A Man's Guide to Menopause by Dr Mary Claire Haver

Right then, gentlemen (and anyone supporting a woman through menopause), let's have a chat about what's really going on when the women in your life hits this particular milestone. Dr Mary Claire Haver has written something rather brilliant that every partner, son, brother, and friend needs to read.

First things first - menopause isn't some minor inconvenience involving a few hot flashes and no more periods. That's like saying pregnancy is just about getting a bit rounder. The reality is far more complex and, frankly, more fascinating than most people realise.

What's actually happening is a complete hormonal overhaul spanning several years. Three major hormones - oestrogen, progesterone, and testosterone - don't just politely decline; they undergo dramatic shifts that affect nearly every system in her body. Oestrogen receptors are found throughout the body, including the brain, bones, muscles, blood vessels, bladder, immune system, and skin. When oestrogen swings wildly and then drops off a cliff, every system has to adapt.

Progesterone, which is used to help with sleep and calm the nervous system, becomes erratic. This explains why she might feel "wired but exhausted" - tired yet unable to get proper restorative sleep. Testosterone, which women need too (just at lower levels than men), continues its gradual decline while everything else goes haywire.

Here's a perspective that might help: men typically lose about 1% of their testosterone each year after midlife. If men lost most of their testosterone in just a few years, nobody would tell them to "just get through it." Yet that's exactly what women have been told for generations about one of the steepest hormonal changes the human body can face.

When she says she doesn't feel like herself, she means it literally. Her brain's sleep centres are finding a new balance, memory and mood pathways are shifting, bones are losing density rapidly, and her metabolism is genuinely changing. The weight gain around her middle isn't about willpower - it's about real metabolic changes driven by hormone loss.

This transition often highlights relationships that have been on autopilot. It's not necessarily a crisis - it can be an invitation to pause and ask what you both need now. Dr Haver mentions seeing couples in her practice where partners come to appointments not to speak for their wives, but to truly listen and learn how to support them.

The good news? Modern hormone therapy, when started within ten years of menopause, can protect bone density, improve sleep, ease hot flashes, and maintain sexual health. Body-identical hormones today aren't what older studies made people fear.

How can you help? Believe her when she describes symptoms. Learn about what oestrogen, progesterone, and testosterone actually do. Protect her peace - perimenopause hits during the busiest years with teenagers, ageing parents, and career demands. Make her sleep sacred and her exercise time non-negotiable. If intimacy has changed, discuss it openly and honestly rather than letting shame grow in silence.

The message is clear: she's not fading, she's transforming. 

Just a friendly reminder: I'm sharing what I've learned, not prescribing what you should do. Always chat with your GP about what's right for your unique situation!

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