There comes a point in many women’s lives when what once felt manageable no longer does. Not because they are failing. Not because they are too sensitive. Not because they suddenly became difficult. But because midlife has a way of bringing the truth to the surface.
For many South Asian women, that truth is layered. It lives in the body, yes, but also in culture, conditioning, silence, duty, shame, identity, and the quiet weight of everything we have carried for far too long. Menopause is often spoken about as a hormonal event, but for so many women, it is also emotional, relational, psychological, and deeply revealing. It can stir questions that have been buried under years of coping: Who am I now? What am I no longer willing to endure? What is this stage of life asking me to see, say, and change?
That is why I wanted to speak with Shireen Noor. Shireen is a psychoanalytic psychotherapist and licensed couples therapist in private practice in Hertfordshire and London. Her work sits at the intersection of trauma, culture, migration, identity, and decolonising psychoanalysis, with a particular focus on South Asian experiences of mental health. She also has a deep interest in the psychological shifts of midlife for South Asian women, especially the way this season can invite a powerful rethinking of self, relationships, and life direction.
In this conversation, we explore what menopause can begin to expose in relationships, why silence and endurance have such a cost, and how midlife can become not just a destabilising chapter, but a deeply transformative one. We talk about inherited scripts, emotional labour, intimacy, shame, and the quiet but radical act of becoming more honest about what you need.
If you have ever felt like you were carrying more than anyone could see, or like this season of life is changing you in ways you struggle to explain, I think this conversation will meet you where you are.
In South Asian cultures, women are often taught to endure rather than express. In midlife and menopause, what does that endurance start costing us in our relationships?
Yes, in South Asian culture, women take on a lot. The subliminal message is to endure, to be selfless. But I often say the meaning of selfless is ‘thinking less of yourself’, but at what cost? Menopause symptoms are not just hormonal. They reflect years of psychosocial stresses of navigating culture, tradition, honour of the family and expectations, and these can take a toll. The positive is that menopause is a wake-up call for many women; they become more aware of what they have been enduring. It becomes a point in their life that they feel that they can say no and express what is acceptable to them. I don’t think it has been at a cost to their relationships; in fact, it can strengthen relationships. It’s being able to know that you can put healthy boundaries. Menopause is a phase in life to rethink what is toxic in relationships, friendships, career and family. It is a time for growth, transformation and investing in yourself.
You work with couples around culture, interfaith dynamics, in-laws, and mixed marriages. Where do you most often see menopause becoming the unspoken third person in the relationship?
I like your question, Kiran. I believe that any life-changing event can become an unspoken third person in a relationship if we allow it to be and give it power. This can be an in-law, partner, friend or illness and also menopause. Menopause is a natural phase of life; we know every woman will go through it. How it impacts us and how we relate to it is up to us. I believe that menopause can be a life-transforming experience; it’s our body’s way of telling us its ok to pause, reflect, reassess and reinvent.
Many women describe feeling disconnected from themselves during menopause. What does that self-disconnection tend to trigger in a partnership, even when there’s love?
Menopause is a stage of transition in a woman’s life; it is not just our bodies that are changing, but we change mentally too. What was familiar and known to you is no longer familiar; you don’t understand what is happening to you. Hot flushes, insomnia, irritability, exhaustion, your moods may fluctuate and shift.
Now add your partner witnessing these changes, if neither of you have information about menopause and don’t communicate, suffer in silence, you might end up blaming yourself. If couples don’t communicate, they grow distant. You both may end up feeling guilty or blaming yourself. Couples need to keep talking, even when it feels uncomfortable. This is where therapy can help if you need it, even for a brief time.
If you could name the top three misunderstandings partners have about menopause, what are they, and what do you wish partners understood instead?
The first is the lack of information; many women and their partners simply don’t have enough information about what menopause involves. Please find your tribe, by that I mean women like you in a similar stage of life. Their journey might be different, but a community is essential to share, listen and support one another.
The second is the belief, is it me? Is something wrong with me? Am I not enough anymore? Women can internalise physical and mental changes that are not their fault as a personal failure. Remember, it is ok to pause, look inwards, and listen to what your body and mind are telling you.
The third is comparison. The thoughts or being told by other people, too, my mother, mother-in-law or auntie went through it, she was ok, so I should be too. But every woman and every generation’s experience is unique. Circumstances and emotional histories are not identical.
In South Asian families, conversations about sex, desire, and emotional needs can be loaded with shame. How does that show up in couples’ work during midlife?
