If you only have a minute
- Perimenopause is the years-long transition before menopause. It often starts in the early 40s, sometimes the late 30s, and hormones rise and fall unpredictably.
- It can show up as poor sleep, a short fuse, brain fog, anxiety and lower desire. Partners often read it as rejection.
- She is not crazy and not being difficult. Track symptoms, see a provider who takes midlife seriously, and get checked for overlap like thyroid changes.
- He should never ask "Is it your hormones?" mid-argument. Ask what's been hardest lately, then listen.
"Who was that?"
Have you ever snapped at your husband over something small, then sat in the bathroom thinking, who was that? Or maybe you're the husband wondering where the woman you married went. Dr. Ransom opens this episode with her own moment at 42: cooking for her family, her husband quietly reaching for a pot to help, and a sharp "Get out of the kitchen" that surprised them both.
That's perimenopause. Estrogen and progesterone stop following a steady monthly rhythm and start rising and falling without warning. Menopause itself is one day, twelve months in a row without a period. Everything before it is the ride up, and the unpredictability is the hardest part: a good week, an awful week, and no clear reason why.
"You're not losing yourself. You're just changing, and your marriage can change with you."Dr. Regina Ransom
The cycle it creates
Her body changes, confidence drops, and she doesn't want to be seen or touched. He feels rejected or confused, so he withdraws or pushes. She feels alone and unseen. It's the same kind of cycle from The Dance Most Couples Are Doing, with hormones as the spark.
One couple Dr. Ransom worked with felt their marriage was failing. Every talk turned into yelling over the kids, the garbage, the dishes. Over a four-day intensive they discovered perimenopause was a big piece of it. It was a season they hadn't recognized, and naming it changed how they faced it.
For her
- Track sleep, mood, cycle and energy for a month or two.
- See a provider who takes midlife symptoms seriously. Get a second opinion if you feel dismissed.
- Ask about thyroid and other overlaps instead of guessing.
- Name it to your partner before a hard day, not in the middle of a fight.
For him
- Her pulling away is usually not about you. Don't make it your story.
- Never ask "Is it your hormones?", especially mid-argument.
- Ask "What's been hardest for you lately?" Then just listen.
- Help with the practical things: the room temperature, the kids, an appointment.
The body check-in
Pick a time when neither of you is tired or upset. It takes ten minutes.
"Her pulling away is usually not about you. So don't make it your story."Dr. Regina Ransom, to the husbands
Full transcriptRead the whole conversation
Read the whole conversation
0:36I want to ask a question. Have you ever snapped at your husband over something small, then sat in the bathroom thinking, who was that? Or maybe you're the husband wondering where the woman you married went. Today, we're talking about a season a lot of couples walk through without a name for it. Many women in their 40s start feeling off long before anyone says the word perimenopause.
I can remember back when I was in my 40s. I was about 42 at the time. And I was in the kitchen cooking dinner for my hubby and my children who were over visiting. My hubby, being the wonderful man that he is, came into the kitchen at some point to help me. He didn't say anything. I remember him reaching down in the cabinet to grab a pot for me. And out of nowhere, I looked at him and said, What are you doing? Get out of the kitchen. And my voice was high-pitched, and it just totally caught him off guard. He just looked at me like I don't even recognize the person talking to me right now. And he didn't say anything, and he just walked out of the kitchen, put the pot back in the cabinet. So this is what I mean. Sometimes you don't even know what's happening in the moment. And then later you're thinking, what was that?
Well, let's talk a little bit about perimenopause, because that's what it is. A lot of women do not understand perimenopause. They hear the term, but don't really know what that means. So perimenopause is the transition leading up to menopause. It's not menopause yet. Estrogen levels and progesterone rise and fall unpredictably instead of following a very steady monthly rhythm like they should. It often starts in the early 40s, sometimes even late 30s. And the bad part is it can last several years. Menopause itself is one day: 12 months in a row without a period. Everything before that is the ride up to menopause.
The unpredictability is the hard part. Good week, awful week, and no clear reason why...
The full transcript continues here on the live page.