Menopause, relationships and sex

In this episode, leading endocrinologist Dr Christina Jang talks about the effects menopause can have on daily life, work, relationships and sex.

We're also joined again by Michelle, who talks more about her experiences of dealing with menopause at work. Then we welcome Heather, who shares how she and her wife have navigated menopause together.

How can menopause affect my personal and work relationships? I don't feel like sex - is that normal? What can I do to help deal with the stress of menopause? Listen to find out.

Make sure you subscribe so you don't miss our next episode where we discuss Menopausal Hormone Therapy (MHT).

Featured in this episode

Katie May

Our host Katie is a single mum in her late 30s. She is a communications expert with 17 years’ experience and is passionate about health and wellbeing. She is currently studying Italian just for fun and absolutely adores her pet greyhound, Piper.

Dr Christina Jang

Dr Jang is a Brisbane-based endocrinologist treating all endocrine conditions, with a special interest in female reproductive endocrinology, including menopause. She is a staff specialist in endocrinology at the Royal Brisbane and Women's Hospital (RBWH). She is a senior lecturer at the University of Queensland and president-elect of the Australasian Menopause Society (AMS).

For her, endocrinology is an area of medicine which presents opportunities to deliver far-reaching benefits to her patients.

Michelle

Michelle is 59-years-old and has been an English Language Studies (ESL) teacher for 11 years and a children’s party performer for 14 years prior to that. She likes reading Stephen King novels, pretending that she can cook, and being at the beck and call of a fluffy princess cat.

She has been happily married for 25 years to a handsome man who has been very patient with her menopausal moments.

Heather

Heather is a 56-year-old Canadian who has been living in Australia with her wife for over 20 years.

She had surgery and radiation for hormone receptive invasive ductal carcinoma (IDC) breast cancer and can't have menopausal hormone therapy (MHT).

Her main menopausal symptom has been severe hot flushes (3 to 4 per hour). She was prescribed antidepressants only, until she discovered a medication that controls vasomotor symptoms (VMS) in 2024. She now only experiences one hot flush a day and has a better quality of life.

Episode Resources

Relationships Australia

Relationships Australia is a leading provider of relationship support services for individuals, families and communities. They are not a crisis service, but if you have questions or concerns about your relationship, family, or any other aspect of your personal life, call them on 1300 364 277 to discuss which of their services will best support you. For more information visit Relationships Australia.

Australasian Menopause Society (AMS)

The AMS is a not-for-profit member-based society aiming to improve the quality of life for women during and after the menopause. The AMS helps women and their health professionals better understand the transition through this stage of life by providing accurate, evidence-based information about premature menopause, perimenopause, menopausal hormone therapy (MHT) and alternatives, osteoporosis and how to locate a doctor interested in women's health. Find out more from AMS.

Jean Hailes for Women's Health

Jean Hailes for Women's Health is a national not-for-profit organisation dedicated to improving women's health across Australia through every life stage. They work in public health, research, clinical services and policy. Their website has practical and easy-to-understand information for women and for health professionals. Visit Jean Hailes for Women's Health for more information.

Lifeline

Lifeline provides free, 24-hour telephone crisis support service in Australia. Counsellors are available to provide mental health support and emotional assistance, not only via telephone but face-to-face and online. Visit Lifeline or call 13 11 14.

Beyond Blue

Beyond Blue is an Australian mental health and wellbeing support organisation. They offer free, qualified mental health support via chat or phone. For more information visit the Beyond Blue website or call them on 1300 22 4636.

Women's Wellbeing Line

The Women’s Wellbeing Line provides free mental health support and therapeutic counselling for women, girls and gender diverse folk in Queensland. For more information visit Women’s Wellbeing Line or call 1800 4WOMEN (1800 496 636).

Transcript

Episode 4 Menopause and life after | Leaving perimenopause and what symptoms will you experience now?

Vox pop:

When I started menopause, the discussions were around dry eyes and hot flushes. No one spoke about vaginal dryness. So, it's not just your ovaries, you know, hanging up their saddle and going ‘we're done’. But it's, it's everything.

