Author: The Beauty Nation

While the multiplicity of etiological influences is acknowledged, the factor of religious orthodoxy still remains of major import in primary orgasmic dysfunction as in almost every form of human sexual inadequacy.

In the total of 193 women who have never achieved orgasmic return before referral to the Foundation for treatment, 42 were products of rigidly channelized religious control. Eighteen were from Catholic, 26 from Jewish, and 7 from fundamentalist Protestant backgrounds. It may also be recalled that 9 of these 42 primarily non-orgasmic women reflecting orthodox religious backgrounds also were identified as having the clinical complaint of vaginismus, while 3 more women with orthodox religious backgrounds had to contend with situational orgasmic dysfunction and vaginismus simultaneously.

History of Orgasm and Religion

Reflecting the control of orthodox religious demands upon the orgasmically dysfunctional woman and her husband is presented to underscore the Foundation’s professional concern for any orthodoxy influenced imprinting and environmental input that can and does impose severely negative influences upon the susceptible woman’s psychosocial structure relative to her facility for sexual functioning.

After 9 years of a marriage that had not been consummated, Mr. and Mrs. A were referred to the Foundation for treatment. He was 26 and she was 24 years old at marriage. Mrs. A’s family background was one of unquestioned obedience to parents and to disciplinary religious tenets. She was one of three siblings, the middle child to an elder brother by three years and a younger sister by two years.

Other than her father, religion was the overwhelming influence in her life. The specific religious orientation of Protestant fundamentalism encompassed total dedication to the concept that sex and sin were synonymous words.

Mrs. A remembers her father, who died when she was 19, as a Godlike figure whose opinion in all matters was an absolute law in the home. Control of dress, social commitment, educational direction and in fact, school selection through college were his responsibility. There were long daily sessions, of family prayer interspersed with paternal pronouncements, never family discussions. On Sunday the entire day was devoted to the church, with activities running the gamut of Sunday school, formal service, and young people’s groups.

The young woman described a cold, formal, controlled family environment in which there was complete demand for dress as well as toilet privacy. Not only were the elder brother and sisters socially isolated, but the sisters also were given separate rooms and encouraged to protect individual privacy. She never remembers having seen her mother, father, brother, or sister in an undressed state.

Sex Was Never Mentioned

All literature, including newspapers, available to the family group was evaluated by her father for possibly suggestive or controversial material. There was a restricted list of radio programs to which the children could listen.

Mrs. A had no concept of her mother except as a woman living a life of rigid emotional control, essentially without a described personality, fully dedicated to the concept that woman’s role was one of service.

She considered it her duty and her privilege to clean, cook, and care for children, and to wait upon her husband. There is no recall of pleasant moments of quiet exchange between mother and daughter, or, for that matter, of any freedom to discuss matters of the moment with either her brother or her sister.

Menstrual, The Monthly Curse

As a young girl, she was totally unprepared for the onset of menstruation. The first menstrual period occurred while she was in school she was terrified, ran home, and was received by a thoroughly embarrassed mother who coldly explained to the young girl that this was a woman’s lot.

She was told that as a woman she must expect to suffer this “curse” every month.

Her mother warned her that once a month she would be quite ill with “bad pains” in her stomach and closed the discussion with the admonition that she was never to discuss the subject with anyone, particularly not with her younger sister. The admonition was obeyed to the letter. The mother provided the protective materials necessary and left the girl to her own devices. There was no discussion of when or how to use the menstrual protection provided.

Menstrual cramping had its onset with the second menstrual period and continued to be a serious psychosocial handicap until Mrs. A was seen in therapy. She also described the fact that her younger sister was confined to bed with monthly frequency while maturing.

During the teenage years, dating in groups was permitted by her father for church-social activities and occasionally, well-chaperoned school events.

College, selected by her father, was a coeducational institution which was described by her as living by the “18-inch rule,” i.e., handholding was forbidden and 18 inches were required between male and female students at all times. Her dating was rare and well chaperoned. After graduation she worked as a secretary in a publishing house specializing in religious tracts. Here she met and married a man of almost identical religious background.

