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Treatment of Pregnancy and related Disorder
Treatment of Irregular Periods
Management of Pregnancy
Treatment of Ovarian Cysts
Management of Pregnancy Query
Treatment of Painful Periods
Avoiding Pregnancy Procedures
Treatment of Painful Sexual Intercourse
Treatment of Heavy Periods
Treatment of Polycystic Ovary Syndrome
Treatment of Breast Pain
Treatment of Vaginal Discharge
Treatment of Miscarriage
Treatment of Vaginal Itching
Treatment of Fertility
Treatment of Delayed Periods
Treatment of Vaginal Infection
Management of Fertile Period
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Sexuality in all its forms can be an important part of our health and identity. However, in the indian society sexuality is often considered the domain of the young, and the idea of older women having and enjoying sex sits uncomfortably with many people. The ideas of older women’s sexuality often stem from Victorian times, where the woman was passive in her sex life, and sex was mainly for reproductive purposes Hence, the idea was that sex would stop after the menopause.
The menopause is often described as a very negative time for women, especially in medical literature. On the other hand, many feminists celebrate the menopause and subsequent years as a time of positive change, without the commitment to childrearing, and a time to find new fulfilment. The experience for each individual woman is probably somewhere in the middle.
Hormonal changes in the menopause, such as a drop in oestrogen levels within the body, can bring about physical changes such as vaginal dryness, which can affect the sex life. But at the same time, there are many ways of adjusting to these bodily changes that can lead to new ways of lovemaking.
Physical complaints and sexuality:
Vulval discomfort -
When you get older, your body produces less oestrogen. This can cause vaginal dryness, which means that sex might become less enjoyable or even painful.
Urinary Tract Infections (UTIs)-
When a woman’s vaginal walls become thinner because of lower levels of oestrogen in her body after menopause, penetrative sex can not only cause vaginal discomfort, it can also cause urinary irritation or urinary tract infections. This is because the urethral passage also thins. Penetration might irritate the bladder and the urinary tract through the thin walls of the vagina. This irritation can lead to infections.
Sexually Transmitted Infections (STI) and AIDS-
Articles and books on STIs hardly ever talk about older women specifically, but STIs as well as HIV/AIDs are on the increase in older women. This might partly be because women after the menopause do not need to use birth control, and therefore also do not use protection such as condoms anymore. If you have had the same partner for many years, and your partner has also not had any other sexual partners, the risk of getting a sexually transmitted infection is low. But if either you or your partner has unprotected sex with anyone else, the risk is increased. There are many different STIs, and some of them do not have any symptoms. However, if you notice any unusual or smelly discharge from the vagina, bleeding, blisters, itches, pains or sores, you should go to a sexual health clinic.
Sometimes women may experience pelvic cramps during or after sex, especially women who have penetrative sex. It is more likely to happen if you do not have orgasms very often, and is generally nothing to worry about. Just like any muscle in the body, it can ache if it doesn’t get used very much and then gets a lot of exercise.
Sometimes, changes in the family can be difficult to adjust to when getting older, for example if your children leave home or you stop working and retire. It can help to talk with your friends and your partner about these changes and how they make you feel.
Because of the physical changes that occur as part of the aging process, it is possible that you may feel less comfortable with your body and that you lose some of your self-esteem. But again, these changes happen gradually, and many women adjust well to them.
However, if fatigue or psychological illnesses such as chronic depression or anxiety develop, they can interfere with your libido and sex life.
Medications and sexuality:
As women get older, they are more likely to need long-term medications. Often, these medicines have side effects that influence libido, for instant blood pressure medications, and tranquillisers. However, alternative therapies might be available, and if you think that medication impacts negatively on your sex drive, speak to your doctor and ask if there is an alternative. Antihistamines and other drugs can cause drying of the vagina, and although this might not influence your libido, it might curb your enjoyment of sex.
Many women actually enjoy sex more in later life, maybe because they are more experienced, and know what they want. In addition, there may be more opportunity for spontaneous sex, for instance if you have children who have now left home. Overall, women in their late 40s are said to be much more likely to have fulfilling sex lives and multiple orgasms than women half their age 5.Women’s sexual response is different from men, and many women do not have ‘spontaneous desire’, meaning it may not be until starting to engage in some sort of sexual activity that they start to feel sexual desire, and many women do not have any sexual feelings or thoughts, unless engaging in sexual activity. Because women’s sexuality is so complex, it might actually be more appropriate to try and solve occurring problems with counselling and medication.
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Most women attain menopause between the ages of late 40s and early 60s, the average age being about 51. This is an important milestone in a women's gynecological history. One major change is altered female hormone levels, and this leads to a lot of physiological changes. From hot flashes to mood swings, there is also increased predisposition to osteoporosis and uterine cancer.
If you have not had your menstrual cycles for close to 12 months, chances are you are into menopause. So, that means absolutely no vaginal bleeding anymore whatsoever. However, if you experience bleeding, even spotting, be on the alert. It is not normal and needs to be examined, and if required, diagnosed and treated.
Postmenopausal bleeding or PMB, as it is popularly called, can be due to a variety of reasons. While it could be something as trivial as inflammation of the uterine or vaginal lining, it could also be an indication of more severe issues like cancer.
- Atrophic vaginitis: Decreasing hormonal levels lead to increased dryness and therefore inflammation of the vaginal and uterine tissue. This is one of the common causes of bleeding after menopause.
- Endometrial atrophy: Also caused by lower hormone levels, the lining of the body of the uterus gradually thins down and can get inflamed.
- Polyps: Noncancerous growths in the uterus, cervix, vulva, or vagina can also lead to bleeding.
- Infections: General infection of any area along the uterine tract could lead to occasional bleeding.
- Cancers: Though only 1 in 10 PMB cases turn out to be cancers, the prognosis improves with early diagnosis and intervention.
Diagnosis: As repeated above, reach out to your doctor if you notice postmenopausal bleeding. Diagnostic methods could include the following:
- Physical examination
- Transvaginal ultrasound
- Endometrial biopsy
- Dilatation and Curettage
Treatment: Needless to say, this would depend on the diagnosis. For very minor cases with diagnosis like altered hormone levels, no treatment may be required other than modification of the hormone replacement therapy. For endometrial atrophy and atrophic vaginitis, use of estrogen creams and pessaries would be sufficient. Polyps would require removal followed by cauterization (application of slight heat) to stop the bleeding.
Cancer: This would depend on the type and location and require a combination of chemotherapy and surgery. Removal of the uterus also may be required in some cases. So, if you have had bleeding of any sort after a year of menopause, do not ignore it.