Women often don’t tell their doctors about incontinence, overactive bladder, and pelvic organ prolapse, but those problems are common.

Urinary incontinence is the accidental release of urine. It can happen when you cough, laugh, sneeze, or jog. Or you may have a sudden need to go to the bathroom but can’t get there in time. Bladder control problems are very common, especially among older adults. They usually do not cause major health problems, but they can be embarrassing.

Incontinence can be a short-term problem caused by a urinary tract infection, a medicine, or constipation. It gets better when you treat the problem that is causing it. But this topic focuses on ongoing (chronic) urinary incontinence.

There are two main kinds of chronic incontinence. Some women have both.
* Stress incontinence occurs when you sneeze, cough, laugh, jog, or do other things that put pressure on your bladder. It is the most common type of bladder control problem in women.
* Urge incontinence happens when you have a strong need to urinate but can’t reach the toilet in time. This can happen even when your bladder is holding only a small amount of urine. Some women may have no warning before they accidentally leak urine. Other women may leak urine when they drink water or when they hear or touch running water. Overactive bladder is a kind of urge incontinence. But not everyone with overactive bladder leaks urine.

Mixed incontinence is a combination of different types of bladder control problems, usually stress and urge incontinence. These problems often occur together in older women.
Chronic bladder control problems may be caused by:
* Weak muscles in the lower urinary tract.
* Problems or damage either in the urinary tract or in the nerves that control urination.

Stress incontinence can be caused by childbirth, weight gain, or other conditions that stretch the pelvic floor muscles. When these muscles cannot support your bladder properly, the bladder drops down and pushes against the vagina. You cannot tighten the muscles that close off the urethra. So, urine may leak because of the extra pressure on the bladder when you cough, sneeze, laugh, exercise, or do other activities.

Urge incontinence is caused by an overactive bladder muscle that pushes urine out of the bladder. It may be caused by irritation of the bladder, emotional stress, or brain conditions such as Parkinson’s disease or stroke.

The main symptom of urinary incontinence is the accidental release of urine. If you have stress incontinence, you may leak a small to medium amount of urine when you cough, sneeze, laugh, exercise, or do similar things.

If you have urge incontinence, you may feel a sudden urge to urinate and the need to urinate often. With this type of bladder control problem, you may leak a larger amount of urine that can soak your clothes or run down your legs.

If you have mixed incontinence, you may have symptoms of both problems.
Most bladder control problems can be improved or cured.

Incontinence is not inevitable with age. It is treatable and often curable at all ages. If you experience incontinence, it may help you to remember that loss of bladder control can be treated. Talk to your doctor about it.

A bladder infection, also called cystitis, is an inflammation of the urinary bladder, a type of urinary tract infection. The inner lining of the bladder becomes inflamed (red and swollen) and the urine becomes full of bacteria. Bacteria are the usual cause of infection. Rarely a virus may cause it. Normally there should be no bacteria in the urinary tract.

Bladder infections are more common among women than men because of their shorter urethra, making it easer for bacteria from the anus or genital area to reach the bladder. This can happen during such activities as wiping after using the toilet or sexual intercourse. Most infections of the urinary tract are caused this way.

Bladder infections often occur in young women who have just become sexually active and have sexual intercourse often. In addition, bladder infections can occur anytime the flow of urine is blocked or emptying of the bladder is incomplete due to pregnancy in women.

Bacteria that have traveled up the urethra and into the bladder usually cause bladder infections. The most common bacteria associated with bladder infections in women include: Escherichia coli (about eighty percent of cases), Staphylococcus saprophyticus , Klebsiella, Enterobacter , and Proteus species.

Risk factors include sexual intercourse, use of a diaphragm for birth control, an abnormally short urethra, diabetes or chronic dehydration, the absence of a specific enzyme in vaginal secretions, inadequate personal hygiene and pregnancy.

