Urinary tract infections often arise due to the decline in the hormone estrogen that occurs post-menopause. A similar decrease in estrogen happens if you undergo ovarian removal or specific cancer therapies. But why does reduced estrogen lead to UTIs? Estrogen plays a vital role in keeping the tissues in the vagina and urethra flexible and hydrated.

Not intended as medical advice, but for informational and educational purposes only.

Understanding and maintaining sexual health is a vital aspect of one's overall sense of self and well-being. However, it is essential to recognize that there is no universal standard when it comes to sexual activity and desire. Some individuals experience a significant decrease in desire as they reach midlife, while others may see an increase in interest, and yet others may notice no change whatsoever. Only you and your partner can determine whether your sexual life aligns with your needs and desires.

Issues in Sexual Function.

Sexual dysfunction can significantly disrupt one's life. There are four main areas where these issues can arise: sexual desire, arousal, orgasm, and sexual pain. These problems often overlap; for instance, someone who has a low level of sexual desire might also encounter difficulties with arousal or achieving orgasm.

Sexual desire: The reduction in estrogen production during menopause can lead to hot flashes and night sweats, which can disturb sleep and, consequently, reduce sexual interest. Lowered estrogen levels can also cause vaginal dryness and thinning of the vaginal lining, making penetrative sex uncomfortable or painful.

Hormonal changes: These are merely one part of a complex set of factors that affect sexual activity during midlife and beyond. Social changes such as altering partnerships (due to divorce or dating), children moving out or returning home, and the responsibility of caring for aging or ill parents frequently occur during this period.

Partner's sexual issues: These can also impact desire. Changes in body image, self-esteem, and concerns about aging are significant factors. The level of sexual interest post-menopause is often influenced by one’s past levels of sexual interest.

Medical conditions: Various health problems can result in low sexual desire. Additionally, some medications, especially those used to treat depression, can interfere with sexual function.

Challenges in Sexual Health.

In addition to issues with sexual desire, women may face three other main categories of sexual problems:

Difficulty with arousal: Some women may find themselves unable to achieve or maintain genital arousal.

Difficulty with orgasm: Whether this issue is a new development or a lifelong concern, some women may struggle to reach orgasm.

Sexual pain: Pain during sex can stem from multiple causes. Vaginal dryness can be alleviated with the use of lubricants and vaginal moisturizers to maintain moisture and reduce friction. Low-dose vaginal estrogen therapy (ET) is another potential solution.

Seeking Professional Assistance.

Understanding these factors and communicating sexual concerns with a healthcare professional can enhance desire and overall sexual satisfaction. A professional evaluation can identify underlying medical or psychological causes of low sexual desire. Though many individuals find it challenging to discuss sexual problems, healthcare professionals are valuable resources in achieving optimal sexual health. Counseling can aid in managing difficult medical, relationship, or family issues contributing to sexual health concerns. Healthcare professionals can also refer you to specialists who focus on treating sexual concerns.

By exploring and addressing these aspects, one can work towards a fulfilling and satisfying sexual life, ensuring that their needs and those of their partner are met in a healthy and balanced manner.

Not intended as medical advice, but for informational and educational purposes only.

This can be a difficult question to answer because I am not sure exactly what symptoms that you are trying to manage. Supplements typically only address one symptom at a time. There are some supplements that have shown benefit for some symptoms, but not for others. 

As for vasomotor symptoms, or hot flashes and night sweats, The Menopause Society included a section in the 2023 Nonhormonal Position statement on dietary supplements for the treatment of these symptoms and listed whether they recommended the use of it or not. For two of the most common supplements, soy and black cohosh, the answer was no, The Menopause Society does not recommend either. The reason was that they could not find consistent strong evidence in the studies they looked at that it actually helped hot flashes more than placebo. Additionally, they did not recommend black cohosh because they found some studies that showed it increased risk for liver disease. 

As for other common perimenopause symptoms, there is evidence that some supplements may help other specific symptoms, for example difficulty sleeping.   

The main thing to remember with supplements, is that generally, each supplement only addresses one particular symptom. It is also important to remember that supplements do not replace depleted hormone levels, so you won't get the same broad benefits and symptom relief from one supplement that you might from  hormone therapy. 

This is not intended for medical advice, but informational and educational purposes only. 

