Effects of Aging

Around menopause (see Section 22, Chapter 243), changes in the genital organs occur rapidly. Menstrual cycles stop, and the ovaries stop producing estrogen. After menopause, the tissues of the labia minora, clitoris, vagina, and urethra thin (atrophy). This thinning can result in chronic irritation, dryness, and a discharge from the vagina. Vaginal infections are more likely to develop. Also after menopause, the uterus, fallopian tubes, and ovaries become smaller.

With aging, there is a decrease in the amount of muscle and connective tissue, including that in muscles, ligaments, and other tissues that support the bladder, uterus, vagina, and rectum. As a result, these organs may sag or drop down (prolapse), sometimes causing difficulty urinating, loss of control over urination or bowel movements (incontinence), or pain during sexual intercourse.

Because there is less estrogen to stimulate milk ducts, the breasts decrease in size and may sag. The connective tissue that supports the breast also decreases, contributing to sagging. Fibrous tissue in the breasts is replaced with fat, making the breasts less firm.

Despite these changes, many women enjoy sexual activity more after menopause, possibly because they are no longer able to become pregnant. In addition, after menopause, the ovaries continue to produce male sex hormones. Male sex hormones help maintain the sex drive, slow the loss of muscle tissue, and contribute to an overall sense of well-being.