Possible symptoms of a bladder infection in women include:

• Urinating more often
• Feeling an urgent need to urinate
• A burning, stinging, or pressure sensation during urination
• A crampy pain or discomfort in the lower abdomen just above the pubic bone or sometimes in the lower back
• A need to urinate more often in the night
• Cloudy urine that smells bad
• Blood in the urine
• Leaking of urine
• Fever and occasionally chills.

To help prevent a bladder infection from recurring, urinate often during the day and empty your bladder completely each time.
In addition, women who tend to have bladder infections often should follow these guidelines:

• Talk to your Doctor
• Drink plenty of water
• Do not delay urinating when you feel the need to urinate
• Keep the vaginal area clean
• Urinate after intercourse. Never combine anal and vaginal intercourse
• Wear cotton underwear
• Avoid tight clothes in the genital area
• Do not wear a wet bathing suit for long periods of time.
• During pregnancy, tell your doctor if you have a history of urinary tract problems. Your provider may order tests for bacteria in your urine before you have symptoms of infection.

A woman’s sexual desires naturally vary over the years and low sex drive affects at least one out of five women in the United States.

While emotions are frequently behind a loss of sex drive in younger women, doctors say it is frequently the aging process itself that’s behind desire changes in women over age 45.

Highs and lows sexual desire commonly coincide with the beginning or end of a relationship or with major life changes, such as pregnancy, menopause or illness.

A low sex drive is the most common sexual complaint made by women - up to 30% to 40% of them. The American Medical Association has estimated that several million US women suffer from low sex drive or libido.

A low sex drive in women refers to a lack of interest in sexual relations. In medical terms, you have hypoactive sexual desire disorder if you have a persistent or recurrent lack of interest in sex that causes you personal distress. It is not unusual to experience a temporary decline in sexual desire at some point, and many women do. But if it persists, it may present problems.

Low sex drive can result from physical conditions (such as illness or pregnancy), psychological issues (such as stress or anxiety), or other factors.

The major symptom of low sex drive in women is a low or absent desire for sex. According to some studies, more than 40 percent of women complain of low sexual desire at some point. The percentage is smaller — 5 percent to 15 percent — if you only count women with ongoing problems.

Researchers acknowledge that it’s difficult to measure what’s normal and what’s not. There is no number to define low sex drive. It varies from woman to woman.

The signs of a low sex drive include:

• Less frequent sexual thoughts and fantasies
• Reduced sexual desire
• Reluctance to initiate sex
• Less frequent masturbation
• Lack of desire for sex when you’ve gone without sex for days, weeks, or months (depending on what was previously normal for you) 

Causes can include:

• Sexual problems: Pain during sex – dyspareunia - or inability to orgasm.
• Medical diseases: Nonsexual diseases including arthritis, cancer, diabetes, high blood pressure, coronary artery disease and neurological diseases. Infertility also can contribute to low sex drive, even after infertility treatments are over.
• Medications: Prescription medications including antidepressants, blood pressure medications, chemotherapy drugs and antihistamines.
• Alcohol and drugs.
• Surgery: Surgeries related to your breasts or your genital tract can affect your body image, function and desire for sex.
• Fatigue

Hormone changes can also lead to low sexual drive:

Menopause:  Estrogen levels drop during the transition to menopause, which can cause a decreased interest in sex and dryer vaginal tissues, resulting in painful or uncomfortable sex.

Pregnancy and breast-feeding: Hormone changes during pregnancy, after having a baby and during breast-feeding. Also, fatigue, changes in body image can contribute to changes in your sexual desire.
Psychological causes that can guide you to low sexual drive:

• Mental health problems, such as anxiety or depression
• Stress, such as financial stress or work stress
• Poor body image
• Low self-esteem
• History of physical or sexual abuse

Relationship issues might also lead you to low sexual desire:

• Lack of connection with your partner
• Unresolved conflicts or fights
• Poor communication of sexual needs and preferences
• Infidelity or breach of trust

But loss of sex drive is not something you have to live with; there is much you can do to regain your sex drive and your happy outlook on life. Talk to you doctor about it.

Perimenopause marks the interval in which your body begins its transition into menopause. Menopause is when women stop menstruating -having periods- and their ovaries gradually stop working.

