Man's Guide to Menopause
What’s a partner to do as his wife goes through “the change?”
By Denise Mann
Hot flashes are certainly news flashes – and for good reason. Each day, 4,000 women in the US and Canada enter menopause.
But what about their partners?
The hot flashes, sudden mood changes and other symptoms of menopause certainly wreak havoc on a woman’s life, but little attention has been given to how her partner feels – and what he can do to help -- when she is having a flash, is uncharacteristically forgetful or shuns sexual intercourse because it’s too painful.
“The most important thing men need to know about menopause is that jokes about menopause can be hazardous to their heath,” says women’s health expert Donnica Moore, MD, founder and president of the Sapphire Women’s Health Group in Neshanic Station, NJ and the website www.drdonnica.com. “While partners often feel the brunt of the unpredictable mood swings and changes in everything from sexual appetite to sleep patterns, do not to take this personally,” she tells HealthNewsDigest.com.
“In general, the men who are most attractive to women are those who listen [but] sometimes the best thing a man can do for his partner is drive her to a doctor’s office,” she says. And “reinforce the message that I am there for you and know that you haven’t changed even though your hormones have,” Moore advises.
In the past women have relied on hormone replacement therapy (HRT) to replace the declining levels of estrogen that occurs during menopause and to treat its symptoms, but HRT has fallen out of favor due to a host of negative studies. Recently a major arm of the Women's Health Initiative (WHI) study was stopped early when it was found that the HRT used in the study slightly increased the risk of breast cancer, heart attack, stroke and blood clots over the long term.
Until this study broke, it was not unusual to prescribe long-term HRT to prevent heart disease and bone loss as well as relieve acute symptoms such as hot flashes and vaginal atrophy. Many women took HRT for decades, but now doctors are confused and many are falling back on recommending HRT only for short-term relief of severe menopausal symptoms.
What’s more, the pendulum may still be in motion when it comes to HRT. A Food and Drug Administration (FDA) reproductive health expert recently said that the risks of taking hormone replacement therapy (HRT) may not extend to every single type of hormone preparation. The WHI study participants took PremPro, a product that contains a combination of estrogen and a progestin. While many doctors may avoid prescribing PremPro that should not convict every other form of therapy, the FDA-expert added.
“My one piece of advice is to be patient and supportive that menopausal symptoms don’t go on forever and are typically over in a span of 1 to 3 years and are mostly treatable,” says James A. Simon, MD, clinical professor of obstetrics/gynecology at George Washington School of Medicine in DC and medical director of the Women’s Health Research Center in Laurel, MD.
Dr Simon says that men need to be aware of some of the less publicized symptoms of menopause.
Like what?
“The feeling of bugs crawling up and down their skin is relatively common so is difficulty swallowing,” he says, adding that just knowing that a woman may experience such sensations can go a great deal in assuaging her anxiety.
Short-term memory loss bothers the spouse the most outside of the sexual arena, he adds, noting that men should exercise patience when their partner seems forgetful.
Viagra (sildenafil citrate), the male sexual dysfunction drug, complicated things a bit when it became available in 1998. Since then, VIAGRA has helped more than 16 million men around the world improve their sex lives, and amazingly, nine tablets are dispensed every second worldwide, according to drug maker Pfizer.
“Now we have men with a 20-year-old erection versus a 70-year-old vagina,” Dr. Simon says. “Before Viagra, an aging man was less erect, less turgid and that is fine in a woman whose vagina is not particularly lubricated, but with Viagra it's a formula for disaster including laceration, severe pain and bleeding,” he says.
When it comes to sexual function, vaginal dryness and atrophy can be treated by local hormones for women who don’t want to be on systemic therapy or systemic or alternatively women can use a vaginal moisturizer like Replens and a lubricant like KY Jelly or Astroglide at the time of intercourse, Dr. Simon suggests.
“A 70-year-old woman using a local estrogen may have a vagina that is indistinguishable from her younger counterpart,” he adds.
Fouad R. Kandeel, MD, PHD, director of the Male Potency and Reproductive Clinic at the City of Hope, agrees:
“It’s very important that if a woman needs HRT, she not be denied because the vaginal wall will become atrophic for lack of estrogen [and] local estrogen replacement therapy may work very well,” he says.
Devices for women including a prescription clitoral suction device that helps bring the blood and promote engorgement can be helpful, he adds, noting that Viagra and other such drugs being tested in women.