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What To Expect When Entering Menopause

Can Menopause Affect My Sex Life

What should I expect when entering menopause? with Alexandra Band, DO and Melissa Jordan, MD

After menopause, your body has less estrogen. This major change in your hormonal balance can affect your sex life. Many menopausal women may notice that theyre not as easily aroused as before. Sometimes, women also may be less sensitive to touch and other physical contact than before menopause.

These feelings, coupled with the other emotional changes you may be experiencing, can all lead to a decreased interest in sex. Keep in mind that your body is going through a lot of change during menopause. Some of the other factors that can play a role in a decreased sex drive can include:

  • Having bladder control problems.
  • Having trouble sleeping through the night.
  • Experiencing stress, anxiety or depression.
  • Coping with other medical conditions and medications.

All of these factors can disrupt your life and even cause tension in your relationship. In addition to these changes, the lower levels of estrogen in your body can actually cause a decrease in the blood supply to the vagina. This can cause dryness. When you dont have the right amount of lubrication in the vagina, it can be thin, pale and dry. This can lead to painful intercourse.

Menopause Symptoms At Age 45

Around the age of 45 many women enter pre-menopause and start to notice the first signs that menopause is coming. For some women, the symptoms are mild and short-lasting. For others, menopause symptoms can be disruptive and long-lasting.

Some of the earliest signs of menopause may include:

Changes to your period

Period changes are usually the first signs of menopause. For example, your period may start to happen every six to eight weeks. Or you may miss a couple months before it comes back again. You may also have a heavier flow or a lighter flow from time to time.

That said, its important to know you can still get pregnant during perimenopause. So, continue to use birth control in the lead up to menopause as you normally would. Also, if youve missed your period and youre not sure whether perimenopause has started, consider taking a pregnancy test as a first step.

Mood changes

As your hormone levels change, you may find yourself more irritable, anxious, sad or forgetful than usual. Your sex drive can also decrease or increase.

These changes are very typical as your body approaches menopause. So, be kind to yourself, practice self-care and ask for help if youre having trouble.

Sleeping problems

You may find it difficult to get to sleep, or you may wake up in the middle of the night. Sleep trouble can contribute to a constant feeling of tiredness, which can make you moodier.

Menopause: What To Expect And When To Seek Help

When you come to the end of your childbearing years, your body reacts to menopause with a few expected and sometimes uncomfortable symptoms.

Fortunately, there are ways to manage the side effects of menopause, and your physician can help you navigate this phase of your life. While each person will experience a unique set of symptoms during menopause, there are some common changes you can expect during this time of transition.

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How Your Doctor Can Help

Your physician can offer more than just moral support and advice for at-home treatments during perimenopause and menopause. They may also recommend:

Hormone therapy: Menopause hormone therapy can help regulate mood swings and some of the other hormonal changes that occur during your transitional years. Hormone therapy comes with a variety of its own side effects, but you and your doctor may decide its in your best interest.

Oral contraceptives: Despite the fact that youre exiting your childbearing years, oral contraceptives may still be prescribed to you. Birth control pills help regulate hormones and may stave off extreme hot flashes, as well as regulating unpredictable periods during this time of life.

Other medications: Your doctor may also prescribe medications for depression, anxiety, or vaginal dryness. He or she may also recommend over the counter products, including vaginal lubricants and moisturizers.

Going through menopause can bring about a variety of physiological changes. Contact Tri-City Medical Center today if you have any questions or concerns about how to navigate this transitional stage in your life.

How Does Perimenopause Affect My Body

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During perimenopause, estrogen levels decrease. Estrogen is a key female hormone. It plays a role in maintaining many body systems, including the female reproductive system. Estrogen levels may continue to be irregular throughout perimenopause.

When you reach menopause, your body makes so little estrogen that your ovaries no longer release eggs. At this point, you stop having your period.

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How Can You Treat Menopausal Symptoms

The remedies with the most robust clinical data are pharmacological remedies such as hormone replacement therapy. These are among the remedies that have been shown to be the most efficacious in mitigating postmenopausal symptoms. For women who cant take hormones or simply prefer not to, there are other non-hormonal medications that have been shown to help with menopause symptoms such as gabapentin and antidepressants, especially in the selective serotonin reuptake inhibitor family.

For women suffering from vaginal dryness, vaginal hormonal therapy is an option, as are over-the-counter feminine moisturizers. Approximately 50-75% of women use complementary or alternative therapy to help with symptoms associated with menopause. We now have some evidence that cognitive-behavioral therapy and hypnosis are showing promising results for decreasing the quantity and severity of hot flashes.

Anecdotally, the patients most likely to thrive during this decade have been noted to engage in activities that support a holistic approach to health and wellness. Although there arent many clinical studies that can account for their efficacy, these activities can include yoga, exercise, acupuncture, mind-body-based therapy , and mindfulness practices.

