Rekindling Connection in Couplepause (Part 2)

July 27, 2022

By: Rachel Noonan, PharmD

Confusion. Embarrassment. Avoidance. These feelings run rampant among couples in menopause and andropause. The lack of communication and outreach about symptoms during these transitions puts undue pressure on longstanding relationships.

It may be time to consider traditional approaches outdated. A fresh look at the realities aging couples deal with is long overdue. That’s where couplepause comes in.

The term couplepause encompasses the challenges menopausal and andropausal patients as well as their partners face together. The idea behind couplepause stems from the realization that addressing only part of a partnership, one person alone, is not as beneficial as assessing the needs of the couple as a whole. Neglecting to treat the couple as a unit may even hurt instead of help.

Nurturing communication and involvement will encourage understanding and engage support within a partnership. Talk to each other. Show your person you care. Studies show your partner is more likely to seek treatment if you encourage them to do so. Partners want to know about the issues their companion is struggling to overcome.

Once you have identified the difficulties you two want to conquer together, it’s time to reach out to your provider. Personal hardships make it easy to get caught up in a cycle of helplessness; outside perspective is key to seeing a way forward. Joint consultations are a great opportunity to realize the potential you two share. Your provider is an incredible resource with the necessary expertise to factor in health concerns, both physical and psychological, when discussing therapeutic options. Chronic disease states and the medications used to treat them can complicate sexual function later in life. A clinical eye offers a comprehensive evaluation of the many factors compromising wellness.

Consent is important; both parties must be ready to embark on this journey of collective discovery. Be patient and supportive with your partner if they are still adjusting to their body’s changes. Most companions seek assistance when they recognize relationship satisfaction is on the line. Your active involvement will be critical when the time is right.

Consultations offering menopause and andropause education will prevent misplaced blame, a misstep common in couples unfamiliar with the circumstances of advancing age.   Medication support such as compounded hormone replacement with estrogen, testosterone, or DHEA may also help. The goal is to build intimacy and foster connection using the method that is most accessible to you.

Despite the presence of sexual challenges in established relationships, don’t overlook the happiness and fulfillment that accompanies enduring partnerships. Contentment is right at your fingertips. The complex nature of relationships means there are many sides to every story, the context of your life matters.  Start small. Rebuild slowly and intentionally. A moment of embarrassment or vulnerability is worth preventing years of disunity. You two have come this far, and your future together could be brighter than you ever imagined.

Read Part I


  1. Bachmann GA, Leiblum SR. The impact of hormones on menopausal sexuality: a literature review. Menopause. 2004 Jan-Feb;11(1):120-30. doi: 10.1097/01.GME.0000075502.60230.28. PMID: 14716193.
  2. Corona G, Petrone L, Mannucci E, Magini A, Lotti F, Ricca V, Chiarini V, Forti G, Maggi M. Assessment of the relational factor in male patients consulting for sexual dysfunction: the concept of couple sexual dysfunction. J Androl. 2006 Nov-Dec;27(6):795-801. doi: 10.2164/jandrol.106.000638. Epub 2006 Jun 28. PMID: 16809271.
  3. Elena Colonnello, Erika Limoncin, Giacomo Ciocca, Andrea Sansone, Daniele Mollaioli, Giancarlo Balercia, Hartmut Porst, Hui Zhang, Xi Yu, Yan Zhang, Emmanuele A. Jannini, The Lost Penis Syndrome: A New Clinical Entity in Sexual Medicine, Sexual Medicine Reviews,Volume 10, Issue 1,2022, Pages 113-129, ISSN 2050-0521,
  4. Fisher WA, Donahue KL, Long JS, Heiman JR, Rosen RC, Sand MS. Individual and Partner Correlates of Sexual Satisfaction and Relationship Happiness in Midlife Couples: Dyadic Analysis of the International Survey of Relationships. Arch Sex Behav. 2015 Aug;44(6):1609-20. doi: 10.1007/s10508-014-0426-8. Epub 2014 Nov 5. PMID: 25370356.
  5. Granville L, Pregler J. Women’s Sexual Health and Aging. J Am Geriatr Soc. 2018 Mar;66(3):595-601. doi: 10.1111/jgs.15198. Epub 2018 Jan 24. PMID: 29363110.
  6. Jannini EA, Nappi RE. Couplepause: A New Paradigm in Treating Sexual Dysfunction During Menopause and Andropause. Sex Med Rev. 2018 Jul;6(3):384-395. doi: 10.1016/j.sxmr.2017.11.002. Epub 2018 Jan 19. PMID: 29371146.
  7. Li H, Gao T, Wang R. The role of the sexual partner in managing erectile dysfunction. Nat Rev Urol. 2016 Mar;13(3):168-77. doi: 10.1038/nrurol.2015.315. Epub 2016 Feb 2. PMID: 26832165.
  8. Nappi RE, Kingsberg S, Maamari R, Simon J. The CLOSER (CLarifying Vaginal Atrophy’s Impact On SEx and Relationships) survey: implications of vaginal discomfort in postmenopausal women and in male partners. J Sex Med. 2013 Sep;10(9):2232-41. doi: 10.1111/jsm.12235. Epub 2013 Jun 27. PMID: 23809691.
  9. Parish SJ, Hahn SR, Goldstein SW, Giraldi A, Kingsberg SA, Larkin L, Minkin MJ, Brown V, Christiansen K, Hartzell-Cushanick R, Kelly-Jones A, Rullo J, Sadovsky R, Faubion SS. The International Society for the Study of Women’s Sexual Health Process of Care for the Identification of Sexual Concerns and Problems in Women. Mayo Clin Proc. 2019 May;94(5):842-856. doi: 10.1016/j.mayocp.2019.01.009. Epub 2019 Apr 4. PMID: 30954288.
  10. Rosen RC, Heiman JR, Long JS, Fisher WA, Sand MS. Men with Sexual Problems and Their Partners: Findings from the International Survey of Relationships. Arch Sex Behav. 2016 Jan;45(1):159-73. doi: 10.1007/s10508-015-0568-3. Epub 2015 Jul 31. PMID: 26228991.