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Menopause

Menopause is a process of permanent cessation of menstruation at an end of reproductive life that is cause by loss of ovarian follicular activity. It is when the last and final menstruation occurs. Clinical diagnosis can be confirmed after following stoppage of menstruation (amenorrhea) for 12 consecutive months with no other pathology. This is the time a woman is declared to reach menopause only retrospectively. Premenopause refers to the period prior to menopause, postmenopause to the period after menopause and perimenopause to the period around menopause (40–55 years).

Climacteric is the period of time during which a woman passes from the reproductive to the nonreproductive stage. This phase covers 5–10 years on either side of menopause.

Perimenopause is the part of the climacteric when the menstrual cycle is likely to be irregular.

Postmenopause is the phase of life that comes after the menopause.

Age at which menopause occurs is genetically predetermined. The age of menopause is not related to age of menarche or age at last pregnancy. It is also not related to number of pregnancy, lactation, use of oral pill, socioeconomic condition, race, height or weight. Thinner women have early menopause. However, cigarette smoking and severe malnutrition may cause early menopause. Age of menopause ranges around 45–55 years, average about fifty years.

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Few years prior to menopause, along with depletion of the ovarian follicles, the follicles become resistant to pituitary gonadotropins. As a result, effective folliculogenesis is impaired with diminished estradiol production. There will be a significant reduce with the level of serum estradiol from 50–300 pg/mL before menopause to 10–20 pg/mL after menopause. This decreases the negative feedback effect on hypothalamopituitary axis resulting in increase in FSH. The increase in FSH is also due to diminished inhibin. Inhibin, a peptide, is secreted by the granulosa cells of the ovarian follicle. The increase of LH occurs subsequently.

Disturbed folliculogenesis during this period may result in anovulation, oligo-ovulation, premature corpus luteum or corpus luteal insufficiency. The sustained level of estrogens may even cause endometrial hyperplasia and clinical manifestation of menstrual abnormalities prior to menopause. The mean cycle length is significantly shorter. This is due to shortening of the follicular phase of the cycle.

Luteal phase length remaining constant. Ultimately, no more follicles are available and even some exist, they are resistant to gonadotropins Estradiol production drops down to the optimal level of 20 pg/mL → no endometrial growth → absence of menstruation.

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Following menopause, the predominant estrogen is estrone and to a lesser extent estradiol. Serum level of estrone (30–70 pg/mL) is higher than that of estradiol (10–20 pg/mL). The major source of estrone is peripheral conversion (aromatization) of androgens from adrenals (mainly) and ovaries. The aromatization occurs at the level of muscle and adipose tissue. The trace amount of estradiol is derived from peripheral conversion of estrone and androgens. Compared to estradiol, estrone is biologically less (about one-tenth) potent.

When the sources fail to provide the precursors of estrogen for around 5–10 years after menopause, there will be a significant reduce in estrogen and trophic hormones. Then it can be confirmed that the woman is in a state of true menopause.

Diseases that can affect ovaries

Unfortunately women can develop different diseases in their ovaries and besides the physical pain that these diseases bring in some cases they even lead to infertility.

Ovarian cancer is very rare disease and it certainly appears much less than cervical cancer. It is very difficult to detect ovarian cancer and if it is detected early there are fairly good chances for successful treatment. This type of cancer often occurs in women after menopause, in women who have not yet given birth, women that have close relatives suffering from this disease or some similar diseases like uterine cancer, breast cancer and cancer of the end of the colon as well as women who are suffering from obesity. Having all these things in mind, we can conclude that taking birth control pills and breastfeeding significantly reduces the risk of ovarian cancer. This type of cancer can affect one or both ovaries. There are some distinctive symptoms that accompany this disease but they occur very late. Some of those symptoms include – pain in the abdomen, vaginal bleeding, stomach problems, bloating and abdominal tumescence. If the gynecologist during medical examination finds thickenings it is very likely that he will perform laparotomy or/and laparoscopy. Ovarian cancer that is detected at an early stage can be treated with surgical removal of the ovary/ovaries (oophorectomy) and at a later stage with surgical removal of the uterus (hysterectomy).

