By Valinda Harlan, LMHC, LPC | Bright Future Counseling LLC | Couples Counseling PNW Perimenopause and symptoms of menopause can start in your 40s. Couples counseling can help Key Takeaways Menopause is a significant hormonal and emotional transition that affects not just the person experiencing it, but the relationship as a whole. Mood changes, body image shifts, sleep disruption, and loss of sexual desire are all common, and none of them have to permanently damage your rel