The Quiet Transition

They notice distance growing, they notice intimacy declining, they notice barbs entering what used to be normal conversations. The relationship can begin to feel increasingly functional. Conversations revolve around children’s appointments, grocery lists and trash day. The moments that once felt effortless seem to require more thought, while the changes themselves often remain unspoken because neither partner can fully explain what is happening. Life continues, but it no longer feels as familiar as it once did.

Uncertainty Replaces Familiarity

Over time, that sense of familiarity is replaced by uncertainty. There is uncertainty about what kind of day today will be, uncertainty about whether a conversation will end in connection or conflict, and uncertainty about how to respond when the person you love seems to be experiencing something neither of you fully understands. Even when there are good days, there can be a feeling that the ground beneath the relationship has shifted, making it harder to trust what tomorrow might bring.

During my recent Substack Live, offered an explanation that changed the way I think about this experience.

“Any change has the potential of triggering that threat response.”

Perimenopause is viewed as neither good nor bad. It is simply experienced as something different. That difference alone is enough to capture the brain’s attention. Throughout our evolution, change has often signalled that our environment deserves closer observation, so the brain responds by becoming more alert. It starts watching more carefully, looking for patterns and trying to determine whether this new situation requires us to adapt. Before we have consciously made sense of what is happening, our nervous system has already recognised that something important has changed.

This isn’t a male perspective, it’s a human one. As Paul said later in our conversation:

“It’s safer to assume danger and risk and be wrong than it is to assume safety and be wrong.”

Basic Survival

That’s a basic survival instinct. The brain doesn’t differentiate between a conversation that slides into conflict and being chased by a lion. Physiologically, many of the same systems become active. Heart rate increases, attention narrows and the mind starts scanning the environment more closely. Long before we have consciously decided whether something is dangerous, the brain has already begun preparing us to respond.

When the relationship you’ve relied upon for years begins to feel different, that same system can become active. The rhythm you once knew is disrupted and things that once felt predictable become less so. Plans change. Conversations take unexpected turns. Familiar ways of connecting no longer seem to have the same effect. None of those changes necessarily mean the relationship is in danger, but they are enough to hold the brain’s attention.

That helps explain why many men begin asking more questions. They want to understand what has changed and, more importantly, whether the relationship is still safe. Those questions often focus on impact rather than symptoms. “What’s wrong?” “What can I do?” “How do we get back to where we were?” Meanwhile, their partner may be trying to understand why she is waking at three in the morning, why she feels exhausted or why emotions that once felt manageable now seem unpredictable. They are living through the same transition, but experiencing completely different problems.

I often think about the way men and women search for information online. A man may type, “Why doesn’t my wife want to be close to me?” His partner may be searching, “Why am I awake at 3am every night?” Neither question is unreasonable. They simply reflect two very different experiences of the same stage of life.

At the heart of those searches is something Dr. Paul Jenkins said:

“Threat is always perceived whether it’s real or not.”

Perception Creates Response

If the brain perceives a threat, it responds as though one exists. It doesn’t wait for certainty. That doesn’t mean the relationship is failing. It means the brain has recognised significant change and is trying to work out whether it needs to protect us.

The encouraging part is that the threat response isn’t the end of the story.

“Awareness precedes choice.”

Once we recognise what the brain is doing, we are no longer being carried along by it without noticing. We can recognise heightened alertness for what it is instead of allowing it to shape every interaction. We can ask different questions, slow our reactions and remember that change, on its own, is not evidence that something is wrong.

Perimenopause asks both partners to adapt to a relationship that no longer follows familiar patterns. For many men, that can feel deeply unsettling because predictability has been replaced by uncertainty. The brain has evolved to notice change because, throughout human history, overlooking genuine threats carried enormous consequences. That instinct has served us well for thousands of years. But in a relationship, especially one moving through perimenopause, the changes we notice are often invitations to understand rather than warnings to defend against.

During the Live Paul offered a free ebook called Portable Positivity you can download it here.

You can watch the full conversation here:

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The Midlife Brief

Simon Salt — Fri, 17 Jul 2026 13:26:08 GMT

I’m sharing the posts that I found most interesting and helpful this week.

Some are menopause specific, others are more midlife focused. All have been posts that made my “saved” list.

Let me know if you’ve saved posts and if you think I would find them helpful.

Menopause Transition

AthenaBIO Newsletter

Drug Discovery for Menopause

In Conversation with Dr. Peter Fedichev…

14 days ago · 6 likes · AthenaBIO

Menopause Weight Loss Mentor

WHY TESTOSTERONE ISN’T JUST A MALE HORMONE (AND NO ONE TOLD YOU YOURS WAS DISAPPEARING TOO)

Meet the hormone you’ve probably never had tested, never been told about, and possibly never even associated with yourself.Thanks for reading! Subscribe for free to receive new posts and support my work…

12 days ago · 1 like · Menopause Weight Loss Mentor

Hot & Bothered: A Weekly Newsletter

Menopause Changes "Down South"

Hello from Utah! My husband and I are picking up the car our son has been using during his internship and are driving back to Ohio via three new-to-us national parks. A few years ago we decided we wanted to visit all 63 national parks and after our road trip we’ll have visited 31 - so nearly half way there…

9 days ago · 1 like · Rebecca Mudrick

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Midlife

The Niceness Trap

The Invisible Burden Midlife Women Carry

Last week I climbed into bed completely exhausted…

11 days ago

Awesomely Awake with Shawn Fink

You Are Not Crazy

“You may think I'm crazy, but I'm just telling the truth." — Nina Simone…

15 days ago · 8 likes · 3 comments · Shawn Fink | Awesomely Awake

The Yoga Almanac

We Rested. It Was Bliss.

Good food. Delicious company. A divine swim. And sweet, sweet rest…

15 days ago · 13 likes · 8 comments · Monika Maurer

The Midlife Leap

Neil the Seal, Midlife Women, and the Art of Being Ungovernable

If you’ve ever said “WTF is next?”—you’re in the right place. Subscribe to The Midlife Leap for unfiltered truth, small wins, and big shifts…

12 days ago · 2 likes · 1 comment · Joyce Layman

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The Stories Men Tell Themselves

Simon Salt — Tue, 14 Jul 2026 13:25:37 GMT

When I look back at the beginning of the journey my wife and I have been on over the last eight or so years, I’ve noticed something I was doing then and, if I’m being honest, still catch myself doing occasionally.