Another disease that is more common in ovaries is ovarian cysts. They usually occur because of certain irregularities in the release of the oocytes from the follicle. If the follicle is not torn, it can result in a cyst. The vast majority of cysts are benign and some of them increase size, get harder and can cause irregular menstrual cycle, pain and discomfort in the stomach area. Sometimes the pain can occur during sexual intercourse. Gynecologists can discover cysts very easy during medical examination as he explores the area around the uterus and the ovaries. After that he will perform an ultrasound or laparoscopy. Cysts may disappear on their own but some of them need to be removed. In rare cases when the cyst is very large, a surgery may be necessary.

Women usually detect that they are suffering from polycystic ovary syndrome when they find out that they cannot conceive. In this case we are talking about disturbance in the process of secretion of pituitary hormones, which trigger the process of developing eggs in the ovary. Some of the most common symptoms of polycystic ovaries are – irregular menstrual cycles, acne, oily skin, excessive body hair and excessive weight. This disease can be treated with medications that provide normal hormonal balance.

Another thing that must be mentioned when we talk about ovary diseases is oophorectomy. This term is used to describe surgical removal of one or both ovaries. This procedure is usually performed in cases of certain types of cancer, large cysts or as part of hysterectomy. Doctors will try every method before they decide that the removal of the second ovary is necessary.

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Sex after Menopause

A lot of people are wondering if menopause is the last stage in a woman’s active sexual life. The answer is clear – certainly not.

Many people, including both men and women, are convinced that over time, when a woman enters menopause (the period when het fertile age is finished) her ability to enjoy sex is finished too. This of course is completely wrong. Furthermore, there are cases when women in this period of life enjoy sex even more because they are feeling more relaxed knowing that they should not worry about getting pregnant and because of the constant fear that someone might interrupt their sex act. Their children are probably grown and they’ve left the house a long time ago. Although there are some specific changes in the body of a woman in this period that may caused lower sex drive, those changes are not the only reason for low libido. This sex drive can be reduced because of some medications, diseases, and the level of stress that usually comes during this period and possibly because of the lowered self-confidence.

During menopause the body produces lower amounts of estrogen, female hormone and some people believe that this is the main reason for the decreased sex drive. However, many studies have shown that this is not the case. The main factors that cause decreased sex drive are actually linked with the attitude of some women toward their sexuality and their general health. The decline estrogen levels is certainly not the key factor for reduced sex drive and during these studies researchers have found out a really interesting fact – only women who expected that menopause will cause decreased sex drive after menopause feel that decreased sex drive. This means that this problem is linked with psychology too. If a woman has a positive attitude toward sexuality she certainly won’t notice the reduced production of estrogen in her body.

Many women during menopause start taking testosterone. This steroid hormone from the androgen group can be purchased only with prescription. With the help of testosterone women are able to ease some of the menopause symptoms like well known heat waves and night sweating. However, this is not the only benefit of using testosterone. Thanks to testosterone, women can increase their energy levels, improve their overall condition and most importantly increase their sex drive. But besides the positive effects taking testosterone brings some risks too. Probably the biggest danger is developing of breast cancer and although these cases are rare you should be careful with the dosage and follow the instructions.

Having all these things in mind, it’s not wrong to say that there is no general rule when it comes to menopause and sex drive. There is no proven link between menopause and decreased libido and most likely this is a consequence of some other factors and not the changes that occur in the body during menopause. Finally, there is no reason why women should not enjoy sex when they are mature.

How can acupuncture improve your sex life?

We have all heard about the health benefits of acupuncture but little is known about the fact that acupuncture can improve sexual life too.

Acupuncture is a well known ancient Chinese method used to improve better blood circulation and balancing your life energy in your body. As Chinese acupuncturist like to say – acupuncture is trying to find the perfect balance between yin and yang (in this case – male and female energies). An experienced acupuncturist can easily determine a possible imbalance in the body and by placing needles in higher energetic lines (called meridians) he can stimulate the flow of the energy throughout the body.

