Vasomotor symptoms of menopause can destabilize your internal temperature—and your relationships
Every night I was faced with extreme temperatures. After having hot flashes before bed, I would sweat through my t-shirts all night and wake up freezing, as if I had swum in a glacial lake instead of sleeping.
After months of this nightly hot-cold cycle, I found a system. I had a stack of clean t-shirts next to the bed. After sweating through one, I reached for the next one at the top of the pile, changed my clothes, and tossed the discarded shirt onto the floor in a soaking wet heap. After a while I didn’t even fully wake up: I felt the cold, changed my shirt and immediately fell asleep again. It was perfect – for me.
For my husband it was less than perfect. He would wake up fully every time I bounced around in bed and changed my shirt and couldn’t go back to sleep for hours. When he finally left our bed to sleep in his office, I realized that he too was suffering from my menopause.
Night sweats and hot flashes, the vasomotor symptoms (VMS) of menopause, are associated with declining estrogen levels. Falling estrogen levels during menopause lead to an imbalance of a brain chemical called neurokinin B (NKB) in the temperature control center of the brain. This chemical imbalance can lead to hot flashes and night sweats. Women can suffer from VMS for years, sometimes even more than a decade.
Check out: Ways to Deal with Common Menopausal Symptoms >>
Vasomotor symptoms of menopause are undertreated
VMS are common but are inadequately treated. In fact, in one small study, nearly 9 in 10 women reported daily VMS, occurring on average up to five times, but only one in three of these women received treatment for their symptoms. Two out of three women reported that their symptoms lasted up to five years, with some women even reporting that they had suffered from VMS for more than a decade. The women also reported that VMS disrupted sleep and decreased their physical, emotional, and mental well-being.
Sheryl Kingsberg, Ph.D., chief of behavioral medicine at University Hospitals Cleveland Medical Center and a member of the HealthyWomen Women’s Health Advisory Council, said her research (which was sponsored by Astellas) has shown that moderate to severe VMS also disrupts relationships.
In the study co-authored by Kingsberg, nearly four in 10 women and more than four in 10 of their partners reported a decline in relationship satisfaction. While slightly less than half of the women reported that VMS caused the decline in satisfaction, more than half of their partners believed that VMS was the cause. Only a very small percentage of women and their partners reported that VMS had no impact on declining relationship satisfaction.
Menopausal symptoms can lead to reduced intimacy
The study also found that more than 9 in 10 women said VMS reduced their sexual desire, with half describing the effects as “significant.” VMS can also cause less blood to flow to the vagina and clitoris during sex, which plays a role in sexual response. “[Reduction in sexual response] is very common…often [women] “I think it’s just a normal sign of aging,” Kingsberg said. “It’s not that. It’s menopause.”
Genitourinary symptoms of menopause such as vaginal dryness, burning, itching and pain during intercourse can also cause sex to become painful, which can also lead to reduced sexual desire.
A reduced sex drive can significantly impact emotional and physical intimacy. “Women may begin to avoid sexual activity, causing partners to feel rejected or not wanting to hurt their partner when sex has become painful,” Kingsberg said. This can cause couples to stop touching each other. Even the smallest gesture, like a hug or kiss, can be interpreted as a move toward sex, which can trigger fear of physical pain or rejection.
Kingsberg pointed out that couples who are struggling may benefit from learning new communication skills to talk about sex and intimacy and slowly reintegrating physical touch into the relationship.
Open communication can solve relationship problems
To support a partner through menopause, “communication is key,” Kingsberg said. “In our study, we found that both women with VMS and their partners overestimated their own communication skills, while they perceived others’ ability to communicate as lacking. This shows us that there is a communication gap.”
Kingsberg and her colleagues asked how partners perceived their own efforts to support women with VMS. Partners said they were very supportive of women with VMS by showing them acts of love, including turning down the temperature in the bedroom, listening, and being empathetic. However, women with VMS told Kingsberg and her colleagues a different story. “The partners overestimated the support they gave them.”
Kingsberg said partners need to be open about their challenges and needs. “There is a conspiracy of silence around the issues that arise during menopause,” Kingsberg said. “Partners don’t want to embarrass or be critical of women with VMS.”
As it turns out, a conveniently placed stack of t-shirts and a daybed in the office should not be used as treatment options or viewed as long-term solutions. “Women and their partners should not suffer alone or even together,” Kingsberg said. “We found that women are more likely to seek treatment for their symptoms when encouraged to do so by their partners.” By maintaining open communication and actively encouraging resolution-seeking with a trusted healthcare professional—and resisting the urge to cobble together various solutions—partners can be a resource for the fever-stricken women they love.
This educational resource was created with support from Astellas, a member of the HealthyWomen Corporate Advisory Council.
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