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Other Midlife Health Topics

Your physician or clinician is the best resource for your midlife health questions and concerns. Here are a few of the most common topics relating to midlife health.

  • Sexuality

    Some women claim that sex is better than ever after menopause, when there's no reason to worry about periods and unplanned pregnancies. Generally, the more sexually active you are, the fewer problems you are likely to encounter. Declining hormone levels, however, can lead to changes that may make sex uncomfortable. The first of these is vaginal dryness.

    While menopause may not reduce a woman’s desire for sexual intimacy, it can cause discomfort due to vaginal dryness, in medical terms this is called atrophic vaginitis. It’s a problem many women experience during or after menopause. Yet most never discuss it, even in the privacy of their clinician's office. Often women feel that genital discomfort must be endured as part of the aging process. This is not the case!

    Because vaginal dryness has received so little public attention, women often mistakenly blame it on factors such as stress or poor hygiene. In truth, however, vaginal dryness usually results from the declining estrogen levels associated with menopause. Before menopause, estrogen plays an important role in keeping genital tissues elastic and moist. When a woman is sexually aroused, for example, estrogen enables vaginal tissues to become lubricated. When estrogen levels drop, vaginal tissues produce less lubrication. Without adequate lubrication, sex can become uncomfortable, even painful. As a woman gets older, her vaginal walls also become thinner and more vulnerable.

    Reduced hormone levels cause subtle changes in the genital tissues. The pelvic muscles may need strengthening. Lower estrogen levels decrease the blood supply to the vagina and the nerves and glands surrounding it. This makes delicate tissues thinner, drier, and less able to produce secretions to comfortably lubricate before and during intercourse. The vagina becomes dryer, less elastic, and more prone to irritation. Most women find it helpful to use an additional lubricant for sexual activity. Water-soluble lubricants are preferable, as they help reduce the chance of infection. Try to avoid petroleum jelly; many women are allergic, and it damages condoms.

    Certain medications and alcohol may diminish sexual drive, too. But there are also important emotional issues to face. Sexuality is often a delicate balance of emotional and physical issues: How we feel may affect what we are able to do. For example, men may fear impotence will become a more frequent problem as they age. As a woman ages, she may become more anxious about her appearance. This emphasis on youthful physical beauty can interfere with a woman's ability to enjoy sex.

    Older couples may have the same problems that affect people of any age. But they may also have the added concerns of age, retirement and other lifestyle changes, and illness. These problems can cause sexual difficulties. Talk openly with your physician or clinician or see a therapist. These health professionals can often help.

    Learn more about Sexual Health here

    Perimenopause and pregnancy

    The number of follicles (eggs) in the ovaries steadily diminishes over a woman’s reproductive lifetime. By the age of 40 years, the rate of decline becomes faster. But despite the reduction in the amount of follicles available for ripening, ovulation continues in up to 98% of women over the age of 40 who have regular menstrual cycles. This emphasizes the need for contraception – because YES, you can get pregnant!

    Contraception during midlife

    During these perimenopausal years, menstrual cycles tend to become irregular. There is a decline in natural fertility, but contraception is still necessary to avoid unplanned pregnancy. In the United States, the highest incidence of unplanned pregnancy is among adolescents and women over age 35 years.

    Women approaching menopause often have contraceptive requirements that differ from those of younger women – but is equally important. Pregnancy in the late reproductive years is associated with more complications for both mother and baby.

    Every woman has to determine what contraceptive method works best for her depending on her stage of life. Your physician or clinician can help, too. Click here to review birth control information.

    When is it OK to stop using birth control?

    Contraception should be continued for women who are 50 years or older for one year after menstruation has stopped. For women younger than 50 years, contraception should be continued for two years after the last period.

    If you are still using birth control pills (oral contraceptives) as you approach age 50, it may be a good idea to change to another method for several months. This is to get a more accurate picture of your menstrual activity and menopausal status. To determine what method may be the best for you and your lifestyle, read more about the different birth control options. You should also talk to your  physician or clinician for more information.

  • Skin care

    It is sometimes hard to resist the good feeling of the warm sun on your face. But the damage of the ultraviolet rays in sunlight is a major cause of skin cancer, wrinkles, uneven pigmentation (coloring), and rough, dry texture.

    To repair or at least control the sun damage, many women purchase wrinkle-reducing creams, bleaching products to lighten age spots, and skin lotions to keep skin looking smooth and healthy. The best remedy for keeping your skin healthy doesn’t come in a bottle, jar or tube - its free and easy – stay out of the sun!

