Menopause: A Guide for the Perplexed

Dr. Tracey Fein, M.D., Board Certified, Obstetrics-Gynecology

Senior Attending Physician Lenox Hill Hospital, NYC

Over 20 Years in Clinical Practice

Sex gets a little bit complicated as a woman gets a little bit older and menopause is what fuels this complication. We call it menopause like it’s a monolithic thing but in reality it’s a transitional time that stretches over many years with some symptoms arising at different times, some disappearing and some reappearing later. Its three stages; pre-menopause, menopause and post-menopause can emerge as early as 40 years old and post menopause of course, continues until end of life. This process affects 100% of all women. Therefore menopause should be thought of as an experience of continual change over a considerable period of time requiring a continuum of care.

Understanding menopause is challenging because there are so many variable factors. There is age, health background, genetics, lifestyle, stressors such as kids, aging parents, career and so forth. The symptoms vary from woman to woman which can further complicate the subject. Some women have an easy time with little discomfort; others have great discomfort. Many changes can be specific to an individual; some changes are universal to all.

The first stage, pre-menopause is an effective beginning point for understanding the big picture of menopause which in turn helps to form an effective life plan for dealing with its affects. Getting right to the heart of the matter is the subject of women’s sexuality and how pre-menopause affects it. Being a sexually active woman is something that we like to take for granted from young adulthood to post menopause. We all conceive of our sexuality as a kind of flow state that accompanies us as we progress through life. But this idea of sexual vibrancy is never stable. It arises in puberty, peaks in young adulthood but then the hormones that fuel sexual libido and enjoyable sex diminish then cease to be produced in later years. Sex drive diminishes, the ability to experience pleasure fades. This does not happen overnight, it occurs gradually over time. Symptoms begin to arise but in the pre-menopause phase they are often so subtle that they are either not recognized for what they are or attributed to other factors and then go untreated.

Over years, vaginal dryness, loss of sexual desire and other symptoms become pronounced and at this point many women begin to seek treatment, frequently at the age of 50 or older. Changes however can begin 10 years before that time and recognizing the symptoms of it can help the entire process go much smoother. There are herbal treatments, non-hormonal treatments, low dose hormone treatments and laser treatments. All of them are available and appropriate depending on what a woman prefers and what stage of menopause she is experiencing. There are some treatments that are more beneficial at earlier ages that become less effective later on.

That’s why a strategy for dealing with menopause should begin as symptoms first arise. The best approach for treatment depends on age, health background, stress levels and which if any, symptoms of pre- menopause, menopause and post-menopause are felt. Every woman will have a different experience of menopause because each woman is different, her menopause is not everyone’s it’s uniquely hers.

The North American Menopause Society (NAMS) publishes a list of menopause specialists across the U.S. and women may regard it as an important resource for managing their change of life. Linking up with a doctor who understands the symptoms, their variability, what treatments are available and right for you is an important part of aging gracefully and remaining sexually vibrant though menopause.

#menopause #sexproblems #drtraceyfein #monalisatouch