difficult to find a health professional who is knowledgeable about POI, making it challenging to access the healthcare and support that are needed.

There are over 35 commonly reported symptoms of menopause and POI, and your partner may experience none or all of them. They may not experience the same symptoms for the entire transition, or they may have one particular symptom for 10 years. No two women experience the menopause or POI in the same way.

During the menopause some women choose to take hormone replacement therapy (HRT) to help control these symptoms; some women choose not to. Some women choose non-traditional approaches, like CBT, acupuncture, yoga, meditation, supplements, and dietary or lifestyle adjustments, to address their symptoms holistically. There is no "correct" way for a woman to manage her menopause, and it is important that you are understanding and supportive of her decisions.

HRT replaces the oestrogen and progesterone that the body is no longer producing; it can help with symptoms such as hot flushes, vaginal dryness, joint pain, etc. It can also help to protect women from the risks of heart disease, diabetes, dementia, and bone loss that can lead to osteoporosis. As with any medication, there are risks, which your partner can discuss with her health care professional.

Treatment for POI is the same HRT that is offered to older women experiencing menopause symptoms. Women with POI are encouraged to take HRT until they reach the more common age of menopause. Lower levels of oestrogen at a young age mean there is an increased risk of osteoporosis and heart disease. This also means some women can be on HRT for over 3 decades, but the benefits can far outweigh the risks of this medication.

Regardless of the route your partner chooses, it is vital that you are supportive and understanding of her choices. Communicating both of your needs is essential for a happy and fulfilling relationship. There are numerous ways you can communicate with your partner, including;

1. Ask her what she needs; you cannot read minds; asking in a kind and gentle manner will prevent misunderstandings.

2. Redefine expectations within your relationship; maybe it is time for certain roles within the relationship or the responsibility of household and family tasks to change.

3. Be honest about how the transition is affecting you; discuss ways to ease stress and support each other.

When it comes to communication, timing is essential. Choose a moment when you both have the energy and concentration to discuss important topics. Attempting to hold a crucial discussion when the kids are crying, dinner is burning, or the dog is barking typically results in frayed tempers and harsh words. Your choice of language will set the tone of the conversation, but nonverbal communication such as facial expressions and body language are also significant.

Being an active participant in your partner's menopause or POI voyage will make her feel supported and loved. It is a difficult transition for both of you, and she will appreciate your kindness and understanding.