‘Who are you, and what have you done with my wife?’

Men the world over are often bothered and bewildered by the seemingly sudden change in their female partners when they hit the age of menopause. They don’t call it The Change for nothing. I’m a women’s rites-of-passage expert who has been running menopause programs for more than 10 years.

One woman’s husband asked her: “Who are you? And what have you done with my wife?” Other women in my programs have joked that menopause might mean taking a “pause” from “men”. It seems both sexes need some space and education to learn about this previously taboo subject.

Menopause (when a woman’s periods stop) generally occurs with a gradual decline around ages 45 to 55. But symptoms can often start earlier in a phase called perimenopause, in the early 40s, or even in the late 30s.

Women and their partners can be blindsided by the onslaught of symptoms such as hot flushes, insomnia, night sweats, heart palpitations, skin-crawling sensations and stormy mood swings. Women are taken off guard when these symptoms start appearing and find it hard to locate information – or even a medical professional who knows much about it.

There’s been a huge increase in education around puberty and childbirth over the past 20 years. Now we need to do the same for menopause and perimenopause. Midlife women and their husbands, partners and families have been suffering in silence for years. It has to change.

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When hormone replacement therapy arrived, the main source of information about menopause became the pharmaceutical industry. While HRT was initially celebrated and embraced by women, a study published in 2002 saw women in their millions abandon the treatment. This study was subsequently shown to be flawed and safer, more effective ways of taking the hormones have been developed (now called MHT – menopause hormone therapy). This information and other treatments have been very slow to be recognised by medical professionals, and women in general have been kept in the dark.

New, non-hormonal treatments are also being trialled. These operate on the temperature-regulating system in the brain. Going into perimenopause is like withdrawing from a drug addiction. For 30 to 40 years, our female brains have been bathed in the hormone estrogen, which is now declining rapidly. Our bodies can become hot, fidgety and irritable, and our moods swing wildly while this withdrawal happens. It may take place over five to 10 years.

Most women experience some symptoms such as extreme tiredness, hot flushes and night sweats, but about 25 per cent of women suffer major life-disrupting symptoms. Near-systemic breakdown, depression and osteoporosis have all been linked to menopause.