Families who don’t yet know what the word means, please count yourself lucky.
Not-for-profit medical group practice Mayo Clinic describes perimenopause as “the time before menopause when your body is getting ready to stop having periods. Perimenopause is sometimes called the menopausal transition”.
How clinical and boring. While it may be biologically accurate, it could not be further from the hellish reality which is perimenopause.
My wife, F, describes it as a new operating system that downloaded overnight. And the next morning, nothing works the same as before, and you have funky new features you’ve never encountered. Your old settings are forgotten, and you’ll have to find inconvenient workarounds.
As a partner still trying to survive perimenopause, I would just say it’s an operating system refresh that no one expects, and it doesn’t just affect the woman. It affects everyone in the family, necessitating this survival guide.
This piece is written with heavy input from my wife, as we have lived through perimenopause for almost 1½ years now.
One day, my wife of more than two decades was fine, and the next day, I didn’t recognise the woman sleeping next to me any more.
Hormonal havoc
Many women going through perimenopause describe it as hormonal hell. The “flames” include brain fog, mood swings, anxiety, depression, exhaustion and insomnia, all stemming from hormonal fluctuations that disrupt brain chemicals and energy regulation.
What people don’t often talk about is that the family goes through it too.
Perimenopause caused my wife to start heating up like a cellphone with a faulty battery during charging. Remember those Samsung Notes that burst into flames on flights? Welcome to my life.
Imagine going to sleep and waking up to arctic temperatures from the air-conditioning and fan blasting, while steam comes off your previously stably-temperature-regulated wife.
Yes, she’s on fire from the inside, and it’s so cold in your room, you can almost see your breath passing through. Her temperature regulation hormones are in yo-yo mode.
How do you survive? Thicker blankets, thermal underwear, maybe a hot water bottle. But don’t even think of trying to adjust the thermostat if you are still entertaining thoughts of continuing to sleep in your marital bed.
Which brings me to the topic of sleep. Sleeping through the night? Say goodbye to that. You could wake up at any hour and your wife is going to be awake with the whites of her eyes shining with alertness.
Perimenopause caused my wife to become the lightest sleeper. She slept like a rabbit on caffeine, only for the briefest moments, always ready to spring awake to respond to the threat of possible predators.
You might ask, how did I survive my wife’s light sleeping, when my blinking eyelids make such loud noises that they could disrupt her beauty rest? My answer: Don’t blink, even when your eyeballs feel as dry as sandpaper.
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Please don’t ever ask your wife why she’s awake. That will get you stabbed, if not by the carving knife in your kitchen, then by a thousand daggers shooting from her eyes.
I woke up one night to my wife doing a late-night laundry run. An irregular period had hit her, and she felt the compulsive need to strip the sheets and get the laundry done that very moment. Who cares if it was 2am? The laundry had to be done. Period.
On a more serious note, the brain fog, lack of sleep and chronic tiredness result in a huge drain on the mental resources needed just to go about the simple activities of daily living.
A friend of mine, Preeti Mohan, a mother and perimenopause advocate in her mid-40s, shared her own experience.
“There came a point I was absolutely unable to cope, I didn’t even feel like myself any more. I thought I was having early-onset dementia. Everyone around me told me I was not able to handle the stress, and I was burning out.”
During my wife’s perimenopause journey, she suffered through migraines, vertigo and blurry vision so bad that she could not concentrate on her laptop screen at work, resulting in an emergency visit to a neurologist.
Keep calm and seek medical attention
After a year of struggling with perimenopause, my wife eventually agreed to visit our general practitioner.
This started her on a four-month journey of consultations, monitoring, testing and the never-ending drawing of blood.
In all, it took six doctor’s appointments for F to be prescribed hormone replacement therapy (HRT).
It hasn’t been an overnight transformation, but a steady improvement over the last six months she has been on it.
My wife reports that on HRT, she has regular periods, no coping with stains and extra laundry, less tiredness, better sleep and more energy for everything else.
According to a 2025 Stanford Medicine article, “only around 3 per cent of women who are candidates for hormone therapy are actually taking it”. It cites a 20-year medical study of 161,000 women that found no increase in deaths from breast cancer or cardiovascular disease in those on HRT.
HRT can help with perimenopause symptoms and doesn’t increase the risk of dying from breast cancer or cardiovascular disease, a common fear of women who are considering the therapy.
Family showing up
You thought that waking up in the middle of the night was over after the kids stopped needing diaper changes? Forget it. My wife and I are working on this article at 4am, not because of deadlines, but because she’s awake, and that means I’m awake.
When mum struggles, the whole house feels it.
Families that are going through perimenopause will likely have older kids at home. I remember that when my mum was going through perimenopause, I tried to stay away from home as much as possible to avoid her mood swings and irritability. In many ways, I was absent, and I am glad that my sons aren’t.
Having open discussions about what is happening to mum as she goes through perimenopause has given my sons the opportunity to journey with us.
Knowing that she is going through something tough, my two sons have shown up by being extra affectionate, and giving her extra hugs and surprise cuddles, to let her know that whatever she’s going through, she is loved and treasured.
Don’t take things too seriously
Having a sense of humour is important when going through perimenopause as a family.
Between the hot flashes, exhaustion and brain fog-fuelled forgetfulness, there’s plenty to laugh about.
Whether it’s leaving the gas stove on or the cheese wrapper on the dining table after a pre-bedtime snack, don’t let the small things grate. Take it all in your stride and poke fun at it, if everyone is in the right mood.
It matters that the laughter is shared, not at her expense, but in solidarity. Humour lowers the stakes and lightens everything up. Going through perimenopause is not easy, and a sprinkling of laughter and teasing makes it more bearable.
Perimenopause is the first herald of the physical and emotional challenges of ageing. How a family navigates this season – with solidarity, kindness and maybe a chuckle or two – sets the tone for what lies ahead.
Going through perimenopause has been a rich bonding opportunity for the family.
As we continue to age, I am looking forward to taking on our next ageing challenge with F and the family at my side.
Abel Ang is the chairperson of Republic Polytechnic and an adjunct professor at Nanyang Business School.
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