This is a very common issue for women in perimenopause and menopause, and is actually one of those symptoms that gets worse as women progress through their menopause journey. One of the main reasons that lubricants can be so irritating to vulvar and vaginal tissue is that they further dry the tissue and pull moisture out of the tissue rather than add moisture to it, even the lubricants that are labeled "natural". The World Health Organization, WHO, actually has standards for vaginal lubricants to avoid this problem, but many lubricants on the market don't meet these criteria. WHO standards for vaginal lubricants include that the it should have a pH (acidity level) of 4.5 which matches the normal pH of the vagina, and an osmolality of  1200 mOsm/kg (a measure of concentration), but most lubricants on the market have an osmolality and a pH that are both much higher and subsequently pull moisture out of the tissue causing further dryness and irritation. 

Here are a few that meet WHO standards: 

Water Based Lubricants: 

Good Clean Love;

Yes Baby Vaginal Friendly Lubricant

Yes Water Based Intimate Lubricant.

Silicone Based lubricants (may contain small amounts of Vitamin E or coconut oil):

Astroglide X (silicone only)

Astroglide X Silicone gel (silicone and coconut oil)

Uber Lube (silicone and vitamin E)

Vaginal Moisturizers:

Moist Again (water based)

Yes Vaginal Moisturizer (water based)

If you want a completely plant based, natural product, pure coconut oil is very soothing to a lot of women. 

Hopefully,  you will find one of these products helpful and suitable to your body.  

If after a few weeks you don't get any relief, you should see your gynecologist for an exam to make sure there is nothing else causing the irritation. 

Not intended as medical advice, but for informational and educational purposes only. 

Surgical menopause (removal of the ovaries) can cause a sudden drop in hormones including progesterone, estrogen, and testosterone. This can make typical perimenopause and menopause worse for a lot of women. Sleep is profoundly affected for many women.

Since you asked specifically for supplements or nutritional or food supplements, I will start there. Nutrition, you want to make sure to follow a generally healthy diet, there is a lot of debate about what that really means, but broadly speaking, Mediterranean diet has been shown to be one of the healthier diets you can follow. Avoid alcohol, especially before bed, which even though it is a sedative, can actually make sleep much worse, and avoid eating 3 hours before bed. 

As far as supplements go, there are several that may be helpful: melatonin, magnesium threonate, ashwaganda, and L-theanine have been shown to help decrease sleep latency (how long it takes to fall asleep). There are several things to remember with supplements: these are not regulated and there has been shown to be wide product variability--one study showed up to 465% difference in what the bottle contained of the same supplement, so it is strongly recommended to get a product that is third-party tested to try to ensure product quality. You should check with your pharmacist or prescribing doctor or provider that the supplements are safe to take with any prescriptions or other medications. You should also keep in mind these supplements do not usually work right away, you have to give them at least a few weeks-sometimes up to 8-12 weeks for them to work, especially things like ashwaganda and L-theanine. If you are struggling with anxious thoughts which is very common after a hysterectomy & oophorectomy, you might consider CBT-i which is Cognitive Behavioral Therapy for insomnia and is considered a first line treatment for insomnia recommended by the American Academy of Sleep Medicine (AASM) especially for insomnia related to anxiety. 

You didn't mention if you were on Hormone Therapy (HT) or not, but if you are a candidate, you might want to talk to your doctor about trying micronized progesterone. This can be profoundly helpful for women who can't sleep due to a loss of hormones, even if you don't have a uterus. Progesterone works on gaba receptors, very simply put it stimulates the "rest and digest" part of the nervous system versus "fight or flight" which can really help some women sleep. So talk to your provider.

I hope that helps! Thank you for your question.

This is not intended for medical advice, but for educational and informational purposes only. 

As we lose estrogen, vaginal pH changes which decreases the amount of lactobacilli (good vaginal bacteria) and gives rise to more infectious vaginal bacteria like gardnerella (a common organism that causes bacterial vaginosis). Topical vaginal estrogen can often correct the acidity level and subsequently correct the vaginal microbiome and drastically reduce the number of infections you’re getting. Vaginal estrogen is very very safe to use, but it is still a prescription medication in the U.S. so talk to your doctor or other healthcare provider or menopause specialist about the treatment that is right for you.

This is intended for educational and informational purposes only and is not medical advice.

