What Changes in the Body/Mind?
Estrogen receptors are located in tissues throughout the body. Decreased estrogen may impact cognition resulting in mood changes and forgetfulness. Skin and mucus membranes gradually become thinner and dryer, resulting in vaginal discomfort. Urinary issues, such as stress or urge incontinence, urinary tract infections, interstitial cystitis – a form of chronic inflammation of the bladder without infection – are common. Osteopenia and osteoporosis may result in injuries, contributing to a more sedentary lifestyle. Thyroid dysfunction may lead to heart palpitations, difficulty sleeping, anxiety, hair loss, and dry skin. The adrenal glands, which produce hormones to help us cope with acute stress, may be overworked resulting in adrenal fatigue, which contributes to day-time tiredness. Notably, these changes may significantly alter self-image. Depression and anxiety may result from lack of focus or motivation – particularly for women having trouble adjusting to retirement, or that of a partner, or those experiencing “empty nest syndrome.”
Just as teens and young adults receive messages about “ideal” appearance, aging is vilified in the media everywhere – especially for women. Advertisements for plastic surgery feature women who obviously do not “need” any. Skin products and nutritional supplements are called "anti-aging." Sexual dysfunction is often related to self-image and body image changes. Longstanding relationships are vulnerable. Withheld communication and unfinished business with intimate partners can have a more significant impact on sexual desire, responsiveness and satisfaction than symptoms of physiological menopause. Communication about changing needs and desires can make or break a sexual relationship. Concerns about decreasing “attractiveness” and rejection may be barriers for both men and women.
Midlife as a Bridge to Yourself
Sexuality and Wellness during and after Menopause
by Susanrachel Condon LM
For many women, midlife is a bridge from a time of intense focus on others to a shifting focus inward. Those who have grown children and are not needed to care for special needs adult children or aging parents, may find this a time of uncertainty but also of powerful reflection - the second adolescence.
Having spent decades in some cases focusing on personal or professional productivity and choices about childbearing, perhaps experiencing reproductive anxiety and actually raising children, many women find themselves with bursts of creativity hunger for change, enhanced self care, and craving good communication. During and after peri-menopause, which can span as many as ten years, women often feel a growing need to "speak their minds" and express themselves creatively. They speak frankly and take up new endeavors. They return to school, end dysfunctional relationships, join groups and seek intimacy with peers. Those who do not are more prone to chronic illness, social isolation and depression. Physiologic changes triggered by decreasing hormone levels are often the focus of clinicians; while psychosocial needs go unmet. Healthcare providers should listen to women, across the entire lifespan.
The best news is that recent studies have consistently demonstrated a strong sex life has more to do with how healthy you are than how old you are. Cuddling, massage, skin to skin contact, smooching and orgasm stimulate oxytocin secretion. Oxytocin, the hormone of love, is also a life-extending, miracle hormone. It is anti-inflammatory, promotes intimacy, improves sleep, prevents blood pressure spikes and reduces cravings for sweets, drugs and alcohol. The studies also show that resolving existing difficulties through enhanced communication and/or counseling can have an effect on your sex life comparable to having a new partner. It heals. For some women, acceptance of their bodies, increased closeness with their partners after children have
grown, and scheduled time for self-care enhance libido. A healthy sex life, considered in these studies to be related to intimacy 2-4x monthly, can boost immunity, promote cardiovascular health, alleviate stress and increase longevity.
Support for Transitions
Remedies during peri-menopause and beyond may include bioidentical hormones, which are prescribed and made at a compounding pharmacy to meet your specific needs following saliva or blood testing. These hormones may reduce symptoms to make the transition through menopause smoother. Usually in a cream form, they are readily absorbed through the skin. Working with an herbalist is an option for those who prefer to avoid pharmaceuticals.
A nutritional approach should include a whole foods diet, decreased intake of sugar and processed foods, and added immune builders. These are probiotics, fermented foods, anti-inflammatories and anti-oxidant rich foods, extra B & D vitamins, and omega 3 fatty acids. Good sources of healthy fatty acids and immune builders include fresh fruits and vegetables, avocados, walnuts, salmon, fish/algae/krill/flax or borage oils and phyto-estrogens found in organic soy, green tea, and ground flax seeds.
Stress reduction is key to health. Body/mind practices such as qi gong, tai chi, meditation and yoga have been shown to significantly reduce stress, enhance endurance and flexibility and improve mood. Exercise improves sleep, metabolism, bone density, mood and cardiovascular health. The best exercise plan would include weight-bearing exercise which increases heart rate and perfusion of tissues for 30 minutes daily. Ideally, combine cardiovascular exercise with relaxation,
restorative yoga, meditation, or try hypnosis. Get a massage or receive acupuncture regularly. These modalities treat pain and a variety of physical ailments but also soothe the adrenals and contribute to increased endorphins and seratonin, the hormones related to feelings of eurphoria and well-being.
Sexual Satisfaction and Health
For vaginal dryness and irritation or decreased lubrication during sex, consider natural remedies such as coconut oil or other moisturizers several times weekly. Topical aloe juice is soothing after sexual activity if irritation occurs. It doesn’t disrupt pH balance like some synthetic products do. Only silicon or water-based lubricants should be used with condoms. Avoid lubricants with scents or “warming” chemicals. Be sure to empty your bladder before and after sexual activity to enhance comfort and reduce the risk of urinary tract infections.
Health, infection and cancer screening for women has changed drastically during the last several years. Routine pelvic exams are not considered necessary in healthy, asymptomatic women. If you have new partners, consider having both of you tested for sexually transmitted infections. Women between 30 and 65 are advised to have pap smears with human papilloma virus (HPV) co-testing every 3-5 years. Consult your healthcare provider about your cervical cancer screening plan, which should be based on your history and sexual behavior. We now know that almost all cervical cancer is caused by HPV, so the days of annual pap smears are over. Menopausal women who experience vaginal bleeding more than one year after the cessation of menstruation should consult their healthcare providers about endometrial biopsy to rule out uterine cancer. Breast cancer screening options include self-breast exams, clinical breast exams at a healthcare provider’s office, baseline mammograms at 40 and annual mammograms starting at 50. Depending on your history and your family history, you may make a different plan. Thermography, while not covered by most insurance plans, offers a non-invasive way of assessing breast tissue, and does not use radiation.
Women who are informed and proactive about their health and healthcare should seek providers who support their life choices and openly discuss lifestyle compassionately and without judgment. With a strong support system, each woman can build her bridge to a fantastic future.