Whenever something happened that I didn’t understand, I filled in the blanks myself.

I don’t think I’m alone in doing that, and I don’t think it’s unique to men. What I have realized, though, is that the menopause transition has a way of exposing it. Perimenopause brings uncertainty for everyone living through it, especially the woman experiencing it, but also for the partner trying to make sense of changes that often arrive without explanation.

Looking back, I was reacting to what I believed the changes meant. Somewhere along the way I’d already reached a conclusion. Whether that conclusion reflected reality was almost beside the point because, once I’d accepted it as true, I behaved as though it was.

Simple situations like my wife deciding not to watch an episode of our favourite show and choosing instead to spend some time alone reading a book started to take on meanings of their own. There is nothing unusual about wanting some downtime after work. Taken on its own, it probably wouldn’t have registered at all. But alongside other changes that were happening, I began joining dots that may never have belonged together.

What I’ve realized since is not just that I was doing this, it was how fast I switched to this way of thinking about my relationship. It wasn’t a gradual process. And because it wasn’t gradual I never questioned why it was happening.

I had already decided what those situations meant, for me, for my relationship and for my life going forward. Having made those decisions, completely in isolation, I viewed every other change with the same lens.

As I look back now, I realize I rarely stopped to ask whether the conclusions I’d reached were actually true. Once I’d decided my wife’s behaviour meant our relationship was changing, everything else seemed to support that view. I noticed the evenings she wanted to spend alone more than the evenings we laughed together. I remembered the difficult conversations more clearly than the ordinary ones. Without realizing it, instead of gathering evidence, I was only noticing the pieces that fitted the explanation I’d already accepted.

Over time it became automatic. I wasn’t consciously deciding what each change meant. I simply assumed it meant something, and before long I’d settled on an explanation that felt convincing. Because those explanations arrived so naturally, I never stopped to question where they had come from. They felt less like opinions and more like observations.

“It is not the time to self-blame, to blame others, or assign meaning.”

Natalie Buchwald LMHC

I recognised myself in this quote very clearly. Assigning meaning had become my default response to uncertainty. Every change seemed to require an explanation and, if one wasn’t available, I created one. At the time I thought I was making sense of what was happening. Looking back, I can see that many of those explanations told me more about my own fears than they did about what my wife was actually experiencing.

And that was where I was missing what was right in front of me. My wife’s experience had gradually become secondary to my own interpretation of what was happening. Every change felt personal because I was viewing it through the question, “What does this mean for us?” More importantly, “What does it mean for me?” I rarely stopped to consider that she was living through changes she couldn’t always explain herself. While I was searching for certainty, she was often just trying to get through the day.

I began treating individual moments as evidence instead of seeing them as part of a much larger picture. A hug declined became withdrawal. Less affection suggested we were becoming roommates. A quiet evening felt like distance rather than exhaustion. Each moment seemed to reinforce the conclusion I’d already reached. Looking back, I can see I wasn’t paying attention to everything that was happening. I was paying attention to the things that supported the explanation I had already accepted.

“If your partner has other ways of showing you that they are still there, notice them.”

Natalie Buchwald LMHC

I wasn’t seeing the ways my Wife was still there. I was stuck looking for the things that I thought meant she was instead of recognizing the ways she was able to show her presence now. Slowly I started to see them. And that challenged my way of thinking. If she was still there, was it me that had moved? Had I, in an attempt to understand the changes in our relationship somehow created a whole new reality for myself?

While the way I had constructed this new reality happened quickly, moving away from it took more time. Slowly I started to not assign meanings to things. Not every silence had to be explained. A bad day doesn’t predict a bad week. Things can remain uncertain and not have to be resolved immediately.

I wish I could tell you that this has all wrapped up with a nice bow. It hasn’t, I’m still human, I still catch myself telling stories, seeking explanations, assigning meanings. The difference is I’m less likely to believe those stories.

When Uncertainty Becomes Stress with Simon Salt & Paul Jenkins

Simon Salt — Fri, 10 Jul 2026 15:12:09 GMT

Thank you to everyone who tuned into the live video with !

During the live Paul made available a free guide - Portable Positivity - you can get it at www.drpauljenkins.com/tqt

Available for iOS and Android

The Midlife Brief

Simon Salt — Fri, 10 Jul 2026 13:26:13 GMT

I’m sharing the posts that I found most interesting and helpful this week.

Some are menopause specific, others are more midlife focused. All have been posts that made my “saved” list.

Let me know if you’ve saved posts and if you think I would find them helpful.

Menopause Transition

Beyond Perimenopause

Is It Perimenopause or Midlife? Why Your Fatigue Isn't What You Think

Somewhere in your forties, the story got simple…

16 days ago · Dr.Blessing Anyatonwu,DC,MS

The Uplifters

Protecting Your Brain Health in Perimenopause and Menopause

If you’ve ever wondered, “Is it too late for me to...?” the answer’s NO, and The Uplifters are about to show you why. This space is for purpose-driven women who want to do big, brave things in the second half of their lives. I’m your host, Aransas Savas, and I’ve spent the last 20 years at the intersection of behavior change research and coaching…

Listen now

16 days ago · Aransas Savas

Sarah

What Your Doctor Should Have Told You About Perimenopause & Menopause

Please note: the following is for informational purposes only and does not constitute medical advice. Always consult with a qualified healthcare provider before making changes to your nutrition or exercise routine…

17 days ago · Sarah

FIERCE by mitú

Penélope Cruz Just Taught Us More About Perimenopause Than Our Doctors Did

Last week, a woman on Reddit discovered why her shoulder had been in agony for eight months. Soon enough, she found some answers. However, she didn’t find out from her doctor. She didn’t find out from a specialist. She found out thanks to Penélope Cruz on a beauty brand’s YouTube channel…

16 days ago · 19 likes

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Midlife

Jenna’s Substack

Optimize Your Midlife

In this edition…

17 days ago · 1 like · Jenna Braddock RD

Mindful Drinking & Moderation in Midlife: How to Drink Less

Why Hangovers Hit Harder in Midlife

Drinking in midlife is a completely different experience than it was in your 20s…

22 days ago · 1 like · Denise Hamilton-Mace

Notes from Midlife

Will I Smile When I'm 80?

