In the United States, most adult men are married. As of the year 2019, 53 percent of adults ages 30-34 were married, followed by 62.5 percent between ages 35-39, 66.1 percent aged 40-44, and 65.6 percent between 45-49 years old. This means that many men are married to women who are likely perimenopausal, as female hormones can start their decline from the mid-30s onward.

We are seeing an increase in coverage about menopause and perimenopause. From across the pond, the UK government is going to lower the cost of HRT, Davina McCall is launching a call for more workplace protections for women going through menopause, and a widower is now calling upon all men to be mindful of the mental health implications “the change” can introduce, after losing his wife to suicide. 

And even singer and ‘80s chart-topper Rod Stewart is speaking out, saying that if men learned more about menopause, their marriages would survive.

Here, in the States, we’re seeing slightly more traction about perimenopause and menopause, with celebrities like actress Tracee Ellis Ross going public about perimenopause and former supermodel Paulina Porizkova almost baring it all in recounting her menopausal journey. Such coverage should help amplify the voices about perimenopause and menopause that are growing louder, larger and looming over conversations and dialogues about women’s health. And, it is.

Countless online groups and communities are each brimming with tens of thousands of women in search of answers, explanations and solutions for unmanaged and mismanaged symptoms. They are seeking recommendations for doctors and providers. They are leaning on each other for emotional and moral support. They are sharing lifestyle regimens and supplements taken.

But what is missing from this percolating brew of a perimenopausal uprising? The voices of men.

For months, I’ve mentioned to my husband that the treatment of women entering perimenopause and in the throes of menopause would be an absolute game-changer, only if more men got up to speed and spoke out about how it affected – or could affect – the women in their lives. So much would change: Industry would have to adjust. The workplace would re-think what health and wellness really includes. Science would commit to new understandings. Big pharma would develop sustainable solutions that fine-tune hormone replacement therapy beyond its current incarnations – perhaps even one that couples the best of HRT and the best of antidepressants into one seamless pill for the women who need both. There would be fewer suicides of midlife women, fewer midlife divorces and less misunderstanding in general.

If one considers that the average man has not only a wife, but also a mother, aunts, nieces, female cousins, daughters, and friends, co-workers, supervisors, neighbors and acquaintances of the opposite sex, the web of potential influence expands dramatically. So why aren’t men using their gender capital to support women in this phase of life? How can they heighten awareness that will lead to change in policy, medicine, science and daily living?

Let me count the ways.

Create online support groups. There is a major void in the virtual perimenopause landscape – a watering hole for men who need the insight, resources and camaraderie to support not only themselves, but also their wives and girlfriends through this period of change. As they rally together, their voices will coalesce and magnify awareness and the need for more options, both socially and medically.

Propose policy changes. Men are overrepresented in government and business at all levels; as such, they have the numbers and representation to drive serious conversations about policies in the workplace, government (and related programs) and the educational system about perimenopause and menopause. Women are not necessarily seeking special accommodations, but they are interested in wellness programs and workplace-sponsored resources that provide education and advocacy, as well as insurance plans that cover treatments like HRT.

Speak with their primary care physicians about aging. Men go to the doctors, too, albeit usually less frequently. After all, they are human beings who get physicals and other routine checkups. Even though it might not be on the agenda of a typical office visit, men can ask their primary care, internal medicine and family medicine physicians what kind of menopausal medicine options they offer to patients. You know, asking for a friend? Or, if that’s too direct for comfort, they can ask about getting their own testosterone levels checked as a gateway for more conversation. Such inquiries could heighten the awareness and pique the curiosity of doctors, one by one, perhaps eventually creating a groundswell of expanded understanding to serve their women patients.

Talk to their guy friends. Most married men are friends with fellow married men, who have wives of a certain age. Though men are comfortable talking shop about sports, current events, music and celebrities, they tend to tread lightly when it comes to more personal matters. It will take some brave souls to bring up the topic of perimenopause among a crew of cronies, but whomever does will likely be surprised by the shared observations and experiences they’re having with their wives, fiancées or girlfriends.
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Start a campaign. Most of the awareness about perimenopause and menopause is being done by women, predictably so. The few male voices in this space tend to be anti-aging, reproductive and naturopathic doctors who have some monetary skin in the game. If men launched a campaign to raise awareness, it would certainly stand out if for no reason other than the gender of those behind it. 

What are you ideas for how men can become part of the change? Are the men in your lives supporting you during this time? If so, how?

In online perimenopausal communities, two major camps or philosophies quickly emerge: women who are pro-pharma for the treatment of their symptoms and women who are on the naturopathic path. These two schools of thought each have their own merits, and many women, over time, end up combining modalities once they discover the mix that works best for them.
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But what about meditation? It’s often seen as a hocus-pocus, “woo-sah” hobby some people dismiss and make fun of. But when perimenopause strikes, even the most anti-holistic medicine women find themselves turning to it.

In the drive to delay prescribed medical interventions or to incorporate a holistic regimen as part of their perimenopausal game plan, some women meditate to restore a sense of calm to the process. There different types of meditation, such as transcendental meditation, concentrative meditation, mindfulness meditation or progressive relaxation. But meditation is generally defined as “a practice where an individual uses a technique, such as mindfulness, or focusing the mind on a particular object, thought or activity, to train attention and awareness, and achieve a mentally clear and emotionally calm and stable state.”

