9 Lives | Chapter 5 | Part 4: When Andropause and Perimenopause Collide: How to Dance Together Through Hormonal Changes

Midlife brings inevitable hormonal changes for both men and women. For women, perimenopause signals the transition toward menopause, often bringing symptoms such as mood swings, hot flashes, fatigue, and changes in libido due to fluctuating levels of estrogen and progesterone. For men, andropause, or the male equivalent of menopause, occurs when testosterone levels gradually decline. These hormonal shifts affect not only the individuals going through them but also their relationships—especially in heterosexual couples where both partners might be experiencing these changes simultaneously.

Men's hormonal changes are more gradual compared to the dramatic shifts women face during perimenopause. Starting around their 30s or 40s, men experience a slow, gradual decline in testosterone levels, typically around 1% per year. By the time they reach middle age, this decline may start to produce noticeable symptoms. Lower testosterone levels can lead to fatigue, reduced libido, mood swings, irritability, difficulty concentrating, and sometimes even depression. Some men may also experience weight  gain, particularly around the belly, reduced muscle mass, and decreased energy.Similar to perimenopause, men may feel the effects of lower energy, reduced concentration, or motivation at work as testosterone declines.

The combination of both partners experiencing hormonal changes at the same time can add complexity to marriages or partnerships. 

While men's hormonal changes are subtler and happen over a longer period, they still have a significant impact on physical, emotional, and relational well-being during midlife.

The intersection of perimenopause and andropause can create emotional and physical challenges within a relationship. However, it also presents an opportunity for growth and deeper intimacy, as long as both partners are willing to approach these changes with empathy, open communication, and mutual support. This essay explores how couples can navigate the combined effects of andropause and perimenopause while maintaining a strong, supportive relationship.

However, when both partners acknowledge that these changes are part of a larger hormonal landscape, it can foster mutual understanding. Recognizing that the emotional swings, physical fatigue, or decreased sexual desire are largely biologically driven—and not personal—can help prevent unnecessary conflict and frustration.

Communicating When It's Hard to Talk

While perimenopause is more widely discussed, andropause can be a taboo subject for many men, making communication around this issue particularly difficult. Men might feel ashamed or uncomfortable discussing decreased libido, emotional changes, or physical challenges like erectile dysfunction due to societal expectations that link masculinity with virility and strength. Women, too, may struggle to open up about their emotional volatility or changing bodies. But the key to navigating these dual hormonal shifts is communication, even when it’s challenging.

If direct conversation feels too confrontational or uncomfortable for the man, couples can employ subtle approaches. For example, a woman might share her own experiences of perimenopause, using phrases like, "I've been feeling really off-balance emotionally and physically. How have you been feeling lately?" This creates an invitation for the man to open up about his experiences without the pressure of a direct question about andropause. By approaching the topic indirectly and focusing on shared experiences, both partners can enter the conversation more comfortably.

Another way to facilitate communication is by using external resources—like articles or documentaries on midlife hormonal changes—as conversation starters. Watching a program about andropause or reading an article together can make the discussion feel less personal and more objective, allowing for a more open and relaxed dialogue.

Managing Physical Changes and Intimacy

Both perimenopause and andropause can affect physical intimacy, often leading to frustration or confusion if not addressed openly. Women may experience vaginal dryness or discomfort during sex, along with a decrease in libido. For men, lowered testosterone can lead to erectile dysfunction or a diminished interest in sex. These changes can strain a couple’s physical connection if not handled with sensitivity and understanding.

One approach is for couples to redefine intimacy during this time. Instead of focusing solely on sexual activity, partners can explore new ways of connecting, such as non-sexual touch, massages, or simply spending more time together in a nurturing, affectionate way. Communication about physical needs and challenges can also help. For example, the woman might introduce the idea of using lubricants or hormone therapy to address discomfort, while the man could consider discussing testosterone supplements or other treatments with a healthcare provider.

More importantly, patience and flexibility are crucial during this period. It’s essential for both partners to realize that these physical changes don’t signal the end of intimacy; instead, they present an opportunity to explore new dimensions of closeness that may even deepen the relationship.

Compassion and Support

When both partners are undergoing hormonal changes, compassion becomes an essential tool in maintaining harmony. Emotional swings, mood changes, and physical fatigue are common during both perimenopause and andropause, so cultivating patience is crucial. Partners can practice self-care together, developing routines that support physical and emotional well-being. This might include taking walks together, practicing mindfulness, or finding other shared activities that promote relaxation and connection.

It’s also helpful to remember that not all communication has to be verbal. When words are difficult, actions can speak volumes. Simple gestures of care—like making time for one another, listening without judgment, or offering a hug after a stressful day—can provide reassurance and support, even when the challenges of perimenopause and andropause feel overwhelming.

If communication and connection remain difficult, seeking the guidance of a therapist or healthcare professional can help both partners better understand and navigate their changing emotional and physical landscapes. Couples counseling can offer tools to manage the stressors of midlife hormonal shifts, fostering better communication and reinforcing the emotional foundation of the relationship.

The Silver Lining: Growth and Deeper Intimacy

While the hormonal changes of perimenopause and andropause bring challenges, they also offer an opportunity for growth and deeper intimacy. By facing these shifts together—with empathy, patience, and open dialogue—couples can emerge from this period with a stronger emotional connection. The dance of hormonal changes requires both partners to move with grace and understanding, but it also holds the potential for a renewed sense of partnership and love.

Navigating the hormonal shifts of midlife may be a difficult journey, but when couples approach it with shared purpose and compassion, they can turn it into a time of mutual support, resilience, and transformation.