9 questions about menopause you’ve been too embarrassed to ask

Menopause is known for its many different hormonal changes. You might expect some of the menopause symptoms that come before or after this major change, while others will come as a surprise – and may even be a little embarrassing. Here are the most common questions people have about menopause symptoms with answers from top doctors.

This is a common complaint as women approach menopause, says gynaecologist Dr Jason James, “Hormonal changes can result in a drop in free testosterone, the hormone responsible for libido. This, coupled with physical changes and new life stressors can cause women to complain of a drop in or lack of desire for sexual intimacy,” he says. There are some medical options for treatment, but most solutions involve working together as a couple to ensure foreplay and intimacy are prioritised.

Find out more about the three stages of menopause here.

This is a common issue for many menopausal women. Gynaecologist, Dr Steven A. Rabin, had a patient who ceased having orgasms altogether once she hit menopause. He shares, “It turns out she had severe [vaginal] atrophy. The thin, dry skin had shrunk so much it covered over her clitoris, a condition called clitoral phimosis. We were able to help with local oestrogen cream and after six weeks she was back to her old self.”

Dr James says that the hormonal changes of menopause can cause atrophy in the tissues of the vagina and pelvic floor, which can lead to episodes of incontinence with certain activities such as coughing, laughing, sneezing, or jumping. This is called stress urinary incontinence because of physical stress on the pelvic floor. “In addition, hormonal changes can exacerbate overactive bladder symptoms, which cause sudden urges to urinate or leaking before reaching the toilet. Treatment options include bladder retraining, physical therapy, Kegel exercises or surgery,” he says.

Here are some tips on how to cope with an ‘overactive’ bladder.

Night sweats are another form of hot flash that come with perimenopause. Hot flashes, including night sweats, can vary from rare occurrences to dozens a day. Dr James recommends nutritional supplements, prescription medications, and hormones that can alleviate these symptoms, along with regular exercise, diet modifications, and the use of a fan in the bedroom to promote air circulation.

“Vaginal atrophy, a symptom of menopause, can cause vaginal dryness, which leads to pain during intercourse. This pain can cause a feedback loop, which results in a lack of desire to have sex. Increased foreplay, use of vaginal moisturisers, lubricants, hormones, or other medications can all lead to improvement of this common complaint,” says Dr James.

And Dr Rabin takes this further by saying, “Menopausal women experience a peak in their dryness and pain with sex about four years after their final period. The loss of elasticity leads to the inability to accommodate their partner even with gobs of lubrication.” Up until recently, many of the treatments to help with vaginal dryness were oestrogen-based, which may be off-limits for women with a personal or family history of cancer.

Many women experience a decrease in their metabolism that accompanies menopause. “A diet and exercise regimen that once allowed for weight maintenance might now need to be tailored for stricter calorie restriction, carbohydrate reduction, or increased exercise to yield the same results,” says Dr James. Belly fat can be a particularly frustrating menopause body change.

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“Severe emotional mood swings, can have significantly detrimental effects on interpersonal relationships as women journey through menopause. Simply recognising these mood changes can go a long way in minimising their impact,” says Dr James. He recommends exercise, nutritional supplements, cognitive behavioural therapy, along with medications such as antidepressants or hormone replacement therapy to minimise the effect of these mood changes.

Excessive hair loss and excessive hair growth are common during menopause. Unwanted facial hair is called hypertrichosis. It’s very common during and after menopause and is another result of hormonal changes. Dr James says that a thorough review of a patient’s medication regimen and laboratory tests can help pinpoint common causes of hair loss in women and that there are many options available for treatment, so see your doctor or seek out a specialist that concentrates on female hair loss.

Find out how to cope with female hair loss.

Dr Rabin says that every day he has conversations with his patients between ages 40 and 70 about this very issue. “Menopause is marked by the retirement of the ovaries. When they stop producing hormones, specifically oestrogen, many of the tissues in the body begin to change. Vaginal dryness, itching, and cracking make it difficult to go through the day.” He recommends vaginal moisturisers, local oestrogen therapy, systemic hormone therapy as well as other non-hormonal prescriptions based on your needs and goals.

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Source: RD.com