If the real world and social media are any indication of how perimenopausal women are using meditation, then it appears to be a tactic broadly adopted or, at least, tried. Women seem to use meditation for a number of reasons, many related to mood, as they try to calm anxiety or ease depression. Others test it as a way to relieve physical symptoms, like hot flashes, chills and heart palpitations. And, finally, some women use it as a new lifestyle practice to gain perspective, maintain optimism and boost emotional stability.

But, the real question may be, does it work? Does meditation help? Is it really doing anything?

Axing the Anxious State

It turns out that when it comes to feelings of panic or doom, meditation is a solid tool. According to the University of Washington’s School of Medicine, meditation calms the sympathetic nervous system. This is key because the sympathetic nervous system, when revved up, lends to sensations of fight or flight. They say, “[t]hrough meditation, you are essentially deactivating your sympathetic nervous system and turning on the parasympathetic branch. Initial studies have found that over time this practice can help reduce pain, depression, stress and anxiety.”

This is important, as panic attacks can show up for the first time during perimenopause, when fluctuating hormones take women on a rollercoaster ride. Symptoms of panic attacks include nausea or abdominal distress, chills, hot flushes, rapid heart rate, dizziness, sweating, shortness of breath, chest pain, trembling, sense of losing control, de-realization and a few more (as if these weren’t enough!).

In one study, 56 percent of women surveyed had never experienced panic symptoms prior to perimenopause, and one-third of study participants’ panic disorder symptoms went undiagnosed and untreated.

More than Meets the Mind

Meditation, even short-term stints at it, can have measurable benefits on health. One study from 2009 reported that just five days of meditation at 20 minutes per session improved “physiological reactions in heart rate, respiratory amplitude and skin conductance response.” Brain imaging even showed changes related to emotional regulation.

Additional studies have found that meditation has many other add-on benefits, including delaying brain aging, reducing ruminating thoughts, improving concentration and attention, and even assisting in recovery from substance abuse. Moreover, meditation has been associated with reduced blood pressure, decreased pain and strengthened immune system function.

Worth a Try?

Many of the benefits that meditation allegedly and empirically improves are the very same symptoms women need relief from during perimenopause. Less anxiety? Check. Better focused thinking? Absolutely. Reduced stress and lowered blood pressure? For sure. A regained sense of personal control? Yes.

The problem with meditation, however, may be that it requires a commitment. Sure, some people will feel a difference after just one session. But in order to sustain it, meditation must become a practice – that is, a habit or a routine aspect of daily living. Most sources suggest aiming for 20-30 minutes of meditation a day. Since it can be challenging for women to find that bit of undisrupted time, some suggested time frames to do it are:

• Early in the morning, before anyone or anything demands your attention
• After your workout, as part of your cool-down process
• During or after lunch, especially for those who work from home
• In the evening before bedtime, as everyone else in the house is winding down

How to Find Meditations?
Just as there are many types of yoga (yin, ashtanga, vinyasa, kundalini, and so forth), there are various styles of meditation. Generally two main themes emerge: guided meditation and unguided meditation. In a guided meditation, a speaker sets the tone and verbally walks you through imagery, ideas and themes to reflect and focus on. It may or may not be accompanied by music or nature sounds. In an unguided meditation, there is no one speaking, simply silence or perhaps some accompanying music or sounds to inspire and soothe you.

There are also various types of meditation, often by purpose or topic. Meditations are available on specific themes, like Christianity, relationships, finances, stress and more. And the great thing is, meditation can be obtained for free. A quick YouTube search will unearth more meditations than you’ll ever have time for.

While HeadSpace and Calm are meditation apps popularly used, they come at a cost. Free trials or restricted free access may be available, but the unpaid experience is rather limiting.

Meditations for Menopause

Would you believe it? Yes, there are actually meditations for menopause that some thoughtful creators have put together and made widely available. This isn’t a time to get too wrapped up in particulars though – these meditations are great for perimenopause, too.

Female Hormone Balancer Relaxation Meditation
Guided Meditation for Relieving Menopause Symptoms
Hormone Rebalance Hypnosis
Magical Menopause Full Hypnotherapy Session with Binaural Beats Frequencies
Women of Wisdom Menopause Guided Sleep Meditation

In a recent post in an online community I follow, it seems like most women feel like they’ve been left in the lurch. Decades of living, learned wisdom and experiential growth hadn’t prepared them for what they’re facing now. Years of finishing degrees, raising children, buying homes, brokering business deals, serving on community committees and leading successful lives hadn’t prepared them for a very important transition.

A member asked what, if anything, their mothers, aunts or other relatives shared would happen during “the change,” or lead-up to menopause. Almost 300 women responded, and most said: “Absolutely nothing.”

“Absolutely nothing” – only for many of these women to be sidelined by first-time anxiety or depression, night sweats, hot flashes, migraine headaches, relentless weight gain, strange menstrual cycles and much more between the ages of 40-55.

