What Every Man Should Know About Menopause

Paul von Zielbauer
Thu, 22 Jan 2026 20:14:09 -0800
Lifestyle

Women are finally getting the information they've long deserved about menopause and perimenopause — what's happening in their bodies, why their doctors often fail them and what actually helps. As women learn more, men need to catch up (an understatement, to be sure). A working understanding of the basics and how to be a supportive partner simply isn't optional anymore.

I recently talked at length with Dr. Annie Fenn, a board-certified OB-GYN who spent 20 years delivering babies before becoming a menopause specialist, and asked every "dumb question" I could think of. We discussed staple menopause-related topics, including nutrition, alcohol, sex and intimacy and how men can actually help without making things worse.

Are you buckled in? Let's get into it.
Updated: Thu Jan 22, 2026

Women are finally getting the information they've long deserved about menopause and perimenopause — what's happening in their bodies, why their doctors often fail them and what actually helps. As women learn more, men need to catch up (an understatement, to be sure). A working understanding of the basics and how to be a supportive partner simply isn't optional anymore.

I recently talked at length with Dr. Annie Fenn, a board-certified OB-GYN who spent 20 years delivering babies before becoming a menopause specialist, and asked every "dumb question" I could think of. We discussed staple menopause-related topics, including nutrition, alcohol, sex and intimacy and how men can actually help without making things worse.

Are you buckled in? Let's get into it.

First, the basics. Menopause isn't a moment in time but rather a retrospective diagnosis, defined as a full year without a menstrual period. By the time a woman knows she's reached it, she's already been through the hard part: perimenopause, a transition lasting seven years on average. That's one thing men really need to understand about this subject.

During perimenopause, estrogen doesn't decline smoothly. It swings wildly — spiking high, crashing low — with every cycle different from the last. Blood tests are nearly useless because they capture only a snapshot of a moving target. Estrogen receptors exist throughout the body, including hundreds in the brain. When levels plummet, short-term memory falters, word retrieval slows and sleep quality tanks. There's even a phenomenon called "bio-energetic crisis" — head-on-the-desk-at-2-p.m exhaustion.

I asked Fenn if there's anything remotely equivalent in physiology that a guy could relate to. Her answer: Imagine being an elite athlete sidelined by injury. The disrupted sleep, the energy swings, the mood changes ... not to mention the frustrations with not being able to perform as you always have previously.

Now imagine that lasting years.

One misconception Fenn wants to dispel: This isn't primarily an "emotional" problem. When perimenopausal women seem more sensitive, it's usually secondary to poor sleep and physical changes — not hormonal instability of the mind.

Menopause and Nutrition

Perimenopause pushes women toward a pre-diabetic state, with blood sugar swinging and the body wanting to deposit visceral fat. Poor sleep compounds the problem by driving cravings for refined carbs.

Men can help by keeping ultra-processed foods and sugary drinks out of the house and stocking the fridge with Mediterranean-style staples: berries, nuts, whole-grain bread, unsweetened yogurt. Resistance training is particularly valuable for metabolic health — partners can enable time for workouts by taking on other responsibilities.

But here's the critical part: Do it without becoming a "menopause coach." The last thing a perimenopausal woman needs is a partner telling her what she should do.

"Hey, hun, I ran out to the grocery store. I got some snacks I think you'll like. Do you want me to do dinner tonight?" That's the tone Fenn recommends — supportive, not prescriptive.

Menopause and Alcohol

That glass of wine that seems like a kindness? It often makes everything worse. Women metabolize alcohol more slowly than men and perimenopause reduces tolerance further. Even moderate drinking can sabotage already-fragile sleep.

Instead of opening a nice bottle, try: "I was thinking about going dry for a couple of weeks. Want to join me?"

Sex and Intimacy

Decreased desire usually isn't about the relationship or the partner. It's the result of not sleeping well, not feeling like yourself and having only so much energy for so many demands.

Physical symptoms like vaginal dryness have straightforward solutions — vaginal estrogen is safe for almost everyone — but raising the topic requires gentleness and an established comfort with talking about sex. If that comfort doesn't exist, Fenn suggests, now is the time to build it.

Easy Ways for Men to Learn More About Menopause

Fenn recommends "The Menopause Brain" by Lisa Mosconi and "Generation M" by Jessica Shepherd. These aren't gifts for your partner — they're homework for you. Offer to attend doctor appointments. Ask what would help, preferably on a good day.

One final insight from Mosconi's research: As women move through menopause, their amygdala — the brain region governing emotional regulation — becomes less reactive to negative stimuli. This is the neuroscience behind the "I Don't Care Club," that post-menopausal liberation from giving a damn about others' expectations.

For men, this means accepting that your partner may care less about things she once prioritized — the perfect table setting, the expected social performance.