Low Estrogen Health Risks


Osteoporosis is when the bones become weak and brittle due to a lack of calcium. Estrogen preserves bone health by preventing calcium loss. When estrogen levels decline because of hormonal changes, it may increase the risk for fractures in the spine, hips, legs, and arms.

Women who drink a lot of alcohol, smoke, and do not exercise are at an increased risk of osteoporosis. Thin and petite women and those with a family history of osteoporosis also have a higher risk of developing this condition.

Heart Disease

Estrogen seems to play a role in protecting the body from heart disease because it may elevate good cholesterol levels in the blood. A sharp increase in heart disease risk occurs with menopause.

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How Does Menopause Affect Heart Health

People are more likely to develop heart disease after menopause. Lower estrogen levels may be part of the cause. It also could be that other health issues that are more common as people get older. These include gaining weight, becoming less active, and developing high blood pressure or diabetes. You can reduce your risk of these health problems by eating a variety of healthy, nutrient-rich foods. It also helps to stay active and maintain an appropriate weight.

Are There Nonhormonal Options For The Management Of Menopausal Symptoms

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Hormone therapy may not be the right choice for you. Some medical conditions may prevent you from safely being able to use hormone therapy or you may choose not to use that form of treatment for your own personal reasons. Changes to your lifestyle may help you relieve many of your symptoms without need for hormonal intervention.

Lifestyle changes may include:

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What To Expect During Menopause: How It Affects The Body And Mind

Menopause is a natural part of aging and yet its often clouded with misconceptions and dread. Knowing what to expect, and how to prevent or minimize the symptoms of menopause can help make it more manageable.

As the body changes, so do your nutrient and lifestyle needs. Lets take a look at what happens during this transition and five ways to promote good health during and after menopause.

The Stages Of Menopause: When It Begins And What To Expect

In this day of endless information and communication, it is puzzling that women are often unprepared for menopause — the unpleasantness of the symptoms, the disruption to our lives, or the psychological impact of realizing were approaching the change.

The transition wont be half as daunting if you have a good idea where you are on in your menopause transition, and what to expect as you move through the stages of menopause.

Knowing which stage of menopause you are in will help you not only understand and be better prepared for the physiological changes and symptoms you may experience, but even more important, will shine a light on the options that are available to you at each stage for symptom relief.

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Dealing With Perimenopause Symptoms

  • Reduce stress as much as possible
  • Avoid alcohol, spicy foods, and caffeine
  • If you smoke, quit
  • Strive to maintain a healthy weight
  • Try controlled-breathing and self-calming exercises like yoga
  • Some women also find a measure of relief in eating estrogenic foods, including soy products such as soy nuts, edamame and tofu, as well as yams, flaxseeds and other plants that contain phytoestrogens. Estrogenic foods contain compounds like soy isoflavones. Daidzein, a soy isoflavone, is changed by gut bacteria into S-equol, a compound that is structurally similar to estrogen and mimics some of its actions in the body, helping to reduce hot flash symptoms.

Is Hormone Replacement Therapy Safe

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A common question is if hormone therapy is safe and whether it can cause it cancer. Hormone Replacement Therapy can increase the risk of Estrogen-dependent Cancer. Its important to see your provider so they can take a thorough history and help determine your risk and whether estrogen is safe for you. There are alternatives such as hormone creams, etc. Theres a lot more options on the market now than there used to be. Everyone is different and your provider can help guide you through this process.

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What Happens To Your Body During Menopause

During menopause, there is a major transformation happening with the hormone levels in the body. All of the physical symptoms of menopause are caused by the fluctuation in hormone levels. Its important to be aware of what the common symptoms are and ask your doctor about them.

Also, its important to note that while your body is going through changes, menopause is not an illness, nor does it mean the end of your sexuality. Here are some changes that will occur:

  • Irregular periods
  • Lower levels of the following hormones:
  • Estrogen
  • Loss of active ovarian follicles
  • General Recommendations For Ht

    Current guidelines support the use of HT for the treatment of severe hot flashes that do not respond to non-hormonal therapies. General recommendations include:

    • HT may be started in women who have recently entered menopause.
    • HT should not be used in women who have started menopause many years ago.
    • Women should not take HT if they have risks for stroke, heart disease, blood clots, and breast cancer.
    • Currently, there is no consensus on how long HT should be used or at what age it should be discontinued. Treatment should be individualized for a woman’s specific health profile.
    • HT should be used only for menopause symptom management, not for chronic disease prevention.

    Initiating Therapy

    Before starting HT, your doctor should give you a comprehensive physical exam and take your medical history to evaluate your risks for:

    • Heart disease
    • Osteoporosis
    • Breast cancer

    While taking HT, you should have regular mammograms and pelvic exams and Pap smears. Current guidelines recommend that if HT is needed, it should be initiated around the time of menopause. Studies indicate that the risk of serious side effects is lower for women who use HT while in their 50s. Women who start HT past the age of 60 appear to have a higher risk for side effects such as heart attack, stroke, blood clots, or breast cancer. HT should be used with care in this age group.