The courtship was completely circumspect from a physical point of view. The couple arrived at their wedding night with a history of having exchanged three chaste kisses, which not only was the total of their physical courtship but also represented the only times she remembered ever being kissed by a man. Her father had felt such a display of emotion unseemly.

The only time her mother ever discussed a sexual matter was the day of her wedding. Mrs. A was carefully instructed to remember that she now was committed to serve her husband. It would be her duty as a wife to allow her husband “privileges.” The privileges were never spelled out.

She also was assured that she would be hurt by her husband, but that “it” would go away in time. Finally and most important, she was told that “good women” never expressed interest in the “thing.” Her reward for serving her husband would be, hopefully, in having children.

She remembers her wedding night as a long struggle devoted to divergent purposes. Her husband frantically sought to find the proper place to insert his penis, while she fought an equally determined battle with nightclothes and bedclothes to provide as completely a modest covering as possible for the awful experience. The pain her mother had forecast developed as her husband valiantly strove for intromission.

Intercourse Attempts

Although initially there were almost nightly attempts to consummate the marriage, there was total lack of success. It never occurred to Mrs. A that she might cooperate in any way with the insertive attempts since this was to be her husband’s pleasure, it therefore was his responsibility.

She evidenced such a consistently painful response whenever penetration was attempted that frequency of coital attempt dwindled rapidly. The last three years before referral, attempts at consummation occurred approximately once every three to four months.

For nine years this woman only knew that she was physically distressed whenever her husband approached her sexually, and that for some reason the distress did not abate, Her husband occasionally ejaculated while attempting to penetrate, so she thought that he must be “satisfied.”

Whenever Mr. A renewed the struggle to consummate, she was convinced that he had little physical consideration for her.

Her tense, frustrated, negative attitude, initially stimulated by both the pain and the “good woman” concept described by her mother, became in due course one of complete physical rejection of sexual functioning in general and of the man involved in particular.

When seen in therapy, Mrs. A had no concept of what the word masturbation meant. Her husband’s sexual release before marriage had been confined to occasional nocturnal emissions, but he did learn to masturbate after marriage and accomplished ejaculatory release approximately once a week, without his wife’s knowledge. There was no history of extramarital exposure.

Of interest is the fact that Mrs. A’s brother has been twice divorced, reportedly because he cannot function sexually, and her younger sister has never married. As would be expected, at physical examination Mrs. A demonstrated a severe degree of vaginismus in addition to the intact hymen.

In the process of explaining the syndrome of involuntary vaginal spasm to both husband and wife, the procedures described were followed in detail.

When vaginismus was described and then directly demonstrated to both husband and wife, it was the first time Mr. A had ever seen his wife unclothed and also the first time she had submitted to a medical examination.

There obviously were multiple etiological influences combining to create this orgasmic dysfunction, but the repression of all sexual material inherent in the described form of religious orthodoxy certainly was the major factor. Under Foundation direction, the process of education had to include reorientation of both the sexual and social value systems.

The influence of the psychosocial system was turned from a dominant-negative factor to a relatively neutral one during the acute phase of treatment. This alteration in repressive quality allowed Mrs. A’s natural biophysical demand to function without determined opposition, and orgasmic expression was obtained. Obviously, the husband needed a definitive psychosexual evaluation as much as did his wife.

In order to be diagnosed as having primary orgasmic dysfunction, a woman must report a lack of orgasmic attainment during her entire lifespan. There is no definition of male sexual dysfunction that parallels this severity of exclusion.

If a male is judged primarily impotent, the definition means simply that he has never been able to achieve intromission in either homosexual or heterosexual opportunity. However, he might, and usually does, masturbate with some regularity or enjoy occasions of partner manipulation to ejaculation.

For the primarily non-orgasmic woman, however, the definition demands a standard of the total in orgasmic responsivity.

The edict of lifetime non-orgasmic return in the Foundation’s definition of primary orgasmic dysfunction includes a history of consistent non-orgasmic response to all attempts at physical stimulation, such as masturbation or partner (male or female) manipulation, oral-genital contact, and vaginal or rectal intercourse.

In short, every possible physical approach to sexual stimulation initiated by self or received from any partner has been totally unsuccessful in developing an orgasmic experience for the particular woman diagnosed as primarily non-orgasmic.

