Is perimenopause affecting your relationship?

It can be. Perimenopause, the stretch of years before periods stop for good, often brings poor sleep, mood swings, irritability and changes in sex.1 Any of those can strain a relationship. Knowing what’s going on helps both partners stop taking it personally and start treating it as something to handle together.

What happens during perimenopause?

According to the National Institute on Aging, most women start the menopausal transition between 45 and 55, and it can last several years.1 Symptoms vary a lot. Some women have few, others deal with hot flashes, night sweats, trouble sleeping, pain during sex, moodiness and irritability.1

A review by Nanette Santoro, of the University of Colorado’s obstetrics and gynecology department, adds that poor sleep becomes more common, and that depressed mood and anxiety rise during the transition, especially in its later stages.2 The symptoms also feed each other. Women with depressed mood tend to have worse hot flashes and worse sleep.2

Anyone who’s tried to be patient on four hours of sleep can see how that reaches a relationship.

What about sex?

A large study followed more than 3,000 women through the transition. By late perimenopause, desire had dropped on average and pain during sex had become more likely.3 Many other parts of sexual life didn’t change with the transition itself, and overall health and mood were linked to every outcome.3

That’s useful for couples. A dip in desire isn’t automatically a verdict on the relationship, and pain is a medical issue that a doctor can help with, not something to push through.

Why partner support can feel uneven

In a 2024 survey of 71 women going through perimenopause or menopause, many described strong support from female friends who were going through the same thing.4 Partners got mixed reviews. Some were described as very understanding, others less so.4 The sample was small and mostly British, but the gap rings true for a lot of couples.

How to talk about it as a couple

• Name it without making it the whole story. “I think some of this is perimenopause” is different from “it’s just hormones.”
• Partners: ask, don’t diagnose. Joking about hormones in the middle of an argument rarely goes well.
• Protect sleep where you can. Separate blankets, a cooler room, or sleeping apart some nights isn’t a bad sign if it helps you both rest.
• Talk about sex outside the bedroom. What’s changed, what feels good now, what you both want.
• Bring in a professional. The NIA advises women concerned about symptoms to talk with a doctor.1 A couples counselor can help if the arguments have built up.

If the strain is showing up as feeling shaky about the relationship, why you might feel insecure in your relationship at this age goes deeper. For the bigger picture, see what’s actually different about dating in your 40s.