Shame has many layers of meaning and nuances in the South Asian culture. It is rooted in ancient histories, patriarchy, religion and rituals which are part of our everyday lives. It can mean honour and also plays a regulatory function in what is ok to speak about and what is not spoken about. Topics such as women’s reproductive systems, periods, childbirth and pregnancies, menopause, and sex are often wrapped in silence. If a couple has never felt comfortable and open to approach and speak about sex, emotional needs and desire, this silence and discomfort will not disappear in midlife. In couples’ therapy, we gently rework the narrative. There is nothing wrong with rituals or traditions, it is part of our identity. But it is not shameful to express pleasure, to verbalise your desires and the meaning of sex. Midlife can be a powerful moment for both partners to rewrite the script and come together to spark a new energy in their relationship
You speak about inherited belief systems. What are some inherited scripts South Asian women carry into marriage that become harder to live with during menopause?
Many South Asian women carry inherited beliefs in their lifetime, in their relationships and into marriages. The sublimated message that comes through to women is to be accommodating, not to bring shame to the family; they are protectors of honour in the family. The expectation to be a good wife who adjusts, a good mother, and desires becomes secondary to duty and care for others. These scripts may have worked, or at least felt manageable, in younger years. Menopause is like a light bulb moment, when self-awareness deepens, and living life the usual way starts to suffocate. Many women tell me that they don’t want to spend the next 30-40 years of their lives living life the way they have done in the past. Menopause often amplifies the question, who am I beyond service?
A lot of women say: I’m not the same person, and I don’t know how to explain it. What’s a good starting point for a conversation with a partner when words feel impossible?
When a woman says, I am not the same person and she does not know how to explain it, that is already the first step towards being vulnerable and starting a conversation. Nobody is looking for fancy words or a solution. It’s ok for the partner to respond, ‘I don’t know the solution, but I am here to listen, and if you need my help to find a way through, let’s work together. This is enough because it means I care for you and am here to support you.
For women navigating perimenopause while also parenting teens, caring for elders, and holding a career: what relationship patterns do you see emerge under that kind of pressure?
When a woman is navigating perimenopause while parenting teenagers, caring for ageing parents and holding a career, the pressure can be immense. I often see patterns of over-functioning, trying to be perfect and doing their best not to disappoint, specifically herself. As a consequence, resentment can quietly build, and emotional withdrawal can follow. If there has never been shared emotional labour in the relationship, menopause exposes that imbalance. It is not that menopause creates the problem. It reveals what was already uneven, and cracks that were there can become more apparent. The coping strategies that were working before stop being effective.
You work with themes like migration, identity, racism, and attachment trauma. How do these deeper layers complicate menopause and intimacy for South Asian women specifically?
This goes for all women, that menopause does not sit in a vacuum. In the case of South Asian women, add migration histories, racism, shame, expectations of what it means to be a woman, attachment wounds and the pressure to succeed in a new country while preserving culture. A woman learns to survive through endurance, silence and compliance. Menopause can destabilise that coping strategy, and that can feel frightening.
Intimacy may become complicated because for intimacy there is a need to be vulnerable and express your desire, enjoyment and pleasure. But when these have not been expressed, menopause can become even more complicated where intimacy is concerned. Many women may completely shut out intimacy because of the shame that surrounds it. This is why I believe that for South Asian couples, cultural and relational context matters deeply.
If a couple is stuck in blame or distance right now, what’s one small, practical shift you’ve seen create the fastest sense of reconnection?
If a couple is stuck in blame or distance, the fastest shift I often see is moving from defending and attacking to being curious. Make a cup of tea or coffee, sit together, talk, share and listen. Even if it’s five minutes a day, intentional, uninterrupted listening can begin to soften distance, listen, hear and feel. Think about how you would be with a child? Be kind, gentle, share and allow space for sharing. It sounds simple, but it is not always easy, yet it is powerful.
What I appreciated so deeply about this conversation with Shireen is that she did not reduce menopause to symptoms alone. She spoke about it as a threshold. A revealing. A wake-up call. A moment when the patterns, silences, and survival strategies that once kept a woman going begin to feel too tight to live inside anymore.
And I think that matters, because for so many South Asian women, midlife is not simply about hot flushes, sleep disruption, or changing hormones, though those things are real. It is also about finally noticing the emotional cost of a life lived in accommodation. It is about seeing where duty has overshadowed desire, where silence has replaced honesty, and where endurance has been mistaken for strength.
What Shireen reminds us so beautifully is that this season does not have to be the beginning of disconnection. It can be the beginning of a deeper truth. In ourselves, in our relationships, and in the way we choose to live from here.
Midlife can be the point where a woman stops asking, How much more can I take? And starts asking, What do I need now? What is no longer mine to carry? What would it mean to relate to myself and the people I love, with more honesty, tenderness, and courage? That is not selfish. That is wisdom. And maybe that is one of the quiet gifts of this chapter: the invitation to stop disappearing inside your own life.
I hope this conversation leaves you feeling seen, soothed, and perhaps a little braver about the conversations you need to have, with your partner, with your family, and with yourself, because you are allowed to change. You are allowed to need more. You are allowed to outgrow old scripts. And you are allowed to create relationships that can hold the woman you are now becoming.
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