Katie:

Welcome to It Can't Hurt To Ask, the podcast where we answer all your health and wellbeing questions. My name is Katie, and today's episode is all about menopause and how its symptoms can impact your relationships, whether that be with your partner, friends or even work colleagues.

Plus, we'll also be diving into how menopause can affect relationships, intimacy, and the best way to navigate this phase together.

Joining me today is our regular guest, Brisbane-based endocrinologist, Christina.

Christina:

Hi. Thanks for having me. It's a great conversation to be part of.

Katie:

A quick note on terminology. Throughout this podcast we'll be using the terms women and girls. We use these terms inclusively to mean all people who identify as a woman or girl and recognize that people who do not identify as a woman or girl may still be affected by women's health issues.

Before we get started, we'd like to acknowledge the Traditional Custodians of the land on which this podcast has been recorded. For us it's Meanjin, the land of the Yuggera and Turrbal peoples.

So, we know that menopause for some women can bring some physical and emotional changes. So, for those women, how do those symptoms potentially affect their relationships, whether romantic relationships or otherwise?

Christina:

We heard from Alice and Michelle in early episodes that mood symptoms can impact on relationships. Some women can experience irritability, anger, and that can cause friction and conflict with their partner.

From a physical sense, some women get vaginal symptoms, vaginal dryness, and that can impact on a woman's desire to be intimate with their partner as well.

Katie:

So, it sounds like the foundations for good relationships in terms of communication and understanding and compassion will be really important, in those situations for women and their partners who experienced that.

So, what about the workplace though, obviously women will still experience all these menopausal symptoms in the workplace. What does that look like and what can be done?

Christina:

Yeah, definitely touched on that. Women will still experience their symptoms even though they're at work. And women can have really debilitating hot flushes, at work. And that can be very disruptive and impact on their ability to function at work.

And furthermore, a lot of women can be troubled by poor sleep at the time of menopause. And if they're tired all day, again that's going to disrupt their ability to work as they want to.

Katie:

That's definitely one for the employers out there, to be thinking about how their workplace can be more supportive of women going through the menopause, for sure.

And obviously dealing with that and the added stress of feeling like you're not being as productive as you'd like to be, can create a bit of, you know, extra stress and anxiety. So I think it's another important reminder around the mental health component of menopause and making sure that you seek help when you need it.

Christina:

Oh, definitely. I think again that's just where you have that conversation going, feel like you can share your experience, talk to someone about what's going on.

Many workplaces are now taking steps to educate the employees about menopause and the symptoms, and that's really to support their women who are going through menopause working for them. And that's a really positive step.

Katie:

Yeah, for sure. And in previous episodes we talked about other ways to manage some of the symptoms like mindfulness and therapy and that kind of thing. Particularly in episode two, we heard from clinicians Jacqui and Helen, who discussed the lifestyle and diet changes we can make to help manage the symptoms. And there was some really useful information in there. So, if you have missed it, make sure you head back to episode two and have a listen.

Before we continue, we have a trivia question for you, our listeners.

Is it possible to become pregnant during perimenopause? Stay tuned for the answer because we'll give it to you right at the end of the episode.

And if you're enjoying the podcast, don't forget to subscribe and leave us a review because it will help others to find us.

Managing menopause in the workplace can feel like navigating a maze, especially when you're trying to balance your health, your responsibilities, and the reactions of people around you. But as our next guest Michelle discovered, sometimes the journey can be both surprising and even a little funny.

Let's hear from Michelle herself as she shares her experiences of managing hot flushes, creating a supportive environment, and how menopause actually sparked some pretty interesting conversations across cultures and generations.

Michelle:

So going to work, and particularly with being a teacher, having to, yeah, put on a happy face and pretend that everything's normal, particularly when you're having a hot flush or you're trying to teach something was really very difficult.

I ended up just getting a fan and rolling with it and thought to myself, okay, everybody's going through menopause, it's fine. So, I'd take a fan to class and I'd end up having a hot flush and rather than trying to strip everything off, I’d grab my fan and used my fan.

And it was interesting because a couple of the students then, different cultural groups had different reactions to it. And a couple of the ladies, that were older, would sort of go ‘yes, yes, yes, yes, we understand’.

