It is estimated that in the UK today there are as many as 13 million women going through the menopause. Some 25 years ago research looking at the way the menopause was portrayed in the media highlighted a number of problems:

1 the information available was found to be minimal and insufficient

2 menopause was almost always presented as a negative experience or disease, and

3 intervention advice for menopausal women was inconsistent and contradictory Gannon & Stevens, 1998

Recently we have started to see a small, positive shift, with the topic of the menopause shooting up the media agenda. This has led to more widely available information and discussion about the changes women may expect during the menopause. It has also helped to inform women about intervention options such as Hormone Replacement Therapy HRT , which can help alleviate some of the changes women experience.

However, my work with mainly opposite-sex couples over the past ten years has revealed that the menopause can not only lead to additional challenges for women but also for their partner and the couple relationship.

Couples who seek help are often at crisis point in their relationship. Common presenting problems that couples bring include dealing with the fall out of an affair, intimacy issues physical and emotional , communication problems, bereavement, infertility, unresolved feelings of anger and/or resentment from one partner towards the other. The work to rebuild their relationship based on a more solid foundation of mutual trust, respect, empathy and kindness is hard and often painful.

Further difficulties can arise when this coincides with other key events in the couple's life, such as children going through puberty, children leaving home, and the illness and/or death of parents. As stated earlier, the experience of menopause - a key life event for women - may also pose challenges for the couple. Let's look at why and how this might happen.

Women and menopause

One thing that has become clear is that all women experience menopause differently. The hormonal fluctuations associated with the transition from perimenopause the period before menopause where the ovaries gradually make less oestrogen through menopause and post-menopause can lead to physiological and psychological changes, which can vary in both frequency and severity and include:

• hot flushes
• urticaria hives
• fatigue
• osteoporosis weakening of the bones due to reduced levels of oestrogen
• difficulty concentrating and making decisions
• memory loss
• sleep problems
• loss of sexual desire and arousal
• vaginal dryness
• anxiety
• panic attacks
• depression