Recently I’ve been doing some deep thinking. I don’t know if it’s my overactive midlife brain or because I can feel life rushing past. All I know is that my thoughts have been on overdrive…

17 days ago · 5 likes · 4 comments · Ruth Oldfield

Midlife Joybellion

The Power of a Pissed Off Woman

This rage is not chaos; it is clarity sharpened by experience…

16 days ago · 8 likes · 6 comments · Kai Soremekun 🤸🏽‍♀️✊🏽

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35% of Women Say Menopause Influenced their Career Decisions

Simon Salt — Tue, 07 Jul 2026 13:25:08 GMT

When we hear that menopause changes careers, most of us think about promotions, reduced hours or leaving work altogether. We rarely think about what happens when those decisions come home.

The Big Number

In a 2023 study published in Occupational Medicine 35% of women reported that their career decisions were impacted by menopause symptoms.

That number, more than 1/3rd, is large enough to change the workplace and relationships.

A woman who comes home exhausted, who perhaps has less patience because she has been masking symptoms all day at work may well be a very different person than the one who left the home that day.

Beyond the symptoms themselves there is the anxiety of what those symptoms might mean for the household, maybe a reduction in hours, leading to a reduction in pay. They may have guilt about not being able to “perform” the way they used to. A job that was a passion can become a burden.

All this happens invisibly. Their partner sees the end result, they don’t see the burden carried through the workday.

He doesn’t see how brain fog leads to her forgetting a common expression, one that was used daily before, suddenly slipping her mind. He doesn’t see the hot flash that happens in the middle of a presentation, or when helping a customer locate something in the store. The irritability caused by ongoing sleep disruption. This is all happening away from home and yet it impacts it.

“It Was Fine”

What the partner experiences is someone who responds with “it was fine” when asked how their day went. He experiences a partner who has less patience, who is more irritable and he can’t connect the two experiences when he was told “it was fine”.

This is the disconnect. The impact on the relationship. It isn’t influenced by work, it is shaped by the effort needed to get through the work day.

Coming back to the same study - Over half of the respondents (57%) disagreed or strongly disagreed with the statement that there was good awareness and support for employees affected with menopausal symptoms among management. With that type of work environment is it any wonder that she is trying to mask her symptoms? And if that has been the tone of her day it is no surprise that she is exhausted before her evening has even begun.

Home is where she can stop masking, and in fact is somewhere she is most likely to stop masking at all. An uninformed partner may assume the relationship itself has become the problem, when in reality they’re seeing the cost of everything it took to get through the day. Maybe they will take it upon themselves to try and fix the relationship. Those conversations that turn tense, that seem to take on a heavier meaning than they are meant to, those aren’t necessarily a relationship issue, sometimes they are simply a need to recover.

Looking In The Wrong Places

The man may be looking in the wrong place for answers. Instead of looking for answers in the relationship and the home, a better place would be the time spent away from the home. Getting past the “It was fine” and creating a space where the true story can be told. This takes courage from both partners, for one it takes the time to sit and listen to what their partner has to say, and to believe what they are told. For the other it takes the courage to step away from all they are carrying and know that they can unburden themselves.

That is not to say that support is one way or that there is only one experience happening. Both partners are experiencing the menopause transition at the same time, just from very different perspectives. The real work is done in closing the gap between those two perspectives.

Those 35% of women, making decisions about their careers have an impact on the workplace, without doubt. But those decisions don’t stay there. Beyond those decisions is a world outside of work. The personal. And that personal space has to adapt to the changes as well. Maybe that is going to lead to tough financial decisions, cutting back or changing plans. Beyond the physical there is the mental and emotional work that has been performed perhaps for decades, that now needs to be redistributed.

Perhaps it’s time we stop treating work and home as two different stories.

They are the same story happening in two different places.

Want to add to the conversation. Leave a comment. I reply to them all.

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The Midlife Brief

Simon Salt — Fri, 03 Jul 2026 13:25:12 GMT

I’m sharing the posts that I found most interesting and helpful this week.

Some are menopause specific, others are more midlife focused. All have been posts that made my “saved” list.

Let me know if you’ve saved posts and if you think I would find them helpful.

Menopause Transition

My Thoughts on the Matter

No Shit, I Should Advocate for Myself

Women need to advocate for themselves…

a month ago · 4 likes · Sara Larson

The Breadwinners

Perimenopause Barbie?

My 4 year old son was playing with a beat-up pool toy this weekend - hair falling off, arms missing. He looked at her and said, “Momma, what’s wrong with her…

25 days ago · 4 likes · Alexis | The Breadwinners

Dr Fatima Khan

It Starts in the Brain

Cognitive disruption, anxiety, sleep collapse and rage commonly arrive years before the first hot flush. By the time the vasomotor symptoms appear, the brain has already been changing for a long time…

24 days ago · 16 likes · Dr Fatima Khan

Zillion Trillion

am i crazy or is it perimenopause?

So a few weeks ago Alex Taylor & Kate Parfet invited to a “talking circle.” I love them both, so I decided to go, even if I had no clue what a circle was. Were we all gonna braid our hair? Cry together? Burn exes’ photos ? I’m picturing wine, women, soft lighting, someone having an emotional. I said yes before I even read the subject line…

23 days ago · 21 likes · 12 comments · Victoria de la Fuente

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Midlife

Midlife Rising

On overgiving

I sit and type from a vanity unit of a person’s house who means a lot to me…

25 days ago · 3 likes · Rachel Bridget

Midlife BLISS

The Power of Friendships in Midlife

There is a special feeling here on Sundays. More quiet and peaceful than usual. After my lukewarm glass of water, I go for a walk around the garden, usually with Yin, one of our three cats. Eventually James joins us with my cup of coffee, which is more of a cross between cappuccino and latte, and we continue to appreciate our beautiful garden…

a month ago · 6 likes · Luciana Moraes

Midlife Reflections by Christy

What Love Looks Like in Small Things

If you’ve been following this blog for a while, you’ll notice I keep circling this question…

24 days ago · 2 likes · Midlife Reflections by Christy

The Midlife Club

The Grief of Losing the Male Gaze

There is a moment that arrives for many women somewhere in their forties that nobody prepares us for…

a month ago · 4 likes · 2 comments · The Midlife Club

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The Men Who Look Fine

Simon Salt — Tue, 30 Jun 2026 13:26:10 GMT

“The way he fixes things is actually in his ability to hold still.”

