Genetics, sun damage, fat redistribution, smoking, and the decline in estrogen at menopause all contribute to the loss of collagen and elasticity and to the uneven skin tone of aging skin. Decreased water and fat content of the skin as well as reduced sweat and oil production contribute to dryness. Using effective sunscreen, moisturizing, staying hydrated, and not smoking all help improve your skin’s appearance and prevent further damage. (Just make sure you get adequate vitamin D if you are diligent about sunscreen and covering up.) There are many products on the market for aging skin, but only the topical retinoids have a well-documented ability to repair it. Even hormone therapy does not have solid evidence that it helps aging skin, so you should not use it just because it might be helpful.
Sexual desire decreases with age in both sexes, and low desire is common in women in their 40s and 50s, but not universal. Some women have increased interest, while others notice no change at all. There is no major drop in testosterone at menopause. If lack of interest is related to discomfort with intercourse, estrogen may help. What’s important to remember is that there is a full range of psychological, cultural, personal, interpersonal and biological factors that can contribute to declining sexual interest, so if the decline in desire is bothering you, tell your healthcare provider. A clinical evaluation can identify any underlying medical or psychological causes of low sexual desire, which then can be treated as appropriate.
Vaginal dryness is extremely common during menopause. It’s just one of a collection of symptoms known as the genitourinary syndrome of menopause (GSM) that involves changes to the vulvovaginal area, as well as to the urethra and bladder. These changes can lead to vaginal dryness, pain with intercourse, urinary urgency, and sometimes more frequent bladder infections. These body changes and symptoms are commonly associated with decreased estrogen. However, decreased estrogen is not the only cause of vaginal dryness. It is important to stop using soap and powder on the vulva, stop using fabric softeners and anticling products on your underwear, and avoid wearing panty liners and pads. Vaginal moisturizers and lubricants may help. Persistent vaginal dryness and painful intercourse should be evaluated by your healthcare provider. If it is determined to be a symptom of menopause, vaginal dryness can be treated with low-dose vaginal estrogen, or the oral selective estrogen-receptor modulator ospemifene can be used. The Mona Lisa Touch is a new therapy for the treatment of vaginal dryness that is non hormonal, non medication and non surgical that has been FDA-approved using a gentle laser. Regular sexual activity can help preserve vaginal function by increasing blood flow to the genital region and helping maintain the size of the vagina. Without sexual activity and estrogen, the vagina can become smaller as well as dryer. The Mona Lisa Touch is a new therapy for the treatment of vaginal dryness that is non hormonal, non medication and non surgical that has been FDA-approved using a gentle laser.
Most women make the transition into menopause without experiencing depression, but many women report symptoms of moodiness, depressed mood, anxiety, stress, and a decreased sense of well-being during pre-menopause. Women with a history of clinical depression or a history of premenstrual syndrome (PMS) or postpartum depression seem to be particularly vulnerable to recurrent depression during pre-menopause, as are women who report significant stress, sexual dysfunction, physical inactivity, or hot flashes. The idea of growing older may be difficult or depressing for some women. Sometimes menopause just comes at a bad time in a woman’s life. She may have other challenges to deal with at midlife, and menopause gives her one more problem on her list. It has been suggested that mood symptoms may be related to erratic fluctuations in estrogen levels, but limited data exist on why this occurs. Antidepressants are the primary pharmacologic treatment for menopause-associated depression. Menopause hormone therapy and hormone contraceptives can be used as off-label therapies, especially in women with concurrent hot flashes. The wide range of psychological symptoms reported during the menopause transition, from irritability and blue moods to the recurrence of major depression, can be identified and often treated by a woman’s primary care provider or a menopause practitioner.