Acupuncture can help a lot of people. For example, pregnant women can benefit a lot from this practice. The body of a pregnant woman is dealing with a lot of changes during this period. Almost every woman is suffering from some kind of problems during this period; some of them can deal with them easily while others find that difficult. Acupuncture can be very helpful when it comes to morning sickness, reducing the pain in the perineum and some experts recommend acupuncture as an alternative method against pain during labor. This comes as a result of the release of the endorphins thanks to the acupuncture. These endorphins serve as a natural remedy against pain. They also encourage positive thoughts and every persona generally feels better thanks to these hormones.

Acupuncture can also be very helpful for those are entering menopause and even andropause. It can be very useful for women that have problems with vaginal dryness and infertility. Men who are suffering from premature ejaculation and impotence can also try this method.

When it comes to sexual health acupuncture is a known remedy for low libido in both men and women. The acupuncturists focus on certain spots on our bodies like the liver or the kidneys in order to solve these problems. This is very logical if we know that these organs are considered as filters for the body and if they are not working properly this situation can affect the whole body including our sexual organs. Even people who are suffering from sex addiction can benefit from acupuncture. As we have mentioned before acupuncture brings back the balance and sex addiction is an obvious case of body imbalance.

But how exactly does acupuncture work when we talk about sex? First of all, it is not recommended to have sex three hours after and three hours before acupuncture session. The effects of acupuncture can be significantly reduced if you are emotionally distracted and also if you have used some drugs or maybe you’ve had too much food and alcohol.

What makes acupuncture great is that there are almost no side effects. In order to avoid the possibility of side effects find an experienced acupuncturist. Besides that, this alternative method of improve your sexual health is that it doesn’t only affect your sexual health but it also improves your overall health.

Learn more about andropause – male menopause

If you are interested in sexual health and even if you are not, you have probably read something about female menopause. But articles about male menopause or andropause are very rare. Here are some of the things that you should know about andropause.

As you can see the word andropause sounds very similar to menopause and it comes from the Greek words Andros which means Man and Pausis which means End while menopause means end of the menstrual periods. It is worth mentioning that the term andropause is not widely accepted and there are still discussions if it should be used or not.

Whether the term is accepted or not, doesn’t change the fact that there are around 40% of men around 45 to 55 years old that have to deal with andropause. The first signs can be noticed when a man turns 30 years. It is a hormonal change that affects the sensitivity. During the process of aging, men produce less androgen. It is interesting that male and female menopauses have a lot in common and the main difference is that female menopause is a lot more researched. The reason might be the sense of loss of manhood that men feel during this period.

There are some clear symptoms that point to andropause and some of them include – loss or decrease of erection, lack of libido, fatigue, lethargy, depression, irritability, loss of bone mass, nervousness, muscle and joint aches, night sweats, frequent urination, osteoporosis, stress, cardiac arrhythmias, weight gain etc. Some men also feel more maternal, they become more sensitive and kinder.

Mend find very hard to deal with these things and their loss of manhood and that’s why they don’t want to talk about it. However, conversation is one of the most efficient methods for those who want to overcome the problems that andropause brings. You can talk with your friends, partner or doctor or talk with all of them. Just like in any other situation physical activity can be very helpful. And avoiding alcohol and tobacco can be useful too.

It often happens that both partners go through perimenopause simultaneously. This can be very stressful and in some cases devastating for the relationship. The changes in sexuality are very obvious – the erections are not that neither frequent nor predictable/powerful so the man can feel especially embarrassed especially if the woman becomes more imaginative or sexually active in the bed. The feeling of inability to satisfy the partner is constantly present. This situation can be resolved only through conversations. If they are having difficulties, a visit to a therapist is a must. After all they are experts and they have various methods that can help you. All these methods bring changes that can even strengthen the relationship.

Andropause should not be confused with midlife crisis which has its roots in sensibility and it is caused by emotions. Furthermore, midlife crisis usually occurs between 35 and 45 years while andropause usually occurs between 50 and 55 years.