1. Why do I have vaginal dryness (sometimes or all the time)? There are many reasons to consider but the big ones include: not fully aroused, stressed, other things on your mind, on the birth control pill, on clomid (or other fertility medications known to dry up mucus), history of a LEEP procedure on the cervix due to an abnormal pap smear, decongestants (they do not just dry up the nose), dehydration, and hormone changes.
2. Why are some periods unlike other periods? Some women have the “fluke” where their period comes early or late (not pregnant), is really heavy, really light, no cramps, severe cramps…etc and this is different from the normal. Some women alternate months in that one month is an easier period then the next month is a more symptom heavy period. Remember (as I tell my patient’s), your ovaries are sisters not twins therefore “righty” and “lefty” may produce different hormone levels and create different symptoms. Some months may be a “righty” month and others a “lefty” month. In addition, high stress, grief, flying, major transition, heavy exercise, weight loss, and hormone changes can all affect how your cycle rolls.
3. Am I too young for hormone changes? Nope. Hormone changes and imbalance can occur at any age from puberty all the way through menopause. You may be too young for menopause but that does not mean there are not issues with hormone production. Women who do not ovulate do not make progesterone and progesterone is typically known as the calming, soothing, anti-PMS, pro-pregnancy hormone. High estrogen contributes to more PMS-type symptoms, heavier periods, weight gain and tender breasts. Higher testosterone or testosterone sensitivity may create more acne and increased hair growth on the chin, neck, and around the nipples.
4. Why are my periods irregular or why do I spot and bleed more than seems normal? First of all, if you are fully menopausal and have not had a period in 12 months and suddenly you start bleeding, please contact your health care provider as you will need additional work up. If you are peri-menopausal then expect your once regular periods to become very erratic and unpredictable due to the nature of the ovaries changing. Other reasons for most all ages include hormone imbalances, fibroids, polyps, pregnancy, thyroid problems, being low in iron, having Polycystic Ovarian Syndrome (PCOS) and being on the wrong birth control pill dose.
5. Where did my sex drive go? This is tricky. Some women do not start out with a thriving sex drive and as they go through hormone changes it begins to wane even more. Those who are used to a higher drive find themselves perplexed when their mojo is gone. Sex drive for women is rather complicated as it takes into account hormone balance, arousal, stressors, how many things are on their brain, attraction, confidence…and more. Certain medications are known to lower drive such as the birth control pill and anti-depressants. Men typically have an “on/off” switch while women have an entire control panel. Talk with your health care provider about testing for hormones, thyroid, and energy zappers like iron, Vitamin B12 and Vitamin D. Focus on your stress response, eliminating what is not a priority, communicating with your partner about what you need (A dinner out? The laundry done? Compliments? Forplay?) and do not be afraid to explore and change things up within your comfort zone. Perhaps this means new lingerie, the addition of sex toys, erotic readings (grey ties anyone?), more date nights, or a mini-couples vacation.
While being a woman is wonderful and empowering (empowher!), please talk to your health care provider if you recognize some of the symptoms above and suspect your particular symptom is more than just a “fluke.” There may be some true imbalances that require a little tweaking in order to help you feel your healthiest.
1) Bachmnan, G., and Santen, R. Treatment of Vaginal Atrophy. Web. 8 June, 2013.
2) Shifren, J. Sexual dysfunction in women: Epidemiology, risk factors, and evaluation. Web. 8 June, 2013.
3) Welt, C. Physiology of the Normal Menstrual Cycle. Web. 8 June, 2013.