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Sometime in the mid-to-late 1980s, I clearly remember my mother sitting down with my brother and me, telling us about the age-old “birds and the bees.” She sat us on the couch and asked us if we had any questions about how our bodies were changing. Of course, we were mute.

Crickets. Silence. Peak awkwardness.

My brother, two and a half years my senior, giggled. I did, too. We knew what this was about, but sadly we probably already knew too much at our tender ages, for all the wrong reasons, including a happenstance discovery of my parents’ adult film stash.

My mother went on to explain how babies are made, how boys’ and girls’ bodies change, and what we may expect, encounter or feel in the future. There were several of these unscheduled-and-always-weird conversations during our childhood, sometimes with just our mother and other times with my father as well.

I was well-prepared when my period arrived when I was 10 in the fourth grade; it happened at school. I had gone to the bathroom, noticed a brick-red streak in my panties, put on a maxi pad that I already had on my person just in case, and wrapped my jean jacket around my waist. I had read Judy Blume’s “Are You There God, It’s Me, Margaret” multiple times, and I knew who Dr. Ruth was. When my mother came home from work, I told her I started my period. She asked to see it, so I showed her, and she confirmed it was so.

I checked out various books on human development and anatomy from the public library as a child. These books had photos of people, naked with black bars over their eyes, chronicling the course of things like breast development and the sprouting of pubic hair. Our older brother also thought he was hiding issues of Playboy and Penthouse magazines in his room that my brother and I always somehow found during our nosy expeditions around the house.

With my parents’ attempts to prep us for inevitable puberty and its potential byproducts – and the access to other materials (authorized and not) – that illustrated possibilities in greater detail, the attention paid to helping us become well-informed and educated was like a bull’s eye on a dartboard. It was centered, obvious and defined. The main thing, I think, was that our parents didn’t want me getting pregnant or either of us getting any sexually transmitted diseases.

So, I wondered, when it came to my calamitous entrée to perimenopause, why wasn’t I similarly prepared? And when I told my momma what I was experiencing before I knew what it was, why couldn’t she even clue me in?

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The answers are way more complex than this post can thoroughly address. But what I do know is that there are legions of women like me – hitting our 40s (and, in some cases, mid-late 30s) with an unblemished health record starting to have all sorts of weird, seemingly unrelated symptoms.

We may start out having a night or two of broken sleep, or we notice we feel warm while everyone else is fine with the temperature. Then symptoms mount, the sleeplessness is accompanied by night sweats, then connected to feeling anxious for no apparent reason. Menstrual cycles change, vanishing for a month and then flooding for weeks on end. Or women start feeling all sorts of aches and pains, a sense of foreign panic, with migraine headaches and some variety of the dozens and dozens of menopausal and perimenopausal symptoms.

We confide in friends, who are often just as silent as the medical establishment is clueless. We seek insights from other woman elders – our mothers, aunts, older friends and community matriarchs, only to be met with further dismissiveness, quiet and denials that make us feel even crazier. Crazier than we already might from the sudden betrayal of our bodies.

So why is it that women who’ve gone down this path before us don’t guide us? Are they lying, or are they just not telling the truth – and is there a difference, really?

The average age of official menopause in the United States is 51. That cuts across and aggregates all racial groups. But studies show that Black women and Hispanic women reach menopause a few years sooner, on average, and typically have a harder course toward it, with more debilitating and quality-of-life impacting symptoms. So this means that women should have clear guides and personal ambassadors in their 20s-40s, with women who are in their mid-40s and beyond as authorities and testifiers based on personal experience and biology (no matter how young they may feel and how youthful they may look for their age).

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My mother never told me a thing about her menopause or menopause in general until I asked her about it at my age of 43. I’ve never heard a thing about my grandmothers going through it, let alone speaking about it. Likewise, nary an older cousin, aunt or other elder female in my life at all has said a thing. Even in recent times when I’ve shared my experience as a perimenopausal woman, all I get in return ranges from silence to euphemisms that indicate a desire to quickly change the subject or that suggest all this couldn’t really be “that bad.”

Even if these women never told us specifically about perimenopause or menopause, they never shared stories of having an odd adjustment period in their 40s or 50s. They don’t talk about feeling less like themselves, getting ultra-concerned about minor things or needing new medications at a time in their lives when they’ve never needed any before.

I cannot imagine not sharing what I’ve been through with my daughters, just like I won’t spare them the details of pregnancy, childbirth of childrearing. To do so rise to some level of negligence in my role as a mother. Even if I didn’t tell them what I personally have endured, I could create distance by framing this change of life as a medical and scientific fact, a biological reality they may need to prepare for. A test they can study up on for years so they won’t ever need to cram or pull an all-nighter. A store whose catalog is familiar to them, with knowledge of the mechanisms, medicines and modes of lifestyle changes available to them for free – and for a price.
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Why older women aren’t talking about and haven’t talked about their menopause is alien to me. I imagine there must be an element of shame, a very real and no longer implied indictment of their age, their mortality. I can also see that they may feel inept themselves, lacking the vocabulary to put it all together, having little knowledge of what to do and being the living examples who have also fallen victim to the silence themselves.