Menopause: Questions women are thinking, but not asking

Dr. Deepali Patni

Menopause: the permanent end of fertility (and periods!) that commonly happens to women in their late 40s and 50s. For many women, just saying the word “menopause” can increase anxiety levels. Change is never easy, especially as we get older. And although menopause symptoms night sweats, mood swings, sleep problems, weight gain — make it seem like a daunting time in a woman’s life, there are many things that your gynecologist can do to help you through this transition. One of the issues I find in my own practice is that there is plenty of misinformation about menopause, making it hard to separate myth from fact. Talking with your gynecologist about this very important change can help alleviate some of the confusion and maybe even improve your symptoms.

Frequent questions that have come up in my practice include:

My sex drive isn’t what it used to be. Why? There are many hormonal changes that a woman experiences in her transition to menopause. Estrogen and testosterone levels may drop, causing a decreased interest in sex or vaginal dryness, which can make sex uncomfortable. If loss of libido is an issue for you or your partner talk to your gynecologist. He or she can work with you to determine the most appropriate treatment plan. Sometimes the fix can be simple, such as increasing the time that it takes for you to become aroused before intercourse, or incorporating the use of a lubricant or moisturizer. Other times, a gynecologist will recommend hormone replacement therapy. Although there aren’t any FDA-approved testosterone replacement products for women, in the appropriate patient, testosterone combined with estrogen replacement can have a beneficial impact. Keep in mind testosterone therapy can have significant side effects and the long-term risks have not been fully studied.

Menopause has made sex painful. What can I do? If you’re one of the menopausal women who suffer silently from pain during intercourse, you are not alone. Many don’t realize that vulvovaginal atrophy is a common condition that happens as a result of the thinning and weakening of vaginal tissues due to a drop in estrogen after menopause. Make an appointment to see your gynecologist to talk about the available treatment options, which range from vaginal moisturizers and water-based lubricants to topical or oral estrogen treatment. Do I still need to worry about sexually transmitted illnesses? Sexually transmitted illnesses are and always will be a concern for women, even menopausal women. If you are not in a mutually monogamous relationship, always use a condom to help protect against diseases that can be passed through sexual contact. Sexually transmitted illnesses do not discriminate based on age, and I’ve seen menopausal women who have contracted chlamydia, gonorrhea, genital herpes, syphilis and HIV.

What about pregnancy?

Pregnancy in menopause does not happen, but there are some women who believe they have reached menopause and became pregnant, only to find out later that they were still perimenopausal. The general rule is that if you have not had your period in 12 months, then you are in menopause and unlikely to get pregnant. This can be confirmed with a simple blood test.
I’m feeling a lot of pressure down there. Is that bad? Little alarm bells should ring if you are feeling constant pressure in your pelvic area. It doesn’t necessarily mean that something life threatening is happening, but now would be the time to make an appointment with a gynecologist to get it checked out. If you have reached menopause, there are many things that could be causing pressure in the pelvic region, ranging from constipation and fibroid tumors to pelvic floor disorders and cancer. Do not let this symptom go unchecked. Women who have questions about menopause should seek a trusted source for information. Your gynecologist is ready to help guide you through this next phase in your life.

– blueprint.com