Orgasmic In Dreams Or In Fantasy

If a woman is orgasmic in dreams or in fantasy alone, she still would be considered primarily non-orgasmic. Foundation personnel has encountered two women who provided a positive history of an occasional dream sequence with orgasmic return and a negative history of physically initiated orgasmic release.

And since, no woman has been encountered to date that described the ability to fantasy to orgasm without providing a concomitant history of successful orgasmic return from a variety of physically stimulative measures.

There are salient truths about male and female sexual interaction that place the female in a relatively untenable position from the point of view of equality of sexual response. Of primary consideration is the fact of a woman’s physical necessity for an effectively functioning male sexual partner if she is to achieve a coitally experienced orgasmic return.

During coition, the non-orgasmic human female is immediately more disadvantaged than her sexually inadequate partner in that her fears for performance are dual in character. Her primary fear is, of course, for her own inability to respond as a woman, but she frequently must contend with the secondary fear for the inadequacy of male sexual performance.

The outstanding example of such a situation is, of course, that of the woman married to a premature ejaculator.

From the point of view of mutual responsibility for sexual performance, the woman has only to make herself physically available in order to provide the male with ejaculatory satisfaction. When the premature ejaculator in turn makes himself available, there usually is little correlation between intromission, rapid ejaculation, and female orgasmic return during the episode.

When Married To A Premature Ejaculator

The biophysically disadvantaged female usually is additionally disadvantaged from a psychosocial point of view. Not only is there an insufficient bio-physical opportunity to accomplish orgasmic return, but in short order, the wife develops the concept of being sexually used in the marriage. She feels that her husband has no real interest in her personally nor any concept of responsibility to her as a sexual entity.

Sexual Excitation With Intromission

Many times the wife might be at a peak of sexual excitation with intromission. Without fear for her husband’s sexual performance, she could be orgasmically responsive shortly after coital connection, displaying a full bio-physical capacity for sexual response, but as she sees and feels the male thrusting frantically for ejaculatory release, she immediately fears loss of sexual opportunity, is distracted from the input of biophysical stimuli by that fear, and rapidly loses sexual interest.

With the negative psychosocial system influence from the concept of being used more than counterbalancing the high level of biophysically oriented sexual tension she brought to the coital act, the orgasmic opportunity is lost.

A brief attempt should be made to highlight the direct association of male and female sexual dysfunction in marriage, for there were 223 marital couples referred to the Foundation for treatment with bilateral partner complaints of sexual inadequacy. By far the greatest instance of a combined diagnosis was that of a non-orgasmic woman married to a premature ejaculator.

Of the total 186 premature ejaculators treated in the 11-year program, 68 were married to women reported as primarily non-orgasmic and an additional 39 wives were diagnosed as situationally non-orgasmic. Thus, in 107 of the 223 marriages with bilateral partner complaints of sexual dysfunction, the specific male sexual inadequacy was premature ejaculation.

Since the in-depth descriptions of the premature ejaculator presented in the earlier topic include full descriptions of the problems of female sexual functioning in this situation, there is no need for a detailed history representative of the 68 women primarily non-orgasmic in marriages to prematurely ejaculating men.

Another salient feature in the human female’s disadvantaged role in coital connection is the centuries-old concept that it is a woman’s duty to satisfy her sexual partner. When the age-old demand for accommodation during coital connection dominates any woman’s responsivity, her own opportunities for orgasmic expression are lessened proportionately.

If the woman is to express her biophysical drive effectively, she must have the single-standard opportunity to think and feel sexually during the coital connection that previous cultures have accorded the man.

The male partner must consider the marital bed as not only his privilege but also a shared responsibility if his wife is to respond fully with him in coital expression. The heedless male driving for orgasm can carry along the woman already lost in high levels of sexual demand, but his chances of elevating to orgasm the woman who is trying to accommodate to the rhythm, depth, and power of his demanding pelvic thrusting are indeed poor.

It is extremely difficult to categorize female sexual dysfunction on a relatively secure etiological basis. There is such a multiplicity of influences within the biophysical and psychosocial systems that to isolate and underscore a single, major etiological factor in any particular situation is to invite later confrontation with pitfalls in therapeutic progression.

