Someone you love is going through menopause. Read this — it'll take ten minutes and you'll come out understanding something that affects half the population and gets poorly explained almost everywhere else.
1. Menopause isn't a moment — it's years. The proper word for most of what she's going through is perimenopause: the long run-up. It can start in someone's early forties and stretch on for a decade. "Menopause" itself is just a marker — twelve months without a period — by which point most of the experience is already behind her.
2. The symptoms are wider than you'd think. Hot flushes are the famous one. There's also rough sleep, joint aches, brain fog ("I lost my train of thought mid-sentence"), mood shifts, irregular periods, weight that won't budge, hair changes, libido drops. Not all at once, not in any neat order. That's the bit that makes it confusing — for her too.
3. She is not making it up. She is not "being difficult." She is moving through a real, named, biological transition that medical training largely ignores. A surprising number of women get told their symptoms are stress, depression, or just getting older. Most have been quietly wondering "is it just me?" for months before anyone takes them seriously.
4. What helps: being believed. Being asked how she's doing in a way that suggests you actually want to know. Letting her not be sunny.
5. What doesn't help: trying to fix it. Jokes about hot flushes. Comparing her to other women you know who "seem fine." Suggesting she "just" do yoga / drink more water / cut out sugar. Trust me on those.
Over a few years, her body is winding down its reproductive cycle. The hormones that have been roughly steady for thirty-odd years — mainly oestrogen and progesterone — begin to fluctuate wildly before eventually settling much lower.
This sounds technical, but here's the thing: oestrogen affects almost every system in the body. Not just the reproductive bits — but bones, joints, brain, sleep, skin, mood, temperature regulation, cardiovascular function. When it starts swinging unpredictably, all those systems get bumped around. That's why the list of possible symptoms is so long and weird.
It's not "in her head." It's in her endocrine system.
This one catches people off guard. Smart, sharp, capable women suddenly losing words mid-sentence, forgetting what they came into a room for, fumbling tasks they could do in their sleep last year. It's not memory loss. It's not decline. It's a hormonal effect on cognition — and it's temporary.
But it's deeply frightening when it happens to you. Especially because the world makes a lot of jokes about women being "scattered." If she ever mentions this — even casually — take it seriously. The worst thing you can say is "we all forget things, love."
What helps: believing her. Asking how she's actually doing. Taking on extra around the house without making a fuss about it. Going to bed at a sensible time when she's exhausted. Listening when she wants to talk through symptoms or doctor's appointments. Reading something like this page.
What doesn't: trying to fix it. Suggesting solutions. Telling her she should "see someone." Comparing her to friends or family who "seem to handle it fine." Acting as though her mood is something happening to you. Making jokes about menopause as if it's a punchline — even gentle ones.
If you find yourself wanting to suggest a supplement you read about, or a podcast, or a diet change: pause. Ask first if she wants suggestions, or just to be heard. Almost always, the answer is "be heard."
You don't need to be her project manager. You don't need to track her symptoms for her, schedule her appointments, or remind her to take care of herself. She's a capable adult moving through a major life change — not a crisis to be managed.
What she probably needs is much smaller than that. Just being present and not weird about it. Knowing what menopause actually is (you now do). Not flinching when she mentions a symptom. Not making it about you when she's having a hard week.
It's quieter work than "fixing." But it's the work that counts.
This is the one nobody talks about, so let's just say it: libido often drops in perimenopause. It can be sudden, gradual, partial, total. It's usually hormonal — sometimes also a symptom of being exhausted and uncomfortable in your own body for months on end.
It is not about you. It is not because she doesn't love you. It is not permanent for most people. And it is also not something she chose — which means it's not something she can just "snap out of" or "try harder" with.
The single best thing you can do is keep showing affection in ways that aren't sexual. Sit close. Hold her hand. Make her tea. Tell her she's beautiful when she clearly doesn't feel it. The point isn't to "earn" intimacy back — it's to keep the connection warm while her body is doing something neither of you chose.