And some of them bought me in some fans and things like that, which was really sweet. So that was good. It was hard, you know, you just keep, you've just got to keep going with things.

From colleagues it was really good because I work with a lot of women who are older than me, so I can ask them things. Everybody had really different symptoms and it was really hard to try and get this whole, oh, okay, what I'm going through is normal. Or this feeling or that feeling or whatever was normal because they didn't seem to be a normal for anybody. Just similar symptoms.

I work with a lot of guys and they're all sort of in their 20s and things like that. So their wives are nowhere near menopause. I don't know how they went with their mums or anything like that.

And it just became a bit of a joke that I'd be having a hot flush because they'd see me grab a fan and do this. And then a couple of times somebody had realised, and one of the guys had run over with a big fan. And they’d be there, and they’d be fanning me.

And then one of the other guys would come over and he'd have another fan, because I had like six fans on my desk, because students used to give them all to me. And they’d all be fanning me. And I think once or twice I must had about six or seven guys around me fanning me.

And I'm thinking like when I was 20, this would have been a dream come true. It's like when you think about sitting under palm trees, having somebody, you know, fanning like that. So lots of guys doing that, which was really good because I figure that'll kind of help them with their mums and wives and things like that when they go through it as well.

So it became a bit of an open topic of conversation, which is good. And I think young guys these days are a little bit more open to that sort of thing.

I’ve noticed work, culturally, big differences between different cultural groups. African ladies are open about it and they just laugh and go ‘oh, yes teacher, ha ha ha’ and have a big giggle about it. Whereas the Asian ladies were all bringing me in fans.

Katie:

So, Christina, we've talked a lot about the symptoms of menopause and how that can impact our daily life and our working relationships. Now, let's talk more about how this phase of life can impact our romantic relationships.

In a moment, we'll hear from Heather, whose menopause journey began in her late 30s and included a hysterectomy at 40 because of endometriosis. She moved to Australia with her wife more than 20 years ago.

Together, they've navigated menopause, health challenges and caring for their aging parents. Heather shares how open communication helped them support each other throughout all these changes. Let's hear from Heather.

Heather:

Hi, I'm Heather and I'm 56 years old. My perimenopause journey, more like a roller coaster started, I think probably when I was in my late 30s. And I had to have a hysterectomy when I was 40, because of endometriosis.

I think I'm in a unique situation in that I'm gay, and I've always been out, but I have a wife, an Australian wife. I moved here, just over 20 years ago with her, and was welcomed very warmly by her wonderful family.

That was 20 years ago, I think, as is the case, the responsibility of looking after aging parents usually falls on the single children. Or in our case, the childless kids. So, it’s us gays doing a lot of the, a lot of the work. I mean, the rest of the family pitches in, but they also have kids to look after, so they've got a lot of big responsibilities, so we take on those responsibilities. And so our life together is pretty busy.

She's also had to have surgery because of pre-cancerous cells. So, she's been thrown into early menopause as well and didn't recognise the symptoms. And neither one of us did because my symptoms were radically different from hers.

So here we are, she's in the same boat as me, you know, a few years later, and she's just starting to get the hot flashes and the night sweats and all of that jazz, plus with the with the hysterectomy, it's, I think it's probably sped up some of her symptoms.

So, we're working hard on a relationship, to maintain our relationship, amidst the caretaking, you know, the jobs that we're doing, and then our own health, making sure our health is good.

So, I wish there was more awareness about, people in our situation, but there isn't. So we kind of have to write our own script through this.

Katie:

Thanks for Heather for sharing her story. And it's a touching one, noting the difficulties that it's had on her relationship with her wife. Heather also shared with us a practice she's been using for many years to help manage the symptoms of menopause and the daily stresses in her life. So, let's hear about that.

Heather:

I'm not a spiritual person, in the context of I'm not religious, but over the last ten years I've developed a meditation practice. And it's got some Buddhist founding. But it's also rooted in psychology.

And at first, I thought I was doing it to help me get through my PhD and working as an academic because it was quite a stressful, job. But I soon realized that it helped a lot with menopause and the symptoms that I was experiencing. Just being able to regroup and ground myself.