This is a quote I had during a conversation recently with about how men hide stress.

I think that this is so counterintuitive for most men. Being still is the opposite of what men think of when they are going to fix things. Without momentum, without forward movement then men believe they are failing.

A man’s partner is awake at 3am, he notices this, he notices that she is tired and irritable the next day, that she isn’t as clear headed as usual. His natural response is to do something, maybe he even asks the question “What can I do?” The response could be anything from a task to “I don’t know”.

We naturally fill those gaps with our own interpretation and meaning. But as Natalie points out -

“It is not the time to self-blame, to blame others, to assign meaning.”

However, the natural path of things is to do exactly that. To self-blame, to blame others and assign meaning. And the types of meanings men apply tend to catastrophize what is happening. Is this about me? Have I done something wrong? Am I no longer enough?

These, and other questions and interpretations are made because of a lack of information and solid feedback. We are often at a point where our partners can’t give it. They are dealing with this transition in their body that is manifesting in many different ways, at different times and on different days. Even if they have language to describe what they are experiencing they might not be able to reliably describe what is going to happen at any given moment.

While we are personalizing and internalizing the changes that are occurring we can often miss the moments where we can shift away from that mindset. Natalie phrased it this way -

“If your partner has other ways of showing you that they are still there, notice them.”

These might be something simple like holding your hand as you cross a parking lot or making sure you have your favorite snacks on game day. They might not be the ways in which you have measured the health of your relationship before. Perhaps using intimacy, both physical and emotional as a barometer to gauge it. But those moments exist and they can be easy to miss if we are looking to the past.

While men are looking to make sense of what is happening externally there is something else going on internally.

Men often look fine, or even say it out loud, when in fact they are suppressing stress, often because they don’t recognize the stress they are holding. What happens when this stays suppressed too long? What happens when that stress has to be released? Back to Natalie -

“...sometimes the only way to get there is through the acting out, is through the outburst, is through the overwhelm.”

For some men this strain can show up physically too, back pain, teeth grinding, aching jaws, an overall tightness in the body. It affects the whole person, physically and mentally. That in turn affects how they show up in the world, and in their relationships.

Men can see suppression as coping. If they aren’t saying it out loud, that they are overwhelmed, that they are confused it can lead to a body that becomes strained to the point of sickness. Natalie described it as -

“Disease, dis-ease... I’m not at ease. You’re holding dis-ease in your body.”

In the end Men become so practiced at appearing composed that they can lose awareness of their own stress. That stress doesn’t disappear, it eventually emerges through behaviour, physical symptoms, or emotional overwhelm.

Holding still can feel like doing nothing, when in fact it’s the act of resisting the urge to panic, to personalize and internalize. To see that not all situations require fixing or a solution, and being comfortable with that. Understanding that the fix lies not in movement but in holding still.

You can watch the full conversation below

Want to add to the conversation. Leave a comment. I reply to them all.

Leave a comment

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This substack runs on copious amounts of tea. If you’d like to support it, you could always buy me a cuppa.

Buy Me A Cuppa

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The Midlife Brief

Simon Salt — Fri, 26 Jun 2026 13:26:09 GMT

I’m sharing the posts that I found most interesting and helpful this week.

Some are menopause specific, others are more midlife focused. All have been posts that made my “saved” list.

Let me know if you’ve saved posts and if you think I would find them helpful.

Menopause Transition

The Synapse by The Cognition Dietitian

The Menopause Misinformation Machine

THE SYNAPSE SUMMARY…

a month ago · 21 likes · 4 comments · Barbie Boules, RDN

ESG’s Substack

Evidence based menopause supplements

The reality is that most supplements marketed to peri-menopausal women have very little evidence behind them…

a month ago · 10 likes · Emma

Cannabis Science with Mia

Women and Weed: Menopause Edition

Let’s be real about it: Menopause is rough. Menopause is hard. But that is because Menopause is the single biggest software upgrade your ECS goes through other than puberty, and even more so than pregnancy. So of course it’s going to be a wild ride…

a month ago · 29 likes · 1 comment · Mia

Dr Reena Wadia

What Menopause Does to the Gums

She is in her early fifties. Meticulous oral hygiene. Has attended regularly for years. And yet the gums bleed more than they used to, the pockets are deeper than her biofilm levels would suggest, and she mentions - almost as an aside - that her mouth feels dry, her gums feel sensitive, and things generally don’t feel quite right. You reinforce the home…

a month ago · 2 likes · Dr Reena Wadia

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Midlife

Midlife Recalibrated

Why “just push through” stops working in midlife

So many of us are programmed to do things the “right way…

a month ago · 1 like · Leah Davidson

Midlife Soul Dating

Why I’m Choosing to Be the “Ugly” Midlife Woman

A quick note: This piece originally appeared elsewhere, but as that publication is no longer online, I’m republishing it here on Midlife Soul Dating, where its themes of identity, self-worth, and self-trust feel right at home…

a month ago · 14 likes · 5 comments · Kim Petersen

Living Midlife Well

Stress and Hormones in Midlife

When we start talking about hormones in midlife most people think of women experiencing issues, but men, stay with me, because you experience hormone issues in midlife too. Just like the teenage year…

a month ago · 2 likes · Janine Lattimore

How to Midlife

She Muted Me, Then Told Me About It

“Congratulations on the Emmy nomination. I wanted to let you know I muted you…

a month ago · 9 likes · 2 comments · Rosie Acosta

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87% of Women Don't Seek Help for Menopausal Symptoms

Simon Salt — Wed, 24 Jun 2026 13:25:46 GMT

And what the implications are of that.