    Sun Damage

    Sun exposure over many years has a cumulative effect. The skin has many stretchy fibers called elastin. Ultraviolet light breaks down these fibers over time, which results in a loss of elasticity, looser, saggy skin and wrinkles. Easy bruising, fragile skin (prone to easy scrapes), and slower healing may also accompany the elastin damage.

    For the most part, if the damage is done there is not much you can do to reverse it. However, the skin has some resilience and it may self-repair in part. Be certain not to add insult to injury, protect yourself with sunblocks, clothing, hats, sunglasses and shade.

    Smoking

    Smokers have more wrinkles. When comparing a group of smokers and a group of non-smokers with the same age, skin color, skin type and similar lifetime sun exposures – you will find that the smoker group looks older and has more wrinkles that the non-smokers.

    The reason for this difference is unclear. It may be because smoking interferes with normal blood flow in the skin. The solution: avoid smoking from the earliest age! And it’s never too late to quit!

    Skin Cancer

    Sun exposure also puts you at risk for skin cancer. The chance of developing skin cancer increases as people age, especially for those who live in sunny areas of the country.

    There are three types of common skin cancers:

    • Basal cell carcinomas are the most common. They rarely spread to other vital organs, but should be removed since they will grow larger. They especially like to grow deep in cartilage like the nose and the ear.
    • Squamous cell carcinomas are less common but more of a concern. They may have faster growth and an increased chance of spread.
    • Malignant melanomas are the most dangerous of all the skin cancers, because they often spread to other body areas. This cancer requires aggressive treatment. Prevention and early detection is the key to reducing the serious health effects of melanoma.

    The best thing to know about detecting skin cancer is to know the warning signs. Look for differences in color, size, shape, or surface quality (scaliness, oozing, crusting, or bleeding) of any mole or skin lesion. If there is a sudden change in the look of a mole or a new spot, consult your physician.

    Dry Skin

    Skin is drier as we age. The decrease in sweat and oil gland production may also have a drying effect on skin. Exposures to hot air heating systems, hot tubs, chlorinated pools, soaps, etc., further irritate and dry skin. Applying daily moisturizer and avoiding irritating/drying soaps is often helpful in reducing dry skin.

    Other recommendations include:

    • Avoid long soaks in the tub, hot tub, or pool. Use warm or tepid water, and apply bath oil for extra soothing – always be careful though because this makes the tub slippery.
    • Dry gently, don’t rub hard. Leave the skin damp, and follow this with an application of moisturizing skin cream.
    • Use mild detergents for your clothes washing and avoid wearing itchy or scratchy fabrics. (so you don’t scratch at irritated, dry skin)
    • Wear gloves when you go out in cold or windy weather.
    • Avoid sun damage by using moisturizer with sun screen even in the wintertime
    • Use a humidifier to keep the air in your home moist, especially during the winter heating season (remember to keep this clean according to manufacturer’s instructions.)
    • Drink plenty of fluids

    If your skin continues to be very dry and itchy, be sure to schedule an appointment with your physician or clinician.

  • Hair changes

    Fine (vellus) facial hairs, which are normally unnoticeable, may become thicker and darker in certain facial areas during midlife. The chin and upper lip area are common areas for these stubborn hairs to crop up.

    For some women, this can be a big cosmetic problem. Plucking, waxing, using depilatory creams, electrolysis, and laser hair removal are some methods of removing these unwanted hairs. Bleaching the hairs to lighten the color is another alternative. These methods vary in their cost, complications, and long term results. If you are interested in hair removal, discuss this with your clinician to learn more about what methods they recommend.

    Hair growth patterns are due to heredity (genetics), but they also are a response to the changing level of hormones in your body, specifically a decline in the amount of estrogen and a slight rise in the amount of androgen (male hormone). Some physicians feel that hormone replacement therapy may lessen some of these effects, however, this has not been studied in clinical research.

    The texture of your hair may also change - it may be finer. Some women experience thinning of hair in areas of the scalp and pubic region. This is not a midlife female phenomenon – its part of normal aging and it happens to men, too. If you notice this happening prematurely or if it’s alarming to you cosmetically, be sure to discuss this with your physician. There are some topical treatments to promote hair growth (like Rogaine) that produce results in some individuals – but these only last as long as you take the medication. Hair plugs and plastic surgery procedures (not paid for by insurance) may also be helpful to some. There are a variety of hairstyles that may disguise some thinning areas, as well as wigs and hairpieces available in specialty stores.

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