Signs of perimenopause in your wife: what to look out for

She’s sleeping badly, snapping at things that never used to bother her, and by mid-morning she looks like she’s run a marathon. She says it’s stress. Maybe it is. Or maybe there’s something else going on that neither of you has thought of yet.

Menopause doesn’t start with the last period. It starts years before, in perimenopause. For a lot of women that’s their mid-forties, sometimes earlier. And because the changes creep in slowly, the first person to notice is often the one who lives with her every day: you.

Why nobody spots it for so long

Most women at this stage are in the thick of it. Work, children, often their own parents as well. So it’s easy to put every bit of exhaustion down to a busy life. On top of that, hardly anyone has told them that poor sleep, irritability or forgetfulness can be hormonal. Most people think hot flushes and that’s about it.

I’ve seen what happens next in a lot of conversations, and in my own marriage: you both sense something’s off, and you both look for the problem in the wrong place. She blames herself. He blames himself, or her.

The signs to look out for

None of these proves anything on its own. But if several turn up together and stick around for months, it’s worth looking more closely.

Sleep. She wakes in the night and can’t get back to sleep, often at the same time. Sometimes she’s sweating, sometimes she just lies there. In the morning she’s wrecked, and the day starts on an empty tank.

Mood. She’s short-tempered about things that wouldn’t have touched her before. She’s quicker to tears, more anxious, or has days when everything’s too much. This isn’t a character flaw. Fluctuating hormones act directly on the nervous system.

Head. She forgets appointments, loses words mid-sentence or struggles to concentrate. Many women find this frightening and keep it to themselves, because they worry something is seriously wrong.

Body. Look out for these changes:

• Her periods change: closer together, further apart, heavier or lighter than usual.
• Hot flushes during the day, or night sweats.
• Palpitations she’s never had before.
• Aching joints and muscles for no obvious reason.
• Weight gain, especially round the middle, even though she isn’t eating differently.
• More headaches or migraines.

Intimacy. She’s less interested in sex, or sex hurts because things are drier than they used to be. For a lot of men, this is where it starts to feel personal. It rarely is. Often it’s a physical change she can’t yet bring herself to talk about.

What these signs aren’t: proof

Exhaustion, palpitations and low mood can have plenty of other causes, from her thyroid to low iron to depression. So your job isn’t to diagnose her. Your job is to encourage her to get it checked out, ideally by a GP who knows about perimenopause or a menopause clinic.

One thing that saves a lot of couples a lot of frustration: hormone levels swing wildly at this stage, so a single blood test often tells you very little. What matters is the overall picture: symptoms, cycle and how things change over time.

How to bring it up without starting a row

“Is this the menopause?” is the quickest route to an argument. What she hears is: you’re old, you’re difficult, and it’s your fault.

It goes better when you stick to what you’ve noticed and frame it as concern rather than criticism:

• “I’ve noticed you’ve been sleeping badly for weeks. How are you finding it?”
• “You seem really worn out lately. I’m a bit worried. What would help?”
• “I read that poor sleep and feeling on edge can be hormonal. Shall we get it looked at? I’m happy to come with you.”

Pick a calm moment, not the evening after a row. If she shuts it down, leave it and come back to it another time. For what you can actually do day to day, read How to support your wife through perimenopause.

When she shouldn’t wait

Some signs mean she should see her GP sooner rather than later:

• palpitations, especially if they’re strong or new,
• bleeding that’s much heavier than usual or has changed,
• any bleeding after her periods have stopped for a year.

And if she says she can’t go on, withdraws completely, or you’re worried she might harm herself, don’t wait: call 999 in an emergency, NHS 111 for urgent advice, or Samaritans on 116 123, free and around the clock.

The whole thing in one sentence

If your wife has been changing for months and nobody knows why, perimenopause is one of the first questions you should ask, together, without blame, and with a doctor who listens.

Keep reading

• My wife’s perimenopause rage: what’s going on, and what actually helps
• How to support your wife through perimenopause: 7 things that actually help
• What is perimenopause? A plain explanation for men
• All articles

And for her: if she’s carrying everything and no longer knows where she stands, show her the free self-check. Twelve questions, two minutes.

Jan Poulev is a coach and author. He has worked with people for more than thirty years, and for more than ten as a coach for women, men and couples. This article does not replace medical advice.