Although the demographics have changed since the COVID lockdowns, middle-aged women remain a large part of my practice. Many are in their 40s and 50s and are experiencing major changes to their lives and bodies. Specifically, I am speaking about hormonal dysregulation caused by the various stages of menopause.
One of the reasons we started Bioidentical Hormone Replacement Therapy at Medical Weight Loss of New York was because many of these folks were struggling with sleep and low metabolism which was affecting their weight loss. Once addressed, we had happier, healthier patients who lost weight more effectively.
A common theme that arose which I was not expecting was a mismatch between a sense of well-being, libido, etc. between these women and their partners. They would come home energetic and excited for intimacy, only to find their partner sitting in a chair, watching sports, fatigued, out of shape, looking back at them and asking, “What has that doctor done to you?!”
“He can’t keep up with me now.” I hear this frequently. “What should I do?”
We then begin the delicate discussion of how to approach a man going through andropause.
No man wants to feel like the one I described above. They feel lousy and are embarrassed to talk about things like trouble getting and sustaining an erection, loss of muscle strength, etc. Additionally, if you approach him with the subject of Testosterone Replacement Therapy, it is often taken as offending. What is the best approach to the topic? Here are some communication tips to get you back on the same page.
7 Tips for Talking To Your Partner About Bioidentical Hormone Replacement Therapy
- Choose the right moment. Timing and setting are crucial for any serious conversation. Find a moment when you both are relaxed and free from distractions. This could be during a quiet evening at home or a peaceful weekend morning. Avoid times when either of you is stressed or preoccupied with work or other responsibilities.
- Share your own experience. Share your personal experience with BHRT before making it about them. Explain how it has improved your quality of life, energy levels, and libido. Your partner will be more receptive if they see the positive impact the therapy has had on you. For example:
“I’ve been feeling so much better since starting BHRT. My energy levels are up, and it’s really helped with my mood and libido. I think it might be worth looking into for you too. I really miss this part of our lives.”
- Educate yourself on the benefits for him. Before initiating the conversation, educate yourself about BHRT for men, specifically. Start with your own experience as mentioned above, but understanding the common symptoms of hormonal imbalance for men will help you explain the therapy more convincingly and be able to address any concerns your partner might have.
“I’ve read that BHRT can help with low energy and mood swings. It also helps make you stronger and have better recovery from exercise. I have found that to be the case for myself. I think you would love it since you’ve mentioned feeling tired and stressed lately.”
- Be supportive and empathetic. Approach the conversation with openness, but be prepared for resistance. Prepare yourself ahead of time to stay calm if the conversation escalates. Your partner may have reservations, but keep an open space to be able to listen to their concerns and offer reassurance. Make it clear that you’re suggesting this out of love and a desire for both of you to live your best lives.
- Address common misconceptions. There are many misconceptions about hormone replacement therapy, especially for men. Reassure your partner that BHRT is a natural and safe way to balance hormones, using compounds that are chemically identical to those the body produces. You can say something like:
“I know the idea of hormone therapy might sound intimidating, but bioidentical hormones are designed to match our body’s natural hormones. It’s a safe and natural way to get back to feeling like yourself. It’s not a character flaw, it’s a normal process of aging that is totally treatable. If you had a nutritional deficiency causing you to be fatigued, you would replace it. Why not replace a hormonal one?”
- Be patient. Change takes time, and your partner might need some time to think about the idea. Be patient and give them space to process the information. Follow up the conversation gently and occasionally. Be ready to provide additional information, resources, and support as needed. Sometimes they are scared of seeing the provider. I often ask my patients to bring their partners in for a visit with them so they can see that we are supportive and caring and will do a thorough workup including blood work. We will only address necessary deficiencies and in doing so can make a huge difference in their lives.
- Suggest doing it together. BHRT is a great way to improve a relationship, intimacy, and quality of life together. At MWL, we have lots of women who start treatment and later bring in their partners. We even have patients who sync up their treatments, with the women coming in every four months and the men coming in every six months. Taking care of your health with your partner is a team effort as you get older. It’s going to happen eventually, why not enjoy this phase of life together!