54% of Women Had Three or More Symptoms. They Still Didn't Think It Was Perimenopause.

Simon Salt — Tue, 23 Jun 2026 13:25:55 GMT

A recent Brightfield Group survey found that 54% of women aged 35-55 who said they were not in perimenopause, or weren’t sure if they were, reported experiencing three or more symptoms commonly associated with it.

That’s a significant number.

The symptoms themselves were familiar enough. Fatigue, disrupted sleep, mood swings, weight changes, migraines and brain fog. Most women have probably experienced at least one of those symptoms at some point in their lives. Many women experience several of them while balancing work, family responsibilities and the general demands of everyday life.

What interests me is the gap between experiencing symptoms and recognizing what they might mean.

We often hear that awareness of the menopause transition is improving. There are more books, podcasts, webinars, workplace initiatives and social media conversations than ever before. Public figures are talking about their experiences. Employers are beginning to pay attention. Healthcare providers are showing more interest in the topic.

Yet this figure suggests that awareness and recognition may not be the same thing.

Perimenopause doesn’t usually arrive as a single event. Symptoms appear over time and often seem unrelated to one another. A woman may begin sleeping poorly and think nothing of it. Months later she notices changes in mood. Brain fog appears. Migraines become more frequent. Weight becomes harder to manage.

Each symptom has a plausible explanation on its own.

Work is stressful. Life is busy. Sleep has never been great. Getting older brings changes.

Viewed separately, none of these experiences necessarily point toward perimenopause. It is only when they are viewed together that a pattern starts to emerge. By that point months or even years may have passed.

I think there is another factor at play as well.

Most educational content presents symptoms as a list. We see articles titled “34 Symptoms of Perimenopause” or graphics that neatly organize experiences into categories. The information is useful, but real life rarely arrives in that format.

A woman doesn’t experience a list.

She experiences her life.

The symptoms are woven into everything else that is already happening. Poor sleep becomes part of a demanding job. Irritability becomes part of family stress. Brain fog becomes part of a busy schedule. Weight changes become something to be dealt with later when there is more time.

Nothing announces itself as part of a larger transition.

That may help explain why so many women in the Brightfield survey were experiencing multiple symptoms without identifying as being in perimenopause.

The statistic itself doesn’t tell us whether those women eventually recognized what was happening. It doesn’t tell us how severe their symptoms were or whether they later sought help. What it does suggest is that there are still many women experiencing changes without seeing them as connected.

Much of the conversation around menopause focuses on information. How do we educate women? How do we educate partners? How do we educate employers?

Those are valuable questions.

The Brightfield data points toward another question.

How do women recognize themselves in the information once they encounter it?

Because there is a difference between knowing that perimenopause exists and recognizing that it may explain what you have been experiencing for the last six months, a year or even longer.

The women in the Brightfield survey may have known the word.

What they hadn’t necessarily recognized was themselves.

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The Man Who Looks Fine - With Simon and Natalie

Simon Salt — Fri, 19 Jun 2026 15:03:14 GMT

Thank you to everyone who tuned into my live video!

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The Midlife Brief

Simon Salt — Fri, 19 Jun 2026 13:25:28 GMT

I’m sharing the posts that I found most interesting and helpful this week.

Some are menopause specific, others are more midlife focused. All have been posts that made my “saved” list.

Let me know if you’ve saved posts and if you think I would find them helpful.

Menopause Transition

Go With The Flow: Women's Cycle Awareness

Collab: Untethered & Unapologetic: Midlife, Menopause, and Letting it all Go

I was invited to guest post on Lisa Bolin’s substack, Flucking Flourishing last year…

5 months ago · 3 likes · Jess Mujica

Post nominated by

Neurotribe Substack

I Thought I Was Going Crazy

Neurotribe is a space for honest, nuanced stories about neurodivergent life, work, and creativity, built for people who are tired of “fix yourself” narratives and hungry for something more human. For more: Neurotribe Voices | Instagram | About Neurotribe…

2 months ago · 18 likes · 4 comments · Emilia

Studio to Street

From Hormone Havoc to Hormone Health

Dr. Amy Shah is a double board-certified medical doctor and wellness expert specializing in food allergies, hormones, and gut health. She’s also one of the leading voices in the conversation around women’s health, helping to challenge misconceptions and misinformation, and turn the topic from something that’s whispered about between friends to something…

2 months ago · 17 likes · 1 comment · ALO and Kate Williams

Erica Lemke

Women Kept Telling Me Something Was Wrong. Harvard Helped Explain Why.

Harvard Taught Me What Women Have Been Trying to Say for Years…

2 months ago · 1 like · 1 comment · Erica Lemke

If you find The Midlife Brief useful, please share it with others.

Midlife

Hijacked: Hormones Made Me Do It

The Male Midlife Hormone Crash That's Now Happening at 28

There’s a common story we tell about men. Around 45, maybe 50, he became a little more subdued. Softer around the middle, slightly less driven, and definitely less present. The spice for life that used to run through him when he was younger slowly went out, and everyone just accepts it as the cost of getting older. That’s just what happens. That’s the m…

a month ago · 2 likes · 2 comments · Christalyne Causey

Beyond Normal Science

Q&A with Greg Scheinman from Midlife Male

Greg Scheinman, Midlifemale.com…

2 months ago · Westley Spiro MD

Kristine Moe

Sex and Intimacy in Midlife

S and I dove deep into sex and intimacy in midlife at exactly the moment our youngest daughter launched into her undergraduate education — and not entirely by accident…

a month ago · 1 like · Kristine Moe

Derek Thompson

Why Are Men So Bad at Making—and Keeping—Friends?

There are two problems with the famous “male loneliness crisis”—the loneliness part and the male thing…

2 months ago · 358 likes · 7 comments · Derek Thompson

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The Women We Never Hear From

Simon Salt — Tue, 16 Jun 2026 13:26:02 GMT

I live in a bubble.

The Small Menopause Bubble

This is the realization I came to after a few recent conversations I’ve had with other menopause educators, including one earlier this week with , where we both said that we felt like “everyone” was talking about the menopause transition.

