Menopause refers to the period in a woman's life when her last menstrual period occurs. It also marks the transition period when the body stops making estrogens. Menopause usually occurs between ages 40-55. The loss of hormone production can have many effects such as:

• Hot flushes
  
• Night sweats
  
• Vaginal dryness
  
• Mood swings
  
• Disrupted sleep
  
• Nausea
  
• Bladder infections
  
• Decreased sexual desire
  
• Palpitations

   Menopause can also increase the risk of osteoporosis. During menopause women stop producing eggs and are no longer able to become pregnant. Menstrual periods happen less often and finally stop. The reduction in a hormone estrogen and progesterone causes the symptoms of menopause. A gradual decrease in hormone levels will produce only minor effects, but sudden decreases in estrogen levels can produce more severe symptoms. This may also happen after the uterus and ovaries have been removed ( surgical menopause).

Menopause and sexual intimacy

   No evidence suggests menopause reduces a woman's desire for sexual intimacy, but due to what doctors call atrophic vaginitis or vulvovaginitis (vaginal dryness), it may bring on discomfort. Although they never discuss it even in private with their doctors, many women experience vaginal dryness during and after menopause.

   Many women accept genital discomfort as part of the natural aging process. Because the problem of vaginal dryness does not get much attention, women erroneously see it as a result of poor hygiene or stress. In actuality, vaginal dryness usually occurs because of declining estrogen levels associated with menopause. During reproductive years, estrogen functions in keeping genital tissues elastic and moist. For example, when a woman is aroused, estrogen allows vaginal tissues to become lubricated. If estrogen levels fall, vaginal tissues produce less lubrication. Sex may become uncomfortable, even painful without proper lubrication. As women age, the vaginal walls become thinner and more vulnerable.

   During menopause, vaginal lining decreases from three layers of cells to one or two. Thus, some women may not feel relieve with over-the-counter lubricants. Although this product provide moisture, they fail to produce regrowth of loss cell layers. Vaginal dryness and thinning are part of aging; however, Premarin, Prempro, and Premphase can help atrophic vaginitis and aid in the production of vaginal secretions.

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