Female Primary Orgasmic Dysfunction

Describes a condition whereby neither the biophysical nor the psychosocial systems of influence that are required for the effective sexual function is sufficiently dominant to respond to the psychosexually stimulative opportunities provided by self-manipulation, partner manipulation, or coital interchange.

If the concept of two interdigital systems influencing female sexual responsivity can be accepted, what can be considered the weaknesses and the strengths of each?

Input required by either system for the development of peak response is, of course, subject to marked variation. There may be some value in drawing upon the previously described psycho-physiological findings returned from preclinical studies. As a human female response to subjectively identifiable sexual stimuli, reliable patterns of accommodation by one system to the other can be defined, and tend to follow basic requirements set by earlier imprinting.

Patterns of imprinting can be either reinforced or redirected by controlled experimental influence. They can also be diverted in their signaling potential by reorientation of a previously unrealistic sexual value system. The sexual value system, in turn, responds to reprogramming by new, positive experiences.

Variations in the human female’s bio-physical system are, of course, relative to basic body economy. Is the woman in good health, is there a cyclic hormonal ebb and flow to which she is particularly susceptible?

Are the reproductive viscera anatomically and physiologically within “normal” limits, or is there evidence of pelvic pathology?

Is there evidence of broad-ligament laceration, endometriosis, or residual pelvic infection?

Certainly, most forms of pelvic pathology would weigh against the effective functioning of the biophysical system. On the other hand, are there those biophysical patterns that tend to improve the basic facility of her sexual responsivity, and is there well-established metabolic balance, good nutrition, sufficient rest, regularity of sexual outlet?

Each of these factors inevitably improves biophysical responsivity. There must be professional consideration of multiple variables when evaluating the influence of the biophysical system upon female sexual responsivity.

However, the system with the infinitely greater number of variables is that reflecting psychosocial influence.

Most dysfunctional women’s fundamental difficulty is that the requirements of their sexual value systems have never been met. Consequently, the resultant limitations of the psychosocial system have never been overcome.

There are many women who specifically resist the experience of orgasmic response, as they reject their sexual identity and the facility for its active expression. Often these women were exposed during their formative years to such timeworn concepts as “sex is dirty,” “nice girls don’t involve themselves,” “sex is the man’s privilege,” or “sex is for reproduction only.”

There are also those whose resistance is established and sustained by a stored experience of mental or physical trauma (rape, dyspareunia, etc.), which is signaled by every sexual encounter.

Negative Sex View

Again from a negative point of view, there may be extreme fear or apprehension of sexual functioning instilled in any woman by inadequate sex education.

Any situation leading to sexual trauma, real or imagined, during her adolescent or teenage years or her sexual partner’s crude demonstration of his own sexual desires without knowledge of how to protect her sexually, would be quite sufficient to create a negative psychosocial concept of woman’s role in sexual functioning.

The woman living with residual specific sexual trauma (mental or physical) frequently is encountered in this category.

Finally, there is the woman whose background forces her into automatic sublimation of psychosexual response. This individual simply has no expectations for sexual expression that are built upon a basis of reality.

She has presumed that sexual response in some form simply would happen but has a little, idea of its source of expression. In these instances, sexual sublimation is allowed to become a way of life for many reasons. Particularly is this reaction encountered in the woman who has failed to enjoy the privilege of working at being a woman.

On the positive side

The psychosocial value system can overcome physical disability with dominant identification that may be personal and/or situational in nature.

In states of advanced physical disability, the strength of loved-partner identification can provide orgasmic impetus to a woman physically consigned to be sexually unresponsive.

When there has been a pattern of little bio-physical sexual demand, as in a postpartum period, sexual tension may be rapidly restored by the psychosocial stimulation of a vacation, anniversary, or other experience of special significance.

Again the biophysical and psychosocial systems of influence are interdigital in orientation, but there is no biological demand for their mutual complementary responsivity.

It is in the areas of involuntary sublimation that the psychosocial system is gravely handicapped and would tend to exert a negatively dominant influence in contradistinction to any possible biophysical stimulative function.

