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Sex, Menopause, and Aging

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?. Menopause. Ovaries become less responsive to FSH and LH

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Sex, Menopause, and Aging

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  1. Sex,Menopause,and Aging

  2. 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?

  3. Menopause • Ovaries become less responsive to FSH and LH • Patterns of GnRH release from the hypothalamus become altered • Pituitary gland becomes less responsive to GnRH

  4. Perimenopause • Average age at onset in the late 40’s • Irregular menstrual cycles • Somatic and psychological symptoms emerge

  5. Post-menopause • 12 months of amenorrhea • Elevated FSH levels • On average, reached by the early 50’s

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

  7. Factors that may affect timing of menopause • Smoking • Genetics • Number of pregnancies • Body mass

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

  9. Menopause across cultures • Do all women experience menopause as a major negative life event?

  10. www.youngeryounger.com “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

  11. Sexual changes at menopause • Decreased sexual desire • Lower levels of vaginal lubrication • More painful sexual intercourse • What doesn’t change?

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

  13. Early natural menopause • Autoimmune disorders • Genetics • Problems in ovarian development • Chromosomal irregularity • Triple X syndrome • Faulty second X chromosome

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

  15. Aging and sexuality • 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

  16. Sexuality in the elderly • 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

  17. 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?

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