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 Perimenopause, Menopause and Sexuality

Perimenopause means "around menopause" and refers to the time during which the body makes the natural transition to menopause, marking the end of the reproductive years. Perimenopause is also called the menopausal transition.

Women start perimenopause at different ages. Some may notice signs of progression toward menopause, such as menstrual irregularity, brain fog, or memory loss sometime in their 40s, while other women notice changes as early as their mid-30s.

The level of estrogen — the main female hormone — in the body rises and falls unevenly during perimenopause. The menstrual cycles may lengthen or shorten, and they may begin having menstrual cycles in which the ovaries don't release an egg (ovulate). Some may also experience menopause-like symptoms, such as hot flashes, sleep problems and vaginal dryness. 

Once a woman has gone through 12 consecutive months without a menstrual period, they have officially reached menopause, and the perimenopause period is over.

Post-menopause is the period that follows menopause, and lasts the rest of her life.

Some women experience early menopause as a result of surgery, like a hysterectomy, or a natural occurrence; this is known as early or premature menopause.

WHO MENOPAUSE AFFECTS

Menopause affects all women at some point in their lives.

The length of time of perimenopause varies woman to woman—for some women, it only lasts two or three years; for others, it can last 10 to 12 years. The hormonal changes that are a precursor to menopause actually start years before a woman begins menopause.

Menopause can also affect partners, families, and friends. For example, if her sexual desire changes, this may affect her partner. Possible changes in her mood could impact her partner, family, and friends. Despite the risk for impacting their lives, women may find that those closest to them are the most supportive during this time in their lives.

SYMPTOMS OF MENOPAUSE

There are many different symptoms of menopause, due to the various impacts the reduction of estrogen will have on the body:

• Changes in her period: Her periods may be irregular in terms of how much she is bleeding, the duration, and the frequency.
• Hot flashes: These are very common because they are related to the amount of estrogen in the body. A hot flash is a sudden feeling of heat in the body. Most hot flashes last between 30 seconds and 10 minutes and can occur at any time.
• Problems with the vagina and bladder: Decreased levels of estrogen can make the vagina drier, cause vaginal tissue and muscles to become thinner (called vaginal atrophy), possibly making sexual intercourse uncomfortable. Women experiencing this may find it hard to hold urine long enough to go to the bathroom, or may leak urine during exercise, sneezing, coughing, or laughing.
• Sleep problems: She may start having trouble getting a good night’s sleep. This could be caused by insomnia, night sweats, or other reasons.
• Mood changes: She might find herself moodier, irritable, or depressed around the time of menopause.
• Changes in her body: Weight or muscle gain, thinning skin, stiff or achy joints and muscles, or memory problems.
• Osteoporosis: A thinning of bones that makes them less dense, which is a common occurrence during menopause.

Hormone Replacement Therapy

Hormone Replacement Therapy (HRT) is a medical approach commonly used to alleviate menopause symptoms in women. HRT involves supplementing these hormones to alleviate these symptoms and improve overall quality of life.

Great strides have been made with what is known about the positive affects of HRT. What was once considered high risk by some medical professionals, new studies have provided updated data about the potential benefits. 

While HRT effectively addresses menopausal symptoms, its use involves careful consideration of individual health factors, potential risks, and benefits. As with any medical intervention, consultation with healthcare professionals is crucial to determine the most suitable approach tailored to a woman's specific health profile and needs. 

Since there is a great deal of misinformation about HRT, women should seek the advice of a doctor specifically trained in menopause treatment. Women should be suspect of Hormone Replacement approaches that do not take into consideration their individual health factors (like the Hormone Cottages or other such firms that have become popular in recent years). 

EFFECTS ON SEXUALITY

• Due to the decrease in estrogen throughout menopause, some women may experience vaginal dryness, a decrease in natural lubrication, and thinning of their vaginal tissue, which can make sexual activity uncomfortable or painful.
• After menopause, some women feel they have more freedom to express their sexuality because they are no longer worried about becoming pregnant. Some women notice that their arousal and desire has increased or decreased. Changes are different for each woman, and can vary over time and through the different stages of menopause.
• During and after menopause it is important for a woman to understand that what she is experiencing is normal, and many other women are probably experiencing the same things. It is also important that she understand that what was pleasurable for her years ago may not provide the same type of pleasure.

STAYINGHEALTHY

Staying healthy before, during, and after menopause can help reduce the risk of health problems associated with menopause, including osteoporosis and heart disease.

Staying healthy is easy, although it may require some changes in lifestyle. A woman who wants to practice a healthy lifestyle should:

• Not smoke.
• Eat a healthy diet—high in fiber, low in fat, with plenty of fruits, vegetables, and whole-grain foods.
• Get plenty of calcium and vitamin D in her diet to help prevent osteoporosis.
• Learn what her healthy weight should be and strive to maintain it (your health care provider can help with this).
• Do weight-bearing exercises, such as lifting weights, at least three days a week to maintain healthy bones.
• Get regular check-ups from her health care provider, including pelvic and breast exams, Pap smears, mammograms, and colon, rectal, and skin cancer exams.
• Focus on your emotional and mental wellbeing by relaxing and spending time with friends and family.

For women going through menopause, most have found that regaining and maintaining their sexuality can happen through the following:

• Communication: talking to her partner about what feels good, what doesn’t, and any concerns she may have—including low desire, body image issues, and anything else. Especially anything that’s changed as a result of menopause – this will open up the door to opportunity to explore. Additionally, she should keep the dialog open with her doctor, who has a full scope of her medical history.
• Foreplay: Because issues can impact a woman’s confidence in the bedroom, foreplay will allow the opportunity to build excitement and arousal, and possibly offset their decreased desire. They should explore and find new erogenous areas on the body that can turn them on with touch or stimulation.
• Water-based Lubricant: A water-based lubricant can help sex feel more comfortable and pleasurable for a woman experiencing the side effect of vaginal dryness, as it will mimic her natural moisture and is pH balanced.
• Vaginal Wellness Products: Kegel exercises are a great option for women going through menopause to strengthen their vaginal walls, and avoid the negative side-effects impacting bladder.
• Foreplay: Spend more time in foreplay to help build arousal and lubrication. Explore and find new erogenous areas on the body that can turn you on with touch or stimulation.