After all there are podcasts, Substack posts, blogs, YouTube channels, webinars and even the rich and famous talking about it. So do we need more voices? The truth is, those of us talking about this on a regular basis do live in a bubble.

My social media feed is full of posts about the symptoms, treatments, the pros and cons of various therapies. What exercises to do, what food to eat, what exercises not to do, what food not to eat. I write about it, and my readers comment. It’s a bubble.

Much of it I have curated so that I hear from valued resources, those grounded in fact and science. It has taken me a while to establish who those voices are and why I should rely on what they are saying.

Whose Isn’t Hearing it?

The conversation hasn’t reached enough women yet. There is still a lot of work to be done. So the quick answer is yes, we need more voices talking about this.

But are all women hearing it?

I wonder whose stories aren’t making it into those reports, podcasts, webinars, social media posts and workplace discussions? Could it be the women who have neither the access nor the time to consume that media?

The same women who don’t have the means or time to access the care that they need? According to U.S. labor data, about 7 in 10 jobs do not require a four-year degree for entry.

That made me wonder about the women we rarely hear from. The women working shifts, serving customers, caring for patients, stocking shelves, driving buses, cleaning rooms, processing orders, and doing a thousand other jobs that don’t leave much time for webinars, support groups, or specialist appointments. Think about that woman who has to work two jobs to provide for her family. Or the woman not only caring for her own family but now caring for aging parents. Do these women have the time or even if they have the time, do they have the capacity to find this information.

Do those women have the time for that webinar at 2pm on a Wednesday afternoon? And even if they do have the time, do they have the energy? Do they have the necessary health insurance to connect with a menopause certified provider? Do they have the time to spend on Google, Reddit, or other places looking for things that match the symptoms they are experiencing?

There Is More Than Just The Numbers

Of course it isn’t just those women who aren’t receiving the message. Several surveys and reports point to the lack of awareness among women in general, one conducted in 2020 showed that 44% of women were unaware of perimenopause until they started having symptoms, another found that of 3000 women aged 40-65 half were unaware of the term perimenopause altogether, and another conducted in 2025 found that only 15% of women surveyed felt adequately informed about perimenopause - meaning a staggering 85% did not.

Those numbers are revealing, but they really only show part of the picture. Women whose responses are in surveys are the women who had the opportunity to respond to them. Social Media conversations reach the people on those platforms, podcasts about menopause reach those already looking for the information. Even my own writing only reaches those people already interested in the topic. That’s not to say that surveys, studies, reports, webinars and podcasts are bad things or unneeded, they definitely are. It’s just that each of those channels reaches the audience it is generated for. Is there an audience of women not being reached because the channel to reach them hasn’t been built yet?

What is the impact of this gap? We find women who “normalize symptoms” as “getting older”. The consequences of that are that there is unnecessary suffering, relationships are impacted, workplaces are impacted, and there becomes a general sense of “this is just how it is now”.

If many women don’t recognize perimenopause when it starts, and most women don’t seek medical help for symptoms (see last week’s post on that), how many are navigating this transition largely on their own?

Perhaps the measure of success isn’t how many more podcasts, webinars, social media posts and workplace initiatives there are, Perhaps it’s how many women who currently know nothing about perimenopause eventually recognize themselves in the conversation.

The bubble isn’t the problem, forgetting it exists is.

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The Midlife Brief

Simon Salt — Fri, 12 Jun 2026 13:25:22 GMT

I’m sharing the posts that I found most interesting and helpful this week.

Some are menopause specific, others are more midlife focused. All have been posts that made my “saved” list.

Let me know if you’ve saved posts and if you think I would find them helpful.

Menopause Transition

Priestess Presence

Wait … Am I In Perimenopause?

You know when you first walk into a shopping mall and look for the giant map, that directory…

a month ago · 1 like · Priestess Presence

The Movement Edit

Perimenopause and Hormones: What Estrogen, Progesterone, and Testosterone Actually Do

I didn’t know…

2 months ago · 4 likes · 2 comments · The Movement Edit

Go With Your Gut Beyond Menopause

The Commercialized Fear of Menopause Symptoms

Welcome in fellow fascinating Sagers…

2 months ago · 12 likes · 11 comments · Karen Langston

The Menopause Pharmacist Rx

All women deserve access to menopause care, not just the ones that can pay

I recently saw two menopause telehealth companies on morning network TV. They were promoting their services with the message that everyone deserves good care! But, their model suggests otherwise…

2 months ago · 7 likes · 5 comments · Dr. Hollie Wakelyn PharmD

If you find The Midlife Brief useful, please share it with others.

Midlife

Medicated Millennial Mom

Is the Millennial Midlife Crisis Really Just a Cry for Nervous System Regulation?

A few weeks ago there was a popular TikTok and Instagram trend going around about “millennial midlife crisis hobbies.” You know the ones: mahjong, pickleball, needlepoint, bird watching, gardening, sourdough, etc. I made one myself and giggled so hard as I was typing it out that I accidentally listed pickleball twice…

2 months ago · 26 likes · Julia Dzafic

Brain Fog & Chill

The Quiet That Crept In: How Midlife Women Become Invisible and What It's Costing You

There wasn’t a moment. Nobody scheduled it. I didn’t wake up one morning and decide to take up less space. It didn’t happen at a party or in a meeting or during a hard conversation. It crept in the way fog does, slowly enough that by the time I noticed I couldn’t see clearly, I’d already forgotten what clear looked like…

2 months ago · 1 like · Shanay 🦋

Moving From Stuck to Soaring

The Yes That Was Never Yours

June Weekly Series: Owning Your No — Essay 1…

2 months ago · 2 likes · 2 comments · Demetria Henderson

A Woman's Second Half

The Midlife Realization About Where Men Fit

One of the strangest experiences of midlife is realizing how thoroughly many women were taught to build themselves around men without ever being told that was what they were doing. If only this kind of clarity existed at 28…

2 months ago · 331 likes · 45 comments · Patri Steele

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Millennials Meet Menopause

Simon Salt — Wed, 10 Jun 2026 13:27:05 GMT

And The Cost Of Being Unprepared

87% of Women Don't Seek Help for Menopause

Simon Salt — Tue, 09 Jun 2026 13:25:55 GMT

A recent Mayo clinic survey found that 87% of women don’t seek medical help for their menopausal symptoms.

