Why menopause is killing so many midlife marriages – and how you can fix it, by MARIELLA FROSTRUP

Recently (and light-heartedly) I asked my husband how he found me during menopause.

I knew I had suffered as a result of my hormonal chaos, with two years of insomnia, stress and anxiety from the age of 49, but I was sure that I’d skilfully concealed the inner turmoil pretty well, and my family had been left unscathed. Turns out, those years weren’t as emotionally straightforward for him as I’d thought!

The answer my husband gave was quite emphatic and, dare I say, an unpleasant surprise. Words like ‘total nightmare’, ‘impossible’, ‘deranged’ and ‘irrational’ were peppered amongst some less repeatable words. 

According to him I was, at times, not remotely easy to live with. I do take it with a pinch of salt though, as he said similar things about my two pregnancies, periods that I recall as being brimful of excitement and delight, not least at having a cleavage, albeit temporarily.

But it’s true that, during menopause, constant and inexplicable anxiety nibbled away underneath everything I did and may well have made me edgy, tense and more volatile to live with (I’m not apologising by the way). I also now know that it is the same story for countless others.

I’ve spent the past decade scrabbling around in the dark for substantiating evidence to back up my certainty that during peri and menopause, women (and their loved ones) suffer unnecessarily – and Menopause Mandate’s new comprehensive survey of women and their experiences has finally proved me correct.

Menopause Mandate is a campaigning group that I chair with the goal of revolutionising support and advice for women around the subject and our patrons include Davina McCall, Gabby Logan and Lavina Mehta MBE. Nearly 20,000 women took part in our survey, and the results are both revealing and shocking. Perhaps the most gnarly is the revelation that 73 per cent of women felt their symptoms had a detrimental impact on their relationships.

It’s the stuff of those old seaside postcards isn’t it? Her indoors going through the change, and the long-suffering husband telling bawdy jokes in the pub in which he’s had to seek refuge.

But it really is no joke. Menopause affects everyone and it’s not selective about the gender it makes miserable. It might surprise you to hear that I have developed a sense of sympathy for our other halves. If women aren’t being told about menopause – which we aren’t – how are our partners supposed to empathise and sympathise?

Don’t get me wrong, I have little truck with the ‘what about men?’ piteous whines from Andrew Tate and the like that I’ve heard too many times. For millennia men have been perfectly well served by a sturdy, male-constructed patriarchy. 

But when it comes to menopause, they are feeling left out in the cold at a time when women might be dealing with internal struggles, and when conversation around the subject could improve and even save partnerships.

Our survey also revealed the prevalence of psychological symptoms, with brain fog being suffered by 82 per cent of women. While 72 per cent of women referenced low mood, 62 per cent had mood swings and anxiety, 60 per cent insomnia, not to mention 76 per cent referencing weight gain and 69 per cent muscle or joint pain/stiffness.

Sexually, 43 per cent said they had vaginal or vulval dryness and 35 per cent suffered from urinary symptoms. Given all that it’s not surprising that 20 per cent said that sex is painful – and 63 per cent have a low libido. The impact these symptoms have on relationships can be catastrophic and it seems evident that sex might be entirely off the table (rather than previously, and sexily, on it).

Menopause can be a lonely time, especially if you don’t know what’s happening to your once-reliable body. I felt betrayed by the dimples appearing on my belly and thighs and baffled by my stress levels. I’ve always thrived on deadlines, but these now seemed insurmountable.

I had two young children and a demanding job, so I absolutely didn’t have the time or the inclination for introspection or giving my relationship the consideration that it might have required.

That loneliness can spiral – the less you talk about how you’re feeling the more ingrained it becomes as a habit. I did seek professional help, but it took two years, during which time I assumed that my misery was simply part of the ageing process and to be endured.

As I’ve said on many occasions, what I knew about menopause before I found myself in the thick of it could have been written on the back of one of my mother’s short-lived oestrogen patches.

So, when I lay in bed, counting sheep for hours on end or, more likely, counting supermarket orders, deadlines and parents’ evenings, the last thing on my mind was confiding in my husband, who was usually snoring contentedly next to me. (Is there such a thing as smug snoring?).

And besides, confiding about what? When I suffered palpitations brought on by fluctuating oestrogen, I’d lie there hoping that I wasn’t going to die. There’s something inherent within – perhaps some animal wish to die alone, or, more likely, fear of embarrassment – that prevents most of us from hitting the person sharing our bed with a pillow and asking them to go and find the blood pressure monitor.

The two hot flushes I endured, feeling as though I was being microwaved, confirmed that my experience wasn’t as bad as that of many other women. I’ve interviewed those who’ve had 30 a day.

Not everyone wants ‘The Change’ to be (a change. It’s fabulous to feel liberated, and I do think that with loss of hormones can come increasing ambition and drive. But for years I’ve witnessed marriages and partnerships (both straight and same sex) being affected, even destroyed, by this time of life.

