Around menopause, changes in the female reproductive organs occur rapidly. (Menopause is defined as 1 full year after the last menstrual period.) Menstrual cycles stop, and the ovaries stop producing estrogen.
After menopause, the tissues of the labia minora (which surround the opening of the vagina and urethra), clitoris, vagina, and urethra become thin (atrophy). This thinning can result in chronic irritation and dryness of the vagina. Vaginal discharge and urinary tract 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, the affected organs may not be supported and may drop down (prolapse), sometimes causing a feeling of pelvic pressure or fullness. They may bulge at the opening of the vagina and cause difficulty urinating or loss of control of urination or bowel movements (incontinence). Women who have had children are more likely to have such problems, but they may affect any woman.
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Because there is less estrogen to stimulate milk ducts, the breasts decrease in size. The connective tissue that supports the breasts also decreases. The loss of support contributes to changes in breast shape. Fibrous tissue in the breasts is replaced with fat, making the breasts less firm.
Age-related changes in reproductive organs do not interfere with sexual pleasure. However, vaginal dryness after menopause can cause pain during sexual activity, and some women feel a decrease in the desire to have sex.
