Normal changes occur in the female reproductive system as women get older.
Age-related changes in the female reproductive system usually start around the age of 40. Most women do not notice many changes until menopause, or the change of life. Menopause usually starts between ages 45 and 52 and is diagnosed after there have been no menses for 12 months.
The female reproductive system includes the vagina, uterus, ovaries, and external genitalia. As women age, the ovaries are less able to make estrogen. The ovaries begin to shrink. Fat and other materials start to replace the cells that make hormones.
Estrogen is the main female hormone. A more rapid drop in estrogen levels occurs during menopause. Without enough estrogen, the uterus remains stable in size unless it becomes diseased. The muscles of the uterus shrink and are replaced by fat and other materials. The glands in the uterus also get smaller. The uterine lining becomes thinner.
The most bothersome age-related changes usually occur in the vagina. The vagina gets narrower and shorter with age. The walls become thin and less elastic or stretchable. The glands that normally wet the vagina shrink and secrete less lubricant. This makes the vagina become dry, and sex may be painful. The vagina may also itch.
The external genitalia also slowly change. The pubic hair becomes thinner and coarser and may turn gray. The labia, or outer skin folds around the vaginal opening, lose fat and elastic tissue. This causes the labia to become thinner, wrinkled, and less prominent.
Other menopausal symptoms associated with changes in the female reproductive system include: difficulty concentratingfatigueforgetfulnessheadacheshot flashesinsomniairritabilitynight sweatsweight gain
A woman's sex drive may also be affected by aging. Sexual desire is affected by emotional, psychological, social, and physical factors.
Hormones, including estrogen and testosterone, play a significant role in sexual desire. Even though estrogen production is decreased with menopause, small amounts of testosterone continue to be produced. This testosterone production along with many other factors can preserve the sex drive.
Breast tissue and shape are also affected by menopause. Several years after menopause, levels of the female hormones FSH and LH begin to fall. This change leads to decreased muscle tone in the breast. Ligaments within the breast relax, altering the shape of the breasts.
Hormone therapy with estrogen (and in women with an intact uterus, progesterone) can treat some of these changes. This therapy has risks and side effects, however. Women should discuss the risks and benefits of this therapy with their healthcare professional.