Origin of Orgasmic Dysfunction

The potential for orgasmic dysfunction highlighted in the psychosocial-sexual histories of those women in marital couples referred to the Foundation can be described in a composite profile.

A baseline of dysfunctional distress was provided by specific material recalled not only from sexually developmental years but further encompassing all opportunities of potential sexual imprinting, conditioning, and experience storage.

Within this body of material, described in many settings, the dissimulation of sexual feeling consistently was reported as a manifest requirement or as a residual of earlier learning, operant as a requirement. (Imprinting is that process that helps define the behavioral patterns of sexual expression and signal their arousal.)

Origin of Female Negative Dysfunction

At one pole it represented the influence of deliberate parental omission of reference to or discussion of sexual function as a component of the pattern of living. This informationally underprivileged background also failed to provide any example of female sexuality, recognizably secure in expression, which could be emulated.

At one pole it represented the influence of deliberate parental omission of reference to or discussion of sexual function as a component of the pattern of living. This informationally underprivileged background also failed to provide any example of female sexuality, recognizably secure in expression, which could be emulated.

The other extreme of rejective conditioning was reported as rigidly explicit but consistently negative admonition by parental and/or religious authority against personal admission or overt expression of sexual feeling. Between these negative variants, there were many levels of uninformed guidance for the young girl or woman as she struggled with psychosocial enigmas, cultural restrictions, and her own physical sexual awareness.

Usually, such guidance, though often well-intentioned, was more a hindrance than a help as she developed her sexual value system and ultimately her natural sexual function.

In direct parallel to the degree to which the young girl developing a sexual value system seemed to have dissimulated her sexual interests during phases of imprinting, conditioning, and information storing, older women, now sexually dysfunctional, reported consistent precoital evidence of repression of sexual identity in mature sexual encounters.

Residual repression of sexual responsivity in the adult usually went well beyond any earlier theoretical requirements for a social adaptation necessary to maintain virginity, to restrain a partner’s sexual demand, or even to conduct interpersonal relationships in a manner considered appropriate by a representative social authority. Not infrequently the residual repression of sexual responsivity was so acute as to be emphasized clinically with the time-worn cry of “I don’t feel anything.”

Thus, for most primarily non-orgasmic women, repressed expression of sexual identity through ignorance, fear, or authoritative direction was the initial inhibiting influence in failure of sexual function. Not infrequently this source of repression was identified as a crucial factor of influence for situationally non-orgasmic women as well, although these individuals had the facility to overcome or circumnavigate its control under certain circumstances.

Requirements of The Sexual Value

System prevailing during initial opportunities at sexual function could not be fulfilled because of the component of repression, each woman attempted without success to compensate in her desire for sexual expression by developing unrealistic partner identification, the concept of social secureness, or pleasure in environmental circumstances.

In the failure of her own sexual values to serve, there was almost a blind seeking for value substitutes. When a workable substitution was not identified and the void of psychosexual insecurity remained unfilled, sexual dysfunction became an ongoing way of life.

An interesting variation on this classification of repression should be mentioned. There were several primarily non-orgasmic women whose receptivity to the repressive conditioning was slightly different. Their own particular personality characteristics or their relationship to negatively directive authority was such that they fully accepted the concept of sexual rejection.

They developed pride in their ability to comply with sexual repression and did so with apparent social grace. Their selection of a mate in most cases represented a choice of similar background.

The difficulty arose with marriage. On the wedding night, a completely unrealistic, negative sexual value system usually was revealed during their attempt to establish an effective sexual interaction. These women reported either total pelvic anesthesia (“I don’t feel anything”) or isolation of sexual feelings from the context of psychosocial support.

Women entering therapy in a state of non-orgasmic return reflected the complete failure of any effective alignment of their biophysical and psychosocial systems of influence. They had never been able to merge either their points of maximum biophysical demand or their occasions of maximum psychosocial need with optimum environmental circumstances of time, place, or partner response in order to fulfill the requirements of their sexual value systems.

The human female’s facility of physiological response to sexual tensions and her capacity for orgasmic release never have been fully appreciated.

Lack of comprehension may have resulted from the fact that functional evaluation was filtered through the encompassing influence of socio-cultural formulations previously described in this topic.

