Change of life : a psychological study of dreams and the menopause
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Changes to sex drive. But for many, the decreased estrogen, progesterone, and testosterone that come with menopause create a reduced interest in, and pleasure from, sex. Some women experience pain during intercourse.
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Estrogen helps to keep vaginal tissues elastic and lubricated, and low estrogen can lead to thinning of vaginal tissue and vaginal dryness that may make sex uncomfortable. Among my patients who experience this common symptom, the change in sex drive often creates frustration and confusion, as they wonder why their interest in sex feels different—and wonder how to revive that interest.
These emotional and relationship challenges generate worry, frustration, and anger that can compromise sleep. In my next post, I will discuss three symptoms of menopause that a person with menopause may experience and how they might be physically damaging sleep. Sweet Dreams ,. Michael J. Breus, Ph. He is the author of Beauty Sleep. Part 1: A few natural ways to help you sleep better during menopause. Many women struggle with sleep in menopause.
Sleep disturbances in menopause | HealthEngine Blog
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Subscribe Issue Archive. Back Today. Consider Sleep and Screen Time. If a woman with POI does not wish to become pregnant, although the risk is very small, she is advised to use contraception. The combined oral contraceptive pill provides not only contraception, but hormone replacement. Speak to your doctor regarding the appropriate treatment for you. The diagnosis of a premature or early menopause can bring many changes and challenges: when menopause does not come at the age and stage of life you expected it to, it can have a major impact on your wellbeing.
Women who experience premature or early menopause can be at greater risk of depression, anxiety and mood changes. It can be very upsetting for some women to experience menopause in their 20s or 30s when they expected it to happen in their late 40s or 50s. Often this is a time of feelings of loss, sadness and grief. These feelings are very common, along with the feelings of losing your body image, fertility, femininity and sexuality, and feeling old before your time. It can take some time to diagnose a premature or early menopause. Not knowing what is wrong, having no control over symptoms and not knowing what the future holds can be frightening.
Some women with early menopause talk of 'loss of womanhood' and 'loss of dreams'.
Associated illnesses, such as cancer and chemotherapy or surgery to remove ovaries, may also alter the course of your life. Plans, dreams and expectations must be re-thought and that can be very challenging and distressing. During this time, women can experience a sense of loss of control, loss of ability to plan and loss of self-image, but often there is no one with whom to share the grief. Girlfriends might not understand because they are not yet experiencing menopause, and, for some, mothers haven't yet reached menopause either. Women who have induced menopause with the sudden hormonal changes can experience symptoms that are often more severe and unpredictable, which can be distressing.
They may also be coping with other illnesses at the same time, such as a cancer diagnosis. There are many factors that contribute to the emotional wellbeing of a woman experiencing premature or early menopause. Being at greater risk of anxiety and depression is also likely because of a range of other physical, psychological and social influences. Some of these include:. It is important to have a network of family, friends and health professionals who will support you through the initial diagnosis of premature or early menopause, as well as beyond, depending on your age and stage in life.
A premature or early menopause, particularly when it is sudden, can mean a significant change in the way you view your body. The sudden drop in hormones with a surgical menopause for example may make you feel your body is out of your control.
Symptoms that are frustrating, annoying, confusing and distressing can cause you to think differently about your body. Hot flushes, dry skin, a dry vagina and an increased risk of osteoporosis are significant changes to experience in your 20s or 30s. It is not surprising women talk of not being able to trust their body and seeing their body in a negative way, not feeling as attractive or desirable.
A young body is not supposed to behave like this and women often say 'I am a young woman in an older woman's body'. If you are thinking more negatively about your body and it is distressing, you should discuss your feelings with your doctor or a psychologist. Feeling stressed, self-conscious about your body, depressed or anxious about intimacy can make sex uncomfortable, and even painful.
Sometimes, dyspareunia painful sex begins as a physical problem, but then has a flow-on effect to your psychological wellbeing and relationships, causing stress and anxiety. Apart from understanding how the physical symptoms may affect you and your relationships, it is helpful to understand how mood and emotions affect your relationship.
It might be that, as a couple, you need to re-think dreams and plans. Dealing with fertility issues can be difficult for both of you, and seeking help at the earliest time can be good for both of you. Some women who have premature or early menopause are not yet in a committed relationship and this can provide another challenge.
How do you tell a new partner you have already gone through menopause and that you might not be able to have children? Some women lose confidence that they will not be able to have an intimate relationship. Talking with a counsellor about how to approach new relationships can be helpful, even if it is just for a session or two. It can be distressing to have hot flushes and sweats at a young age and even more distressing to have a dry, thin vagina, which makes sex and intimacy painful.
Your sexual relationship may be new, or sex may never have been a problem in the past and now it is.
Sleep disturbances in menopause
Some women find it both frustrating and embarrassing to explain what is going on to a partner. A vicious cycle can develop where past experiences of painful sex cause anticipatory fear of more pain. This fear creates stress, tension and reduces libido and arousal. As a result, sex becomes painful.
Exploring the best possible options and treatments for you as an individual, and using open communication with a partner, is absolutely vital. Taking your partner to a gynaecologist's or doctor's appointments can be helpful. If early menopause has caused problems with your sex life, there are many treatments that can be helpful: it might just be about finding the right one for you. Seeking treatment and advice is recommended to reduce your risk of earlier onset of cardiovascular disease and osteoporosis, as well as to treat your symptoms. Treatment with menopause hormonal therapy MHT or the pill is recommended to reduce severe symptoms and to reduce the long-term health risks associated with early menopause, such as osteoporosis.
However, other therapies may be recommended for moderate to severe symptoms, or if there are reasons, such as breast cancer, for not being able to take MHT or the pill. MHT or the pill is recommended for women diagnosed with premature or early menopause, in order to replace the hormones the body is missing. MHT and the pill both contain an oestrogen and a progestogen type of progesterone and differ by doses, methods of treatment delivery oral or transdermal and types of hormone in the product.
Both an oestrogen and a progestogen are necessary if the uterus has not been removed hysterectomy. Either treatment is recommended to:. For one in 50 women, pregnancy occurs spontaneously after the diagnosis of primary ovarian insufficiency. If a woman wants this chance of spontaneous pregnancy, the hormone therapy consists of continuous oestrogen with cyclic progestin therapy.
If your period doesn't occur, then a pregnancy test should be performed if on MHT. Otherwise, a woman can be prescribed the oral contraceptive pill.
Surviving menopause with some (self) kindness
Both of these therapies will normally give a monthly period. Higher doses of hormones are often prescribed because younger women require more hormones to maintain quality of life and wellbeing. Testosterone, which is also a female hormone, may be considered an appropriate treatment, especially after surgical menopause. Although there are no long-term studies of MHT in women experiencing a premature or early menopause, it is recommended that MHT should be taken until the expected age of menopause years.
All the studies of long-term use of MHT published in recent years have been in women some years after the expected age of menopause, who have a much greater risk of heart disease, stroke and cancer because of their age. Management of women with primary ovarian insufficiency. ESHRE guidelines. Laven JS. Primary ovarian insufficiency. Semin Reprod Med. Epub Aug Hewlett M, Mahalingaiah S. This bride's colourful mehendi outfit is winning the internet!