That’s a surprising number.

The Story Behind The Numbers

The reasons are even more revealing. 65% said they prefer to manage their symptoms on their own. For 37% time was the biggest factor, a lack of awareness of potential treatments was the reason given by 22% of women and embarrassment as a reason was given by 18%.

What interests me is the other responses.

For 37% of women, time was a factor. That speaks to the type of women I believe are being left out of the mainstream conversations. Frontline workers. Those women who don’t have flexible schedules and for whom taking time off to see a doctor has financial implications, loss of wages and the cost of seeing a doctor when they don’t have adequate healthcare solutions.

A lack of awareness is also not surprising. Women are still left in the dark in terms of adequate and well grounded information about the menopause transition. When they do seek information research suggests it comes from a variety of sources, Google, Friends and Family, social media and online communities. What’s missing from this list is clinicians.

Why Aren’t Doctors The First Place Women Turn?

Why might clinicians be one of the last places that a woman turns to? We already identified that 22% of women weren’t aware of potential treatments. But it’s broader than that. Women often don’t connect the symptoms they are feeling together as coming from one source.

The reality for some women is that they may have faced long wait times to see a doctor, perhaps their doctor wasn’t helpful the last time they saw them, or their symptoms were dismissed.

For 18% of women, embarrassment was a factor. They just didn’t want to discuss their symptoms. Some of that can be cultural, some of it ingrained in them to “not be a bother”.

If some of these women aren’t discussing their symptoms with their doctors and they are discussing them in community spaces where they feel safe discussing this topic, the other person that is likely to be left out of the conversation is their partner.

Where Do Men Get Their Information?

Where do their partners turn? Often to similar sources as the women in their lives, Google, AI and online communities. What they don’t have is the knowledge to leverage those sources properly. While a woman might search or discuss symptoms a man is more likely to search or discuss impact. Those are very different perspectives of the same situation. The symptoms are the root cause of the impact but without understanding that men will often jump to conclusions or even imply reasons that don’t exist.

In the MATE survey 63% of men said they had been impacted by menopause, 25% said it had affected their relationship. Those aren’t symptom discussions, those are impact discussions. In many situations, while men want to help they just aren’t finding the answers that can lead them in the direction that their partner needs most.

There is a big difference in searching for information based on “Why is my wife suddenly so different?” and “How can I help with hot flashes?” The results are not going to produce the same results in the relationship.

If women aren’t primarily getting their information from clinicians and men aren’t getting their information from women, then we have two separate people trying to navigate the same situation in isolation. This information gap can be, amongst others, the source of friction between partners. A lack of shared language, of shared knowledge.

When partners start to close that gap they can navigate this transition together.

Want to add to the conversation. Leave a comment. I reply to them all.

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This substack runs on copious amounts of tea. If you’d like to support it, you could always buy me a cuppa.

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The Midlife Brief

Simon Salt — Fri, 05 Jun 2026 13:25:31 GMT

I’m sharing the posts that I found most interesting and helpful this week.

Some are menopause specific, others are more midlife focused. All have been posts that made my “saved” list.

Let me know if you’ve saved posts and if you think I would find them helpful.

Menopause Transition

Ladyparts

What's the deal with menopause boobs?

My grandmother Kate and her sisters, Ruth and Gussie, all wore the kinds of 1950s-era bullet bras that turned their ample bosoms into, well, not really bullets per se but more like torpedos. I couldn’t wait to have a similarly large and pointy pair of my own…

3 months ago · 190 likes · 16 comments · Deborah Copaken

Nichola Raihani's Substack

Why did evolution give us menopause?

In a typical ant colony, there are the haves and the have-nots. The queen, who can reproduce—and the workers, who cannot. The workers are expendable units, cogs in the machine. They exist only to serve the queen, and to increase the reproductive output of the colony…

2 months ago · 7 likes · Nichola Raihani

Awaken Apothecary

What Comes After Menopause?

Lately, I’ve been feeling like I might be standing at the very edge of menopause. Like maybe the hard yards are behind me, and it’s time to take stock and decide what comes next…

2 months ago · 9 likes · 4 comments · Cindy Johns

Teresa Tarmey

Me, Myself And Menopause

Like a third of the UK female population (a third!) I, am menopausal. And not ashamed to admit it, clearly - I’ve spoken about it in British Vogue, I talk about it regularly with my team and clients and, since I’m being perfectly honest, I am dealing with the fallout of it on a daily basis…

2 months ago · 14 likes · 3 comments · Teresa Tarmey

If you find The Midlife Brief useful, please share it with others.

Midlife

I Hate to Tell You, Darling

GenX is ready to save us all.

Here you are, getting smacked by yet more “unprecedented times” …and who better to be your ride-or-die than a generation that’s been there, done that, and bought the Massive Attack concert T-shirt…

2 months ago · 5 likes · Kirstine Stewart

The Longevity Vault

Why Sleep Gets Easier to Break After Midlife

Today's piece is a little different: Scott Anderson interviewed me about sleep after midlife, why a full night can still leave someone unrested, what sleep trackers can show, and why 3 a.m. wakeups often need a more personal read…

2 months ago · 4 likes · Kat Fu, M.S., M.S.

The Worst Years Of Our Lives: The 2000s

Are Millennials Killing the Midlife Crisis Industry?

Life comes at you fast, huh, fellow fortysomethings? Why, just moments ago, we were coming out of our cages and feeling just fine, wriggling into our skinny jeans and laughing at media coverage about how we didn’t understand the value of hard work, marriage, or…

2 months ago · 91 likes · 14 comments · Gabrielle Moss

The Mythic Masculine

The Second Fire: 1:1 Mentorship for the Midlife Passage

Two decades ago, I graduated university…

Listen now

2 months ago · 7 likes · Ian MacKenzie

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When Midlife Arrives Earlier Than Expected

Simon Salt — Tue, 02 Jun 2026 13:25:56 GMT

“I had barely heard the term perimenopause, even though I’m very well educated and passionate about women’s health.” That was the surprising quote from a recent conversation with Laura Tetenbaum, author of the book Millennial Menopause.

