Perimenopause, Relationships and the Search for Connection
What happens to a couple when both people are changing, but neither has much left to give?
I was listening to the Gottmans this morning as I was getting ready for a day of therapy sessions. One of the things I particularly appreciate about them is that they use their own relationship in their teaching. They are not presenting an immaculate version of coupledom; they speak about themselves as a real couple, with warmth, humour, difference and vulnerability.
The conversation was about menopause, and particularly the years leading up to it: perimenopause, and what this transition can mean not only for women but for their partners and their relationships.
When we think about perimenopause, we often think about hot flushes, disrupted sleep, changes in sexual desire, vaginal dryness and frayed nerves.
Undoubtedly these are significant symptoms.
But there is another dimension that can be less visible: what happens psychologically and relationally when a woman is changing, and the relationship has to change with her?
Perimenopause doesn't happen in isolation
Perimenopause can be an intensely lonely experience. Many women find themselves struggling with changes they don't fully understand, while simultaneously trying to continue with work, parenting, relationships and all the other responsibilities of adult life.
And sometimes something happens in the relationship.
What was once tolerable suddenly feels intolerable. Small frustrations create big emotional outbursts. There may be more resentment, more withdrawal, more arguments, or simply a growing sense of living alongside rather than with one another.
Hormonal changes can play an important part. Changes in oestrogen and other hormones can affect sleep, mood, energy, cognition and sexual wellbeing, and these changes can inevitably have an impact on how we experience ourselves and our relationships.
But perimenopause is only a hormonal story.
It can also be an existential one.
Mid-life, late 40s is according to Erikson's stages of psychosocial development, a crisis between generativity and stagnation. The task of this time is seen as nurturing future generations and contributing to communities, resulting in productivity and purpose. Difficulties in this developmental stage can lead to self-absorption and disconnection from the world. What happens when your very biology is pulling you inwards whilst there are also so many demands outwards? What happens to women's sense of self when their body and emotions are different and challening and yet the demands on their time and energy are still high and expect them to perform at high level?
Who am I now?
There can be profound questions underneath the practical changes:
If I can no longer have children, who am I?
If my body is changing, how do I feel about being desirable?
What happens to my sexuality?
Who am I when the years of fertility and young motherhood are behind me?
What is this next chapter of my life actually going to be about?
For some women, these questions arrive while they are still parenting young children. The cultural image and developmental stage of mid-life menopause can suggest that it belongs to a later, quieter stage of life. But many women today are navigating perimenopause while still deeply immersed in parenting, demanding careers and caring for ageing parents.
There may be a long road ahead, just when you feel that you have run out of steam.
And it isn't necessarily only the woman who is going through a transition.
Her partner may be confronting his own questions about ageing, identity, sexuality, work, fatherhood, purpose and the future.
Both people can be changing at the same time.
When two depleted people meet
This is where I think relationships can become particularly vulnerable.
Couples may have spent years building a life around work, children, mortgages, careers, family responsibilities and the practical business of keeping everything going.
There can be very little left over.
The relationship becomes another thing that needs to function.
Both people are depleted, but both need the other person to somehow be at their best: emotionally available, patient, affectionate, sexually responsive, supportive and understanding.
It is an impossible demand.
And so the communication chasm can gradually widen.
One person feels unseen.
The other feels criticised.
One withdraws.
The other pursues.
Sex becomes difficult or disappears altogether.
Resentment builds.
And then each person's response to the disconnection becomes evidence for the other person's fears.
You don't care about me.
I'm not attractive to you anymore.
You never listen.
Nothing I do is good enough.
You've changed.
I don't know you anymore.
The couple can become caught in a cycle that neither person actually wants.
“Slow down and look after yourself”
I remember a friend going through perimenopause more than ten years ago telling me that the secret was to slow down and look after yourself.
It is wonderful advice.
But sometimes I wonder whether we underestimate how difficult that can be.
What if there is no obvious space to slow down?
What if you are working, parenting, supporting teenagers or even primary school children, caring for ageing parents and trying to maintain a relationship?
What if your partner is stretched too?
What if neither of you has enough resources left for the kind of relationship you both want?
This is where I think compassion becomes particularly important.
Not just compassion for the woman experiencing the physical and psychological changes of perimenopause, but compassion for the couple who are trying to navigate a significant transition with depleted resources.
Finding each other again
This is often what brings couples into therapy.
Not necessarily because the relationship has failed.
Sometimes quite the opposite.
There are still needs, hopes, fears and desires there, but the couple no longer has the capacity or the skills to reach one another.
And sometimes individual therapy becomes part of that process too.
Midlife can bring a search for connection with the self as much as with another person.
Who am I now?
What do I want?
What matters to me?
What have I outgrown?
What do I want the second half of my life to look like?
How do I make new meaning beyond what looks like a series of inevitable losses?
There is no single map for this.
We may be moving out of one chapter without knowing exactly what the next one will look like.
Perhaps the task is not to return to the relationship or the person we were before.
Perhaps it is to become curious about who we are becoming — and to find new ways of meeting one another there.
Perimenopause can be a period of profound disruption.
But it can also become an invitation to re-examine and re-imagine the relationship, our sexuality, our identity and the life we have built, and to ask what we want from the years ahead.
Sometimes therapy is the place where those questions can finally be spoken aloud.
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