Transcript Early menopause

Sex,
Menopause,
and Aging
Overview
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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?
Menopause
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Ovaries become less responsive to
FSH and LH
Patterns of GnRH release from the
hypothalamus become altered
Pituitary gland becomes less
responsive to GnRH
Perimenopause
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Average age at onset in the late 40’s
Irregular menstrual cycles
Somatic and psychological symptoms
emerge
Post-menopause
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12 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 menopause
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Smoking
Genetics
Number of pregnancies
Body mass
Symptoms of menopause
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Hot flashes
Mood swings
Vaginal dryness
Vaginal atrophy
Fatigue, weight gain, sleep disorders,
headache, cognitive changes…..
Menopause across
cultures
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Do all women experience menopause
as a major negative life event?
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“Study after study documents the astonishing
effects that estrogen makes women not only
feel better but healthier. Estrogen vastly
improves the quality of day-to-day life for
women by making them more youthful,
energized, and healthier.”
–www.youthtek.com
www.no-wrinkles.com
www.agelessforever.net
Sexual changes at
menopause
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Decreased sexual desire
Lower levels of vaginal lubrication
More painful sexual intercourse
What doesn’t change?
Early menopause
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Surgical menopause
– Removal of the ovaries, usually
accompanied by hysterectomy
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Menopause induced by treatment for
cancer
– Radiation therapy
– Chemotherapy
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Early natural menopause
Early natural menopause
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Autoimmune disorders
Genetics
Problems in ovarian development
Chromosomal irregularity
– Triple X syndrome
– Faulty second X chromosome
Hormone replacement
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Estrogen: systemic or local
Estrogen + progesterone
Androgen replacement?
– Potential benefits
– Possible side effects
Aging and sexuality
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How 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 elderly
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Healthy 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”
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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
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Is the andropause a disorder?