How menopause affects women

The transition through menopause and reaching menopause is experienced by some women as a huge physical and emotional change. Others breeze through it without care or worry. Most of us, though, sit somewhere in the middle.

To get a doctor's perspective, we interviewed Dr. Vivien Brown, a family physician in Toronto who is certified by the North American Menopause Society (NAMS) as an expert in menopause and women's health. NAMS is a leading North American nonprofit organization that helps to promote the health and quality of life of women through the understanding of menopause. Dr. Brown gave her opinion on some frequently asked questions about the symptoms of menopause and how menopause can affect a woman's life.

What impact can menopause have on a woman's life?

Menopause is not a disease. Menopause is a time of transition where the levels of a woman's female hormones such as estrogen begin to decline. Many women may approach this time of their life with a preconceived view of what it means to them, shaped by watching their mother and other female relatives experience menopause. Some women cope better with it than others, and although it's a normal feature of aging, for some women it has a huge impact and can alter their comfort level with their own bodies.

The symptoms of menopause can have a huge impact on a woman's life.

What are the symptoms of menopause? What do you typically see in practice? How common are vaginal symptoms? How common are hot flashes?

Menopause can cause vaginal dryness, hot flashes, sexual dysfunction, joint pain, depression, mood changes, metabolism changes, and sleep disturbances.

Everyone is familiar with hot flashes, but menopause does not equal hot flashes. Some women may not even experience hot flashes.

Vaginal dryness is a common symptom and not necessarily one that women discuss freely or even associate with menopause. There can be discomfort with sexual intercourse if vaginal dryness is not treated.

Sleep disturbance may be related to hot flashes, but not always. Some women may just have trouble sleeping through the night.

The most common symptoms I see in practice are vaginal dryness and hot flashes - these are the symptoms that would often prompt someone to see their doctor.

Most women going through menopause may have some symptoms, but not all are necessarily disabling. I like to compare this situation to women in pregnancy - some women are fine, while others experience nausea and vomiting to varying degrees.

What is vaginal atrophy and how does this affect a woman going through menopause?

Vaginal atrophy is when the normal mucous lining of the vagina loses estrogen and the vagina becomes more fragile. It tears and bleeds more easily, and there is no longer the normal stretch and lubrication that are important in sexual activity.

The vaginal dryness a woman experiences at the beginning of her transition to menopause may not be bothersome and over-the-counter products may help. As a woman transitions further into menopause, the dryness becomes more significant, the tissue gets rawer, there is less elasticity, and the woman gets more uncomfortable with sexual intercourse. She may also experience problems relating to her bladder, such as bladder control issues and more frequent urinary tract infections.

It's very important to note that time will not heal vaginal atrophy. Vaginal atrophy doesn't improve without treatment and, in general, vaginal atrophy gets worse with age.

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