Health Encyclopedia - SpecialTopic
Aging changes in the female reproductive system
The time before menopause is perimenopause. It may begin several years before the last menstrual period. Signs of perimenopause include first more frequent and then occasional missed periods, periods that last longer or shorter,and changes in the amount of menstrual flow. Eventually the periods will become much less frequent, until they stop completely.
Along with changes in your periods, physical changes in your reproductive tract occur as well.
Aging Changes and Their Effects
Menopause is a normal part of a woman's aging process. Most women experience menopause around age 50, though it can occur before then. The usual age range is 45-55.
- The ovaries stop making the hormones estrogen and progesterone.
- The ovaries also stop releasing eggs (ova). After menopause, you can no longer become pregnant.
- Your menstrual periods stop. You know you have gone through menopause after you have had no periods for one year. You should continue to use a birth control method until you have gone a whole year without a period. Any bleeding that you have more than one year after your last period is not normal and should be checked by your health care provider.
As hormone levels fall, other changes occur in the reproductive system, including:
- Vaginal walls become thinner, dryer, less elastic, and may become irritated (atrophic vaginitis). Sometimes sex becomes painful due to these vaginal changes.
- Higher risk of vaginal yeast infections.
- External genital tissue decreases and thins (atrophy of the labia), and can become irritated (pruritus vulvae).
Other common changes include:
- Menopause symptoms such as hot flashes, moodiness, headaches, and trouble sleeping
- Problems with short term memory
- Breast tissue may decrease
- Sex drive (libido) and sexual response may diminish
- High risk of bone loss (osteoporosis)
- Urinary system changes such as frequency and urgency of urination and increased risk of urinary tract infection
- Pubic muscles can lose tone resulting in the vagina, uterus, or urinary bladder falling out of position (prolapse)
Hormone therapy in the form of estrogen or progesterone alone or in combination may help menopause symptoms such as hot flashes or vaginal dryness and pain with intercourse. Hormone therapy has risks, so it is not for every woman. Discuss the risks and benefits of hormone therapy with your health care provider.
To help manage problems such as painful sexual intercourse, using a lubricant during sexual intercourse may help. Vaginal moisturizers are available without a prescription. These can help with vulvar discomfort due to the drying and thinning of the tissues. Topical estrogen applied inside the vagina may help maintain the structure of the vaginal tissues by thickening the tissues and increasing moisture, and sensitivity. Your health care provider can tell you if any of these measures is right for you.
Getting regular exercise, eating healthy foods, and staying involved in activities and with friends and loved ones can help the aging process go more smoothly.
Other Aging Changes to Expect:
Lobo RA. Menopause and care of the mature woman: endocrinology, consequences of estrogen deficiency, effects of hormone replacement therapy, treatment regimens. In: Katz VL, Lentz GM, Lobo RA, Gershenson DM, eds. Comprehensive Gynecology. 6th ed. Philadelphia, PA: Elsevier Mosby; 2012:chap 14.
North American Menopause Society. Estrogen and progestogen use in postmenopausal women: 2010 position statement of The North American Menopause Society. Menopause. 2010 Mar;17(2):242-55.
Reviewed By: Susan Storck, MD, FACOG, Chief, Eastside Department of Obstetrics and Gynecology, Group Health Cooperative of Puget Sound, Bellevue, Washington; Clinical Teaching Faculty, Department of Obstetrics and Gynecology, University of Washington School of Medicine. A.D.A.M. Health Solutions, Ebix, Inc., Editorial Team: David Zieve, MD, MHA, David R. Eltz, Stephanie Slon, and Nissi Wang.