Aging changes in the female reproductive system

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Menopause

Symptoms that accompany menopause vary in severity. Many of the symptoms are triggered by the hormone changes. Only about 20% to 30% of all women have symptoms that are severe enough that they seek medical attention.

Changes occur in the woman's breast tissue at the same time as other reproductive changes. A woman may experience changes in her sex drive (libido) and her sexual response may change, but aging does not prevent a woman from being able to have or enjoy sexual relationships. Most often, things such as availability of a partner, symptoms from vaginal dryness, and psychological and social factors affect a woman's sexual response more than direct aging changes.

COMMON PROBLEMS

The pubic muscles lose tone, and the vagina, uterus or urinary bladder can fall out of position. This is called vaginal prolapse, bladder prolapse, or uterine prolapse, depending on which structure collapses. A prolapse of any of these structures increases the risk of problems such as stress incontinence (urine leakage). Most prolapses can be treated.

Irritation of the external genitals can occur (pruritus vulvae). The vaginal walls become thinner and dryer and may become irritated (atrophic vaginitis). Sexual intercourse may become uncomfortable for some women (dyspareunia). There are changes in the levels of normal microorganisms in the vagina, and there is an increased risk of vaginal yeast infections.

Similar changes to the bladder and urethra may increase symptoms such as frequency and urgency of urination, and there is an increased risk of urinary tract infection after menopause.

Hot flashes, mood disturbances, and sleep disturbances are also common symptoms that occur during menopause. The causes of these changes are not well understood, but they are also related to the decreasing amount of estrogen produced by the ovaries.

Osteoporosis risk is greater in older women. This is, in part, caused by decreased estrogen levels.

PREVENTION and TREATMENT

Adequate lubrication (with a water-soluble lubricant) can help prevent painful sexual intercourse. A topical estrogen (applied inside the vagina) is sometimes recommended to help maintain the structure of the vaginal tissues. Sexual changes are most frequently related to factors other than simple aging.