Watch The Recording

I was surprised by this because we typically see millennials as well informed. They are digital natives, they talk openly about subjects that have been previously almost taboo, like mental health. They live in an information rich society. So where is the disconnect?

The lack of good, well grounded and relatable information available for women, while getting better, is still nowhere it needs to be. If it isn’t reaching GenX women, it most certainly isn’t reaching millennial women.

Even when they have some information, some awareness, what they are usually missing is the preparation. What does the menopause transition mean for a millennial woman? Mothers, who may be experiencing this transition themselves may not have talked about it with their daughters, or if they have it may well have been just a conversation about symptoms.

Nobody Expects It Yet

Typically, when we talk about the menopause transition we envisage women in their late 40’s, early 50’s (after all the average age in the US for arriving at menopause is 51). That places those women firmly in Gen X territory.

Except the true picture of the menopause transition is much broader than that. The symptoms can arrive as early as the mid-30’s, and persist for up to 10 years, sometimes longer. These women aren’t expecting this life stage. A lot of them are at a career inflection point, deciding to move forward and embrace new opportunities. Perhaps some of them are considering starting a family or adding to an existing one.

What they are not thinking about is a life stage that changes everything.

As Lauren pointed out:

“Women that I see still tend to not recognize themselves within the label of perimenopause.”

That label just doesn’t fit the image of a millennial woman. But of the 2 million women entering perimenopause each year in the US up to 500,000 of them are millennials.

When Nobody Believes You

The type and severity of the symptoms they might experience are as unique as the woman herself. Perhaps she decides to consult with a medical professional, her PCP or OB/GYN, only to be told that she is too young to be perimenopausal.

As Lauren pointed out in our conversation -

“If someone is constantly telling you, no, you’re fine, and you’re not, that is going to really impact your mood and your sense of self.”

Women being dismissed by the medical profession isn’t something that is surprising. It is especially common with the menopause transition because of the lack of training that Drs receive. So when a woman is told she is fine, her labs look great, she is left with this feeling that there is something else wrong with her. Perhaps she is imaging things, being over-reactive to situations, or just not coping as well as she should.

Then there is the relationship that starts to become strained. I recently had a conversation with a woman who told me her partner refused to believe she was in perimenopause. Even after her Doctor confirmed it for her. Why? Because what did that mean for him if she was at that stage of life, was he suddenly “old”?

This isn’t uncommon among men, to personalize the menopause transition. To place themselves at the center of the issue. They look to fix a situation, to provide a solution. That is what they are taught to do. To solve things. When faced with a situation that can’t be fixed and has no neat solution, they can find themselves facing an identity shift. “Who am I, if I can’t be useful?”

The Ripples Beyond Her

The menopause transition doesn’t stay at home, the symptoms don’t stop at the front door. A woman carries them with her into her daily life. Perhaps she works outside of the home. Does her workplace make accommodations for women facing this life change? Many don’t. I recently heard an HR professional say “Menopause isn’t on our radar yet”.

These ripples affect their partner, they can roll into his work environment, disturbed sleep, a cycle of conflict at home and more means that others are experiencing the impact of the menopause transition without even realizing it. There aren’t workplace accommodations for men experiencing the menopause transition alongside their partners.

The symptoms people talk about, hot flashes, brain fog, mood swings are the focus of a lot of conversations. And those symptoms are very real. But the symptoms don’t stop there. Each woman’s symptoms will vary across a plethora of symptoms (anywhere up to 100). Suddenly that person that was self-confident and had vision and focus, starts to shift. And that shift can bring with it a loss of confidence.

The Opportunity Millennials Have

For some women it isn’t all doom and gloom. For many they find that they have a new clarity about life. Lauren expressed this as:

“I feel like the best version of myself. I know myself. I don’t stand for bullshit anymore.”

What happens when a generation is more informed, more aware and better prepared for this transitional phase?

The symptoms don’t disappear. The hormonal changes don’t become less significant. The challenges to relationships, careers and identity don’t suddenly go away.

What changes is the experience of them.

Women recognize the signs earlier. Partners understand what they are seeing. Conversations happen sooner. Healthcare is sought earlier. Support arrives before years have been lost to confusion, self-doubt and misdiagnosis.

Preparation doesn’t prevent the menopause transition. It prevents people from facing it alone.

And perhaps that is the real opportunity for millennials. Not to avoid this life stage, but to become the first generation to enter it with the language, knowledge and support that previous generations were denied.

Thanks for reading The Quiet Transition! This post is public so feel free to share it.

You can connect with Lauren here:

Website

You can purchase her book Millennial Menopause here

The Quiet Transition

The Midlife Brief

Menopause Transition

Midlife

Why Everything Suddenly Feels Like a Threat

Uncertainty Replaces Familiarity

Basic Survival

Perception Creates Response

The Midlife Brief

Menopause Transition

Midlife

The Stories Men Tell Themselves

When Uncertainty Becomes Stress with Simon Salt & Paul Jenkins

The Midlife Brief

Menopause Transition

Midlife

35% of Women Say Menopause Influenced their Career Decisions

The Big Number

“It Was Fine”

Looking In The Wrong Places

The Midlife Brief

Menopause Transition

Midlife

The Men Who Look Fine

The Midlife Brief

Menopause Transition

Midlife

87% of Women Don't Seek Help for Menopausal Symptoms

54% of Women Had Three or More Symptoms. They Still Didn't Think It Was Perimenopause.

The Man Who Looks Fine - With Simon and Natalie

The Midlife Brief

Menopause Transition

Midlife

The Women We Never Hear From

The Small Menopause Bubble

Whose Isn’t Hearing it?

There Is More Than Just The Numbers

The Midlife Brief

Menopause Transition

Midlife

Millennials Meet Menopause

87% of Women Don't Seek Help for Menopause

The Story Behind The Numbers

Why Aren’t Doctors The First Place Women Turn?

Where Do Men Get Their Information?

The Midlife Brief

Menopause Transition

Midlife

When Midlife Arrives Earlier Than Expected

Nobody Expects It Yet

When Nobody Believes You

The Ripples Beyond Her

The Opportunity Millennials Have

Watch the full conversation