Sex Menopause and Aging

Sex,Menopause and Aging
Presentation by: Dr. Penny Frohlich
University of Texas at Austin

Sex,Menopause and Aging

Overview
The menopause transition
Sexual changes during and after menopause
Early menopause
Hormone replacement therapy
Aging and sexuality in men and women
The “andropause” - male menopause?


MenopauseOvaries become less responsive to FSH and LH
Patterns of GnRH release from the hypothalamus become altered
Pituitary gland becomes less responsive to GnRH

PerimenopauseAverage age at onset in the late 40’s
Irregular menstrual cycles
Somatic and psychological symptoms emerge

Post-menopause12 months of amenorrhea
Elevated FSH levels
On average, reached by the early 50’s

Is that all?No! The ovaries continue to produce androgens after menopause!

Factors that may affect timing of menopauseSmoking
Genetics
Number of pregnancies
Body mass

Symptoms of menopause Hot flashes
Mood swings
Vaginal dryness
Vaginal atrophy
Fatigue, weight gain, sleep disorders, headache, cognitive changes…..

Menopause across culturesDo all women experience menopause as a major negative life event?

Sexual changes at menopauseDecreased sexual desire
Lower levels of vaginal lubrication
More painful sexual intercourse
What doesn’t change?

Early menopauseSurgical menopause
Removal of the ovaries, usually accompanied by hysterectomy
Menopause induced by treatment for cancer
Radiation therapy
Chemotherapy
Early natural menopause

Early natural menopauseAutoimmune disorders
Genetics
Problems in ovarian development
Chromosomal irregularity
Triple X syndrome
Faulty second X chromosome

Hormone replacementEstrogen: systemic or local
Estrogen + progesterone
Androgen replacement?
Potential benefits
Possible side effects

Aging and sexualityHow do you tell what is caused by menopause and what is caused by natural aging?
A recent longitudinal study concluded that sexual arousal and orgasm are affected by both aging and menopause

Sexuality in the elderlyHealthy sexual relationships may continue into old age
Common problems associated with aging include:
Sexual dysfunction
Death of partner
Cultural attitudes towards sexuality
Health problems

The “andropause”Progressive decline of androgens over time
Symptoms: erectile dysfunction, cognitive impairment, fatigue, vague somatic symptoms
40% of men have ED by age 40
Over two-thirds of men by age 70
Is the andropause a disorder?

Sex,Menopause and Aging.ppt