So, it's a practice I maintain daily. And I often say to my wife, I’m just a little bit stressed out here, I got to go do meditation. And then she knows I'm not actually taking a nap, but I'm going whacking on my headphones and often hanging out with the dog on my lap. And we both just sit there and just bring ourselves down. I use guided meditations and it's incredibly helpful.

Katie:

So, Christina, it's fascinating isn't it, the wide-ranging benefits of meditation. We've touched on it in earlier episodes around mindfulness and meditation and its benefits. But, for me personally, I think what I would like other people to know, if they're thinking about trying it, whether it's for managing menopause or whatever it is, it does take practice, right? It's something you have to practice, practice, practice. It doesn't come naturally necessarily at first. But, yeah, I would definitely recommend people keep trying and keep going with it because it can be really beneficial.

Christina:

I think everyone's different, obviously. And I think Heather's done really well. She's found a means of coping, of managing her symptoms through meditation. It's working for her and she's practicing it. So I think good on her, it's great.

Katie:

Yeah, you're totally right, Christina. And just to add, if you are new to meditation, Queensland Health has a series of guided meditations and soundscapes that you can either watch on YouTube or listen to on your favourite podcast streaming platform. Just search Mind/Land, by Queensland Health.

What about the impacts on our sex life? How can couples come together and support each other when a lady's libido will be reduced and a man's testosterone is the same, and he may want the same sex life that he's always had for his entire life?

Christina:

This can definitely be an issue. Many women experience vaginal dryness as a symptom of menopause, and this can make intercourse very uncomfortable. There are moisturisers, lubricants, and forms of menopausal hormone therapy which may help in that regard.

And libido is a very common issue as well. A lot of women just don't feel like having sex. This is where it's important to talk to a healthcare professional or counselling may be helpful.

Katie:

Is sex normally talked about when a woman comes to their doctor or their specialist in menopause? Is it something that's considered taboo or is it just not discussed at all?

Christina:

No, it's not taboo. I mean, when women see the doctors specifically about their menopausal health, it depends on largely what symptoms they have. So, if it's the physical symptoms, like the hot flushes, the sweats, the poor sleep, we address those. So it's very much tailored to what the woman presents with in terms of her symptoms. The libido, the sex life, may be part of that. Some doctors will raise it. It depends on how the consultation’s going.

Katie:

And before we wrap up, the answer to today's trivia question is yes, it is possible to fall pregnant naturally during perimenopause. Fertility is lower. However, you can get pregnant if you are sexually active, so it's a good reminder to use your chosen form of contraception if you don't want to fall pregnant and are going through perimenopause or menopause.

Christina, for those looking to make lifestyle or dietary changes to manage their symptoms, what's the best place to find reliable information? Should they start doing their own research, or do you think it's better to speak directly with their doctor or health care professional?

Christina:

I think a good starting point would be some websites. I'm going to put in a plug for the Australasian Menopause Society, there’s some factsheets there which talk about diet and lifestyle management.

I think again coming back to the individual approach, it's always good to talk to your doctor about what your needs are, what your dietary requirements are.

Osteoporosis is a big problem around the time of menopause potentially, and we always like women to get lots of calcium in their diet, and that's just one example. So I think talking to your GP. Your GP might recommend you see a dietitian if necessary, but that's a good starting point.

Katie:

Yeah, it's all about going to trusted sources of information, right? There will be a lot of misinformation around lots of health conditions out there. So, make sure you always go to a trusted source or your health care professional.

In our next episode, we'll be diving into Menopausal Hormone Therapy, or MHT, which some of you might know as HRT. For years, there has been a lot of myths and misunderstandings around MHT and we're here to set the record straight.

We'll talk about how far the treatment has come and highlight the real benefits that so many women have experienced. Some say MHT has even saved their lives by helping them reclaim their quality of life. If you've been curious or you're unsure about MHT, this is an episode you don't want to miss.

If you want to find out more about relationships and strategies to help manage them, we'll be discussing this after our episode on MHT.

A big thanks to Christina for joining us again today, and to the team at Queensland Health for making this podcast possible. We'll see you next time on It Can't Hurt To Ask.