Perimenopause includes the years leading up to menopause — anywhere from two to eight years — plus the first year after your final period. It is a transition period in a woman’s life and signals the beginning of the loss of fertility because of the body’s natural aging process.

Perimenopause and menopause are not diseases. They are healthy and natural parts of a woman’s life.

The levels of your reproductive hormones — estrogen and progesterone — rise and fall unevenly during perimenopause. Your menstrual cycles may lengthen or shorten, and you begin having menstrual cycles in which you don’t ovulate. It’s only during cycles when you do ovulate that you can become pregnant.

How long perimenopause starts and lasts may vary form woman to woman. You’ll notice some signs sometime in your 40s, but some women notice changes as early as their mid-30s.

Signs and symptoms
Perimenopause causes some changes in your body such as:

• Menstrual irregularities. The intervals may be longer or shorter, your flow may be scanty to profuse, and you may skip some periods.
• Hot flashes and sleep problems. About 75% to 85% of women experience hot flashes during perimenopause. Their intensity, duration and frequency vary. Sleep problems are often due to hot flashes or night sweats, but sometimes sleep becomes inconsistent even without them.
• Mood changes. Some women experience mood swings, irritability or depression, but the cause of these symptoms may be sleep disruption or other menopausal symptoms more than the hormonal changes of menopause.
• Vaginal and bladder problems. When estrogen levels diminish, your vaginal tissues may lose lubrication and elasticity, making intercourse painful. Low estrogen levels may also leave you more vulnerable to urinary or vaginal infections.
• Decreasing fertility. As ovulation becomes irregular, your ability to conceive decreases.
• Changes in sexual function. During perimenopause, sexual arousal and desire may change. But for most women who had satisfactory sexual intimacy before menopause, this will continue through perimenopause and beyond.
• Loss of bone. With declining estrogen levels, you start to lose bone more quickly than you replace it, increasing your risk of osteoporosis.
• Changing cholesterol levels. Declining estrogen levels may lead to unfavorable changes in your blood cholesterol levels, including an increase in lLDL cholesterol — the "bad" cholesterol. At the same time, HDL cholesterol — the "good" cholesterol — decreases.

As you go through the menopausal transition, your body’s production of estrogen and progestin fluctuates. These hormonal fluctuations are at the root of the changes your body goes through during perimenopause.

Making healthy lifestyles choices may help alleviate some of the symptoms of perimenopause as well as promote good health as you age. These choices include:

• Good nutrition. Low-fat, high-fiber diet that’s rich in fruits, vegetables and whole grains, calcium-rich foods or take a calcium supplement, avoid alcohol and caffeine, which can trigger hot flashes.
• Regular exercise helps prevent weight gain, may reduce the intensity of hot flashes, improves your sleep, strengthens your bones and elevates your mood.
• Stress reduction. Practiced regularly, stress reduction techniques, such as meditation or yoga.
• Vaginal lubricants may ease dryness and pain associated with sexual intercourse

It is important that you talk to your doctor.

The transition to menopause can be a time of great change, a time of reflection and inspiration. Although transitions of any kind can be naturally difficult, many women experience a brand new sense of freedom and anticipate personal growth, because menopausal women have confidence and experience.

Menopause simply means the end of menstruation. As a woman ages, there is a gradual decline in the function of her ovaries and the production of estrogen. Menopause, or the permanent end of menstruation and fertility, is a natural biological process, not a medical illness. Even so, the physical and emotional symptoms of menopause can disrupt your sleep, debilitate your energy and — at least indirectly — generate feelings of sadness and loss.

Women typically menstruate for the last time at about 50 years of age. A few stop menstruating as young as 40, and a very small percentage as late as 60.
When menopause occurs naturally, it tends to take place anywhere between the ages of 40 and 58, with an average age of 51. But for some women it can occur as early as the late 30s, or as late as your 60s. When menopause occurs before 35, it is considered premature menopause.