There also has been the failure to conceptualize the whole of sexual experience for both the human male and female as constituted in two totally separate systems of influence that coexist naturally, both contributing positively or negatively to any state of sexual responsivity, but having no biological demand to function in a complementary manner.

With the reminder that finite analysis of male sexual capacity and physiological response also has attracted little scientific interest in the past.

It should be reemphasized that similarities rather than differences are frequently more significant in comparing male and female sexual responses. By intent, the focus of this chapter is directed toward the human female, but much of what is to be said can and does apply to the human male.

The bio-physically and psychosocially based systems of influence that naturally coexist in any woman have the capacity if not the biological demand to function in mutual support. Obviously, there is an interdigitation of systems that reinforce the natural facility of each to function effectively.

However, there is no factor of human survival or internal biological need defined for the female that is totally dependent upon a complementary interaction of these two systems. Unfortunately, they frequently compete for dominance in problems of sexual dysfunction.

Sexual Value

As a result, when the human female is exposed to negative influences under circumstances of individual susceptibility, she is vulnerable to any form of psychosocial or biophysical conditioning, i.e., the formation of man’s individually unique sexual value systems.

Based upon the manner in which an individual woman internalizes the prevailing psychosocial influence, her sexual value system may or may not reinforce her natural capacity to function sexually.

One need only remember that sexual function can be displaced from its natural context temporarily or even for a lifetime in order to realize the concept’s import. Women cannot erase their psycho-social sexuality or sexual identity as being female, but they can deny their biophysical capacity for natural sexual functioning by conditioned or deliberately controlled physical or psychological withdrawal from sexual exposure.

Woman’s Conscious

Denial of biophysical capacity rarely is a completely successful venture, for her physiological capacity for sexual response infinitely surpasses that of man.

Indeed, her significantly greater susceptibility to negatively based psychosocial influences may imply the existence of a natural state of psycho-sexual-social balance between the sexes that has been culturally established to neutralize a woman’s biophysical superiority.

The specifics of the human female’s physiological reactions to effective levels of sexual tension have been described in detail, but brief clinical consideration of these reactive principles is in order.

For women, as for men, the two specific total-body responses to elevated levels of sexual tension are increased myotonia (muscle tension) and generalized vasocongestion (pooling of blood in tissues), both superficial (sex flush) and deep (breast enlargement).

Clinical Attention

is directed toward female orgasmic dysfunction, one particular biological area is the pelvic structures and is of the moment. Specific evidence has been accumulated of the incidence of both myotonia and vasocongestion in the female’s pelvis. She responds physiologically to sex-tension elevation.

The phases of the female cycle of sexual response established in 1966 will be employed to identify clinically important vasocongestive and myotonic reactions developing in the pelvic viscera of any woman responding to sexual stimulation.

Woman’s Sexual Excitement Phase:

1. Sex-tension increment, the first physical evidence of her response to sexual stimulation is vaginal lubrication. This lubrication is produced by a deep vasocongestive reaction in the tissues surrounding the vaginal barrel. There also is evidence of increased muscle tension as the vaginal barrel expands and distends involuntarily in anticipation of penetration.
2. When sex tensions reach plateau phase levels of responsivity, a local concentration of venous blood develops in the outer third of the vaginal barrel, creating partial constriction of the central lumen. This vaginal evidence of a deep vasocongestive reaction has been termed the orgasmic platform.
3. The uterus increases in size as venous blood is retained within the organ tissues.
4. The clitoris evidence increasing smooth-muscle tension by elevating from its natural, pudendal-overhang positioning and flattening on the anterior border of the symphysis.
5. With orgasm, reached an increment peak of pelvic-tissue vasocongestion and myotonia, the orgasmic platform in the outer third of the vagina and the uterus contract within regularly recurring rhythmicity as evidence of high levels of muscle tension.
6. Finally, with the resolution phase, both vasocongestion and myotonia disappear from the body generally, and the pelvic structures specifically.

If the orgasmic release has been obtained, there is rapid detumescence from these naturally accumulative physiological processes.

The loss of muscle tension and venous blood accumulation is much slower if orgasm has not been experienced and there is an obvious