Not "are you okay?" — too easy to bat away. Try: "What's the hardest bit of this week been?" Then listen. Don't try to fix it. Don't offer solutions. Just hear it. The thing she most wants is to feel like someone actually understands what she's living with.
Something invisible — that you'd normally let her remember. Pick a recurring task and just start doing it. Don't announce it. Don't ask if you should. Just notice what she's carrying and quietly carry some of it.
Menopause appointments are short and often rushed. Having someone else in the room — particularly someone who's done the reading — can mean the difference between being dismissed and being heard. You don't need to talk. Just be there.
The optional bits, for the people who want more.
The female reproductive system runs on a monthly cycle controlled by the brain and the ovaries talking to each other through hormones — mainly oestrogen and progesterone. From puberty until perimenopause, the cycle is roughly predictable. The ovaries release an egg each month, the hormones rise and fall in a coordinated rhythm, and the body knows what it's doing.
In perimenopause, this rhythm starts breaking down. The ovaries become less responsive. Cycles get longer, shorter, missed. Hormone levels — especially oestrogen — fluctuate erratically rather than rising and falling on schedule. This is where most of the symptom complexity comes from: it's not the hormones being low, it's them being chaotic. The body has spent thirty years optimised for predictable hormones; sudden volatility throws everything off.
"Menopause" itself is just the technical end of the transition — twelve consecutive months without a period. After that, hormones settle at a new (much lower) baseline. Many post-menopausal women feel noticeably better than they did in perimenopause, because at least the chaos has stopped.
Hormone Replacement Therapy (HRT) — sometimes called Menopausal Hormone Therapy (MHT) — is exactly what it sounds like: replacing some of the hormones the body has stopped making at a steady rate. It can help significantly with hot flushes, night sweats, sleep, mood, and joint pain, among other things.
It also has a long, complicated history. Twenty years ago, a major study suggested it raised cancer risk; that study has since been heavily reanalysed and the picture is far more nuanced. Modern HRT, for most healthy women starting it under sixty, is now considered both safe and effective. But "most" isn't "all" — it's a real medical decision with real tradeoffs, and one for her and her doctor to make, not for either of you to decide based on something you read online.
What you can usefully do: if she's considering HRT, don't try to talk her into or out of it. Support her in getting good medical advice from someone who actually knows menopause (not all GPs do). And take her decision, whichever way it goes, as hers.
Threshold is a tracking app — she logs how she's feeling, when symptoms hit, what she's tried, what's helping. Over weeks and months, patterns emerge that wouldn't be visible from memory alone.
The big thing this does is make medical appointments useful again. Most GP visits are ten minutes. Without notes, you arrive trying to remember when something started and what you've tried — and you walk out without having quite said what you came to say. With Threshold, she can hand her doctor a clear summary of four months of tracked symptoms. Different conversation.
For you: if she ever shares the summary with you, treat it as her trusting you with something. Read it carefully. You might also notice things she hasn't said out loud yet.
None of these are catastrophic. All of them, said in the wrong moment, land badly:
"At least you don't have to deal with periods anymore." (She still might. And there's a lot more to it than periods.)
"My mum just got on with it." (Her mum probably also went through it alone.)
"It's just hormones." (It is also her life.)
"Have you tried…?" (Yes. Whatever it is. Yes.)
"You're always tired / moody / cold / hot." (Yes. That's the symptom.)
"Maybe you should see someone." (Take her to the GP or health practitioner. Don't suggest a therapist for a hormonal problem.)
This page is mostly about her — fair enough, since menopause is mostly about her — but it's worth saying clearly: this is also hard on you, and that's allowed.
Watching someone you love struggle is hard. Being unable to fix it is hard. Having less of her energy, less of her patience, sometimes less of her affection — these are real losses, even when you understand the cause. Feeling tired yourself, or sometimes resentful, or just confused about what's going on — that's all normal. You're allowed to feel it.
What's not allowed is making any of that her problem on top of the menopause. Talk to a friend, a brother, a therapist, anyone. Just not her. She's already carrying enough.
If you've read this far — really read it — you're already doing more for her than most partners do. The rest is just showing up, again and again, in small ways. She'll notice.
More about Threshold