Women who smoke tend to go through menopause a few years earlier than nonsmokers. Most women notice some menstrual changes -- such as a shortening of cycle length (periods occurring closer together), skipped menstrual periods, and occasional heavy periods -- up to a few years before menstruation ceases. Certain surgical or medical treatments or medical conditions can bring on menopause earlier than expected.
These include:
Hysterectomy,
chemotherapy
and radiation therapy, premature ovarian failure.

There is great variation in experience of menopause among women. About 75% of women have hot flashes. Nighttime hot flashes are more common and may result in chronic sleep deprivation. Mood changes aren’t as well understood, but some women report an obvious change in mood. In addition, women may experience vaginal dryness, painful intercourse, and urinary symptoms. These symptoms are often temporary and pass as your body adjusts. Hormone replacement therapy can help relieve the symptoms in the meantime.

However, menopause does increase your risk of osteoporosis (thinning of the bones) and heart disease.
For women undergoing natural menopause, the process is gradual and is described in three stages:
Perimenopause:  Begins many years before the final menstrual period. It can last 6 years or more, and ends 1 year after the final menstrual period.
Menopause: Menopause is the point when a woman has her last menstrual period. Menopause is diagnosed when a woman has gone without a period for 12 consecutive months.
Postmenopause: These are the years after menopause. During this stage, menopausal symptoms, ease for most women. However, health risks related to the loss of estrogen increase as the woman ages.

The signs and symptoms of menopause include: irregular or skipped periods, hot flashes, changes in sex drive, insomnia, mood swings, fatigue, increased abdominal fat, thinning hair, loss of breast fullness, depression, decreased fertility, racing heart, headaches, joint and muscle aches and pains, vaginal dryness, bladder control problems.

Not all women get all of these symptoms.
Fortunately, many of the signs and symptoms associated with menopause are temporary. Take these steps to help reduce or prevent their effects:

• Cool hot flashes: Get regular exercise, wear lightweight clothes made of natural fibers, and avoid hot beverages, spicy foods, alcohol, hot weather and even a warm room.
• Use relaxation techniques: Meditation, yoga, listening to soft music and massages
• Decrease vaginal discomforts: Use over-the-counter water-based vaginal lubricants or moisturizers. Staying sexually active also helps.
• Optimize your sleep: Avoid caffeine and plan to exercise during the day.
• Strengthen your pelvic floor
• Eat a healthy diet
• Don’t smoke
• Exercise regularly:this will help maintain your body’s hormonal balance
• Avoid stressful situations as much as possible
• Talk to your doctor, schedule regular checkups

The transition to menopause can be a time of great change, a time of reflection and inspiration. Although transitions of any kind can be naturally difficult, many women experience a brand new sense of freedom and anticipate personal growth, because menopausal women have confidence and experience.

Also called urinary incontinence, bladder control problems are a common complication of menopause.
During and after the process of menopause, levels of the female hormone estrogen drop significantly. In addition to controlling your monthly periods and body changes during pregnancy, estrogen helps keep the bladder and the urethra healthy.

Lack of estrogen may also cause the pelvic muscles responsible for bladder control to weaken, resulting in urinary incontinence.

Some of the bladder control problems which may develop because of menopause include:
* Stress incontinence. Pressure from coughing, sneezing, or lifting can push urine through the weakened muscle. This kind of leakage is called stress incontinence. It is one of the most common kinds of bladder control problems in older women.
* Urge incontinence. Urge incontinence is another very common bladder control problem. With this condition, the bladder muscles squeeze at the wrong time -- or all the time -- and cause leaks.
* Painful urination.
* Nocturia. Need to get out of bed to urinate several times a night.

Loss of sexual desire is one of the most common symptoms of menopause, with somewhere between 20% and 45% of menopausal women reporting a decrease in their sex drive.

While some women experience a decrease in libido after menopause, studies have shown that many couples in their 50s and up through their 80s still enjoy a healthy sex life.

Sex during and after menopause has always been an issue of great debate and every woman feels a different way about it. Just because you’re past menopause does not mean that you should live without sexual intimacy. This view about sex during menopause is slowly but surely changing and sex and menopause is now a topic that is open for discussion.