Dr. Mantor's Wrinkle and Weight Solutions, LLC

6982 Worthington Road

Westerville, OH 43082

614.891.2000

Since 2008

D

UGH! You are not alone and this is one of THE most common and one of THE most frustrating symptoms I hear. 

This one can be so so hard, because it is usually multifactorial and can be VERY complex. 

You mentioned that your whole feed is filled with supplements and that you are lost. You are not alone! 

I like to remind people that supplements are just that, they are supplemental. It is not the main thing.

1) SLEEP!! this one is so underrated. So much gets out of whack when we don't sleep--including hunger and satiety hormones and energy expenditure goes down because NEAT (non-exercise activity thermogenesis) decreases. 2) Stress reduction. 3) I am going to say diet and exercise because we really can't get away from that 1) Follow a diet high in protein and fiber those foods tend to be more satiating, 2) exercise-start with something you can be consistent with even if that's only 5 minutes per day, if you can be consistent with it that will have more health benefits for you in the long run than doing a "perfect" workout for a month then burning out. If you can be consistent with it, 2 hours per week of lifting weights has shown to improve body composition/improve muscle mass among many other health benefits.

It also might be time to discuss this with someone who specializes in weight loss. Our registered dietician Danielle and Dr Mantor are an amazing team who can help you with this. Hormone therapy might be something that may help you also. If you have more specific questions about this email me at kristenwithdrmantor@gmail.com

Not intended as medical advice, but informational and educational purposes only.

While HRT or HT can cause a little bit of weight gain it is usually only a few pounds and often related to bloating/water retention.

However, in a new study that has been published in the October issue of Maturitas the researchers reported that MHT counteracts the tendency to age-related weight gain. This study showed significantly less weight gain in the MHT Group compared with the Placebo group after 3-5 years and there were about 2800 women in this  study so it was not a small study. 

I know starting HT can be a big decision and a lot of women have different hesitations for different reasons, and it might not be for everyone,  but if you're having other terrible symptoms, it just might be time to give it a try and see how your body responds to it. 

Have more questions? Please email us at kristenwithdrmantor@gmail.com

Not intended as medical advice, but informational and educational purposes only.

Dr. Mantor's Wrinkle and Weight Solutions, LLC

6982 Worthington Road

Westerville, OH 43082

614.891.2000

WrinkleandWeight.com

Since 2008

#meopausecare #perimenopause #hrt

PCOS, Polycystic Ovarian Syndrome, is a Hormonal Condition That Can Cause Irregular Periods, Excessive Hair Growth, Weight Gain, Acne, Infertility, Dark Skin Patches and

Sleep roblems.

Indeed, perimenopause can commence in your mid-30s. This transitional phase leading to menopause occurs when the ovaries begin to produce fewer hormones. The onset of perimenopause can range from the mid-30s to the mid-50s. It is a natural process that may bring about various physical and emotional symptoms, such as irregular or unpredictable menstrual cycles, hot flashes and night sweats, vaginal dryness, sleep disturbances,  breast tenderness and even odd symtoms, like itchy ears...

Dr. Mantor's Wrinkle and Weight Solutions, LLC

6982 Worthington Road

Westerville, OH 43082

Since 2008.

Complimentary Intial Consultations.

Feeling "off" or what I often hear put "not like myself" is a very common complaint in perimenopause. The average age of menopause is around 52 in the US, and symptoms can start up to 10 years before menopause, so it is quite likely you are in perimenopause. While we can do lab tests to see where your levels are, perimenopause is diagnosed based on your report of symptoms and not by what your lab results are. Understand, it's not that we can't check labs, it's just that hormone levels wildly fluctuate during perimenopause, and they often come back in "normal" range so they don't always help. That being said, if you choose to get labs done and they come back "normal" that does NOT mean that you are not perimenopause, and it certainly doesn't mean that you are crazy! Your symptoms are real, even those subtle ones of just "feeling off" and you do not need a diagnostic lab test to be diagnosed. 

Not intended as medical advice, but informational and educational purposes only.

Schedule your complimentary  appointment today!

Dr. Mantor's Wrinkle and Weight Solutions, LLC

6982 Worthington Road

Westerville, OH 43082

614.891.2000

WrinkleandWeight.com

Since 2008

#meopausecare #perimenopause #hrt