Hormone replacement therapy (HRT) is a medication taken to ease symptoms of menopause

Menopause can be a liberation, a time to celebrate and take control. But I’ve also seen women leave their marriages (I’m not saying their husbands are perfect) and regret it. Or, worse, their husbands have left them ‘because they’ve changed’, which can be devastating. .

One woman whom we interviewed said that her husband had had an affair with a younger woman because she was in such agony she couldn’t face sex. She felt it was entirely her fault – very much the lot of women through the ages.

Those suffering from depression are still too frequently recommended antidepressants rather than HRT which should be the first line treatment for mood symptoms. Over 40 per cent of our respondents, that’s more than 5,000 women, said that antidepressants were offered.

This is a global problem. When writing our book, Cracking the Menopause, Alice Smellie and I interviewed a series of men about the subject. We have just updated this for the US market (to be released in January 2025 as Menopause Is Hot). So, I can exclusively reveal that there is a global lack of masculine understanding around the topic. What also unifies our two glorious nations is the confirmed fear that if you ask a woman if she’s menopausal, you are in seven sorts of relationship trouble.

We need to reclaim the fact that very few plan to or wish to ditch their husbands or partners in midlife. Nobody says, ‘To have and to hold until I’m awake six times a night with hot flushes and experience surges of psychopathic anger’.

There’s a book called Feminine Forever, written back in 1966, by a US gynaecologist called Robert Wilson. He described menopausal women as ‘castrates’ and very much gave the impression that we ought to be hoofing down the HRT and keeping ourselves moist to keep our husbands happy. If you chip away the many layers of set-in-stone misogyny and take a step back, there is a smidgen of truth in what he says. What is too rarely acknowledged is that nobody especially wants our sex lives and our relationships to crumble, and now that we’re a couple of waves of feminism further down the line, this can be admitted.

As for marital relations, perhaps some of you reading this will be uttering a hollow laugh, especially when you take the above symptoms around the vagina and bladder into account. Genitourinary Syndrome of Menopause, as this group of agonies is called, is likely to affect most women to some degree. Put bluntly, a lack of oestrogen may mean a lack of lubrication, thinning skin, painful (or agonising) sex and increased urinary incontinence and UTIs.

I frequently found myself suffering from cystitis, which was surprising, it being a condition more commonly attributed to crazy sex marathons, which 20 years down the line were not on the menu.

I didn’t realise that this is more common in midlife because there’s less healthy bacteria to help prevent infection – an especially bitter pill to swallow as I’d always thought of it as being a young person’s problem.

The last thing any partner wants to do is cause discomfort. I’m no medic, but I have learned that there are many solutions – few of which are talked about or commonly known, and there’s still an air of horror about the idea of dryness, and embarrassment about approaching a healthcare professional.

Absolutely top of the list is local or vaginal oestrogen. This is, incidentally, considered safe for those who’ve had breast cancer (it’s not the same as systemic HRT which affects the whole body).

This is a game-changer for the entire area – including bladder symptoms, and it needs to be taken long-term, not just as a quick-fix course. It’s available via your GP (if you’re lucky) and over the counter. There are also all manner of lubes and moisturisers available – just make sure you avoid perfumes, parabens and glitter!

I did a great deal of reading around the subject and speaking to other women when researching both books. Some find that sex at this time of life is even better because it may require more imagination to make it satisfying for both parties. I also discovered there’s something called ‘outercourse’ which I shall leave to your imagination, but let’s just say that this is a time to embrace a world beyond the missionary position!

It’s by no means all doom and gloom, by the way. Many women find that postmenopause can be a time of wonderful sexual liberation as the fear of pregnancy has gone. What’s more, there are confirmed health benefits to having orgasms; they exercise your pelvic muscles, release the feel-good hormones dopamine and oxytocin and help you sleep.

One dear friend carries a little vibrator around with her the entire time in case she fancies a quickie in the loo at lunchtime. I can only admire her energy.

I don’t think it’s fair to blame menopause for all midlife marital strife. There are plenty of other reasons for relationship collapse, and familiarity can certainly breed contempt all on its own without mitigating circumstances.

But in our busy and already stressful lives, menopause symptoms can add another layer of struggle, and we need to be aware of them, so that we can seek solutions and have conversations in our own homes, not just in Parliament or on the TV.

Menopause affects everybody including our partners and this ties into Menopause Mandate’s ethos about the importance of education for everyone. We are heavily focused on our campaign to get peri and menopause included in the NHS over 40 health check that’s offered to all.

Our survey is, we believe, the biggest ever done about peri and menopause in the UK and the upshot is that 97 per cent of women have symptoms and 96 per cent feel that their quality of life is affected.

When I talk to my husband about how I feel (in any situation) he is almost invariably sympathetic.

And, as we keep saying, like a Greek chorus watching the tragedies inexorably playing out, as long-standing relationships crumble like so many ancient statues, the above is why we all need education and support.