Menopause encompasses three stages: perimenopause, menopause, and postmenopause, each marked by hormonal changes that can impact women's health. Estrogen decline plays a central role in genital issues that arise during this transition, such as vaginal dryness and changes to the vulva's appearance. Experts Dr. Sherry Ross and Dr. Anat Sapan outline how the drop in estrogen leads to less blood flow and elasticity in vaginal tissue, ultimately causing discomfort in daily life and intimacy. Women may experience symptoms like itching, burning, and painful sexual penetration as a result of these changes.
"During perimenopause, the annoying genital symptoms begin, but they aren't as disruptive until menopause officially begins," Ross said.
"With low or nonexistent estrogen, there is less blood flow to the vulva and vaginal tissue, causing dryness, shrinking of the vaginal opening, and less natural lubrication causing pain, itching, irritation, burning and painful sexual penetration," Ross said.
"The primary cause of genital changes during menopause is estrogen decline," said Dr. Anat Sapan, a board-certified OB/GYN and menopause expert.
"The labia minora often become thin and may appear to shrink or, in some cases, seem to disappear entirely," Dr. Anat Sapan said.
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