    Discontinuing Therapy

    Safety Concerns

    Women who should not take hormone therapy include those with the following conditions:

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    Ht Forms And Regimens

    HT comes in several forms:

    • Oral tablets or pills
    • Vaginal ring
    • Topical gel or spray

    HT pills and skin patches are considered “systemic” therapy because the medication delivered affects the entire body. The risk for blood clots, heart attacks, and certain types of cancers is higher with hormone pills than with skin patches or other transdermal forms.

    Vaginal forms of HT are called “local” therapy. Doctors generally prescribe vaginal applications of low-dose estrogen therapy to specifically treat menopausal symptoms such as vaginal dryness and pain during sex. This type of ET is available in a cream, tablet, or ring that is inserted into the vagina.

    “Bioidentical” Hormones

    “Bioidentical” hormone therapy is promoted as a supposedly more natural and safer alternative to commercial prescription hormones. Bioidentical hormones are typically compounded in a pharmacy. Some compounding pharmacies claim that they can customize these formulations based on saliva tests that show a woman’s individual hormone levels.

    The FDA and many professional medical associations warn patients that “bioidentical” is a marketing term that has no scientific validity. Formulations sold in these pharmacies have not undergone FDA regulatory scrutiny. Some of these compounds contain estriol, a weak form of estrogen, which has not been approved by the FDA for use in any drug. In addition, saliva tests do not give accurate or realistic results, as a woman’s hormone levels fluctuate throughout the day.

    When Does Perimenopause Start

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    Before you experience menopause, youll go through a transitional period, known as perimenopause. This phase can last for months or years, and usually starts when youre in your mid-to-late 40s. On average, most women experience perimenopause for about four years before their periods stop completely.

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    Trouble Focusing And Learning

    In the lead-up to menopause two-thirds of women may have difficulty with concentration and memory.

    Keeping physically and mentally active, following a healthful diet, and maintaining an active social life can help with these issues. For example, some people benefit from finding a new hobby or joining a club or a local activity.

    Do All Menopausal Women Experience A Decrease In Sexual Desire

    Not all women experience a decreased sexual desire. In some cases, its just the opposite. This could be because theres no longer any fear of getting pregnant. For many women, this allows them to enjoy sex without worrying about family planning.

    However, it is still important to use protection during sex if not in a monogamous relationship. Once your doctor makes the diagnosis of menopause, you can no longer become pregnant. However, when you are in the menopause transition , you can still become pregnant. You also need to protect yourself from sexually transmitted infections . You can get an STI at any time in your life.

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    What To Expect When Entering Menopause

    Maybe you experienced symptoms of perimenopause or perhaps you stood on the sidelines and watched as your friends and loved ones entered menopause. Entering this phase of life is different for every woman.

    Once youve gone a full year without a period you’ve officially reached menopause. In this stage, your ovaries have stopped releasing eggs and making the female hormone estrogen. If youre going through menopause naturally, meaning you havent had a hysterectomy or oophorectomy, your body has been preparing you for this change for a few years.

    Genetics, environmental factors, and your overall health determine when you start menopause, however, the average age is 51 years old. The symptoms that come with menopause are similar to those of perimenopause, but usually last for 4-5 years and are often lower in intensity and frequency.

    Luckily, there are a handful of natural ways to support your health, and ease perimenopausal and menopausal symptoms.

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    Women who’ve made it to the other side share what the experience is truly like.

    The road to menopause can be rocky and challenging.

    During this mid-life transitional moment, your body produces less estrogen and progesterone hormones. Those plummeting hormone levels can cause profoundly unpleasant side effects that may take place for a few months, or occur for several years, according to the Cleveland Clinic. Think of it as a late-in-life puberty do-over.

    You may be familiar with some signs of approaching menopause, such as hot flashes, brain fog, difficulty sleeping, and moodiness. But reading through a list doesn’t reveal just how dramatic the experience feelsnor are all symptoms of menopause common knowledge. This definitely has its downsides.

    Had I known more I could have spared myself quite a bit of fear and worry, says Jodie Waskis*, from San Clemente, California.

    To help mentally prepare you for what could lay ahead, Prevention spoke with five women about their most surprising menopause symptomsthe extreme fatigue, primal rage, and morealong with what they wish theyd known before entering this life phase.

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    What Triggers A Hot Flash

    There are quite a few normal things in your daily life that could set off a hot flash. Some things to look out for include:

    • Caffeine.
    • Tight clothing.
    • Stress and anxiety.

    Heat, including hot weather, can also trigger a hot flash. Be careful when working out in hot weather this could cause a hot flash.


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