Menopausal women are now understood to be as female as they ever were. Most women who are experiencing menopause take it upon themselves to continue their sexual life. Yet, many menopausal women face a lot of problems on the sexual front. Having to deal with mood swings, hot flashes, depression, and vaginal dryness that makes sex painful.
Causes of Decreased Sex Drive
During menopause, sex drive can drop to very low levels. Some women don’t think about sex nearly as much as they used to before menopause. Others want to have sex, but just aren’t enjoying it enough to make it worth the effort. Decreased libido is thought to be due to lowered levels of estrogen, progesterone, and testosterone present in your body during menopause.

Each of these hormones has a specific role to play in making you experience sexual desire. Estrogen helps you to feel heightened sensitivity during sexual intercourse. Progesterone keeps your libido up. Testosterone, a male sex hormone, boosts sexual desire and lubricates your vagina. When these hormones drop, the same happens to your overall desire for sexual intercourse.

The symptoms that come along with menopause include: vaginal dryness, fatigue, mood swings, depression and self-image issues.

A healthy lifestyle is important for maintaining a healthy sex life.

• Eat healthy foods
• Maintain a healthy weight.
• Do not smoke
• Exercise regularly
• Specific pelvic floor exercises
• Talk with your doctor about symptom relief from vaginal dryness, hot flashes, and decreased sexual desire.

However, it is important to know that you are not alone. A lot can be done to help you increase your libido and feel more comfortable with your changing body.

Not all women have sexual concerns after menopause, and some may feel more sexually free since there is no further chance of pregnancy. Also, women may gain self-confidence as they age. That can improve mental health and often translates to more confidence and comfort with sexual matters.

Hot flashes can happen to you at any time and might leave you sweaty and red-faced.  As many as three out of every four women experience hot flashes as they go through the menopausal transition.  Hot flashes are quite common; they are the most common menopause-related discomfort.

A hot flash is a momentary sensation of heat that may be accompanied by a red, flushed face and sweating. The cause of hot flashes is not known, but may be related to changes in circulation.

Hot flashes occur when the blood vessels near the skin’s surface dilate to cool. This produces the red, flushed look to the face. A woman may also perspire to cool down the body. In addition, some women experience a rapid heart rate or chills.

Hot flashes accompanied with sweating can also occur at night. These are called night sweats and may interfere with sleep.
When you’re having a hot flash, you might experience:

• A feeling of mild warmth to intense heat spreading through your upper body and face
• A flushed appearance with red, blotchy skin on your face, neck and upper chest
• A rapid heartbeat
• Perspiration, mostly on the upper body
• A chilled feeling as the hot flash subsides

Hot flashes vary in frequency and severity — you may have several a day or just a few a week. Some women have hot flashes for a very short time during menopause, for others, hot flashes may continue for several years or indefinitely. Generally, hot flashes are less severe as time passes. You could experience full-on sweating throughout the day and night, or you may just occasionally feel warmer than you used to. Hot flashes can last as long as 30 minutes, but most subside within a couple of minutes. Nighttime hot flashes — or night sweats — can wake you from a sound sleep.

Hot flashes are common during perimenopause — the period of time leading up to menopause — and tend to peak during the first couple of years after menstrual periods have stopped.

While it may be impossible to completely avoid hot flashes during menopause, there are certain triggers that may bring them on more frequently or cause them to be more severe. To prevent hot flashes, avoid these triggers:

• Stress
• Caffeine
• Alcohol
• Spicy foods
• Tight clothing
• Heat
• Cigarette smoke
• Stay cool. Keep your bedroom cool at night. Use fans during the day. Wear light layers of clothes with natural fibers such as cotton.
• Practice deep breathing for 15 minutes in the morning, 15 minutes in the evening and at the onset of hot flashes.
• Exercise daily. Walking, swimming, dancing and bicycling are all good choices.
• Chill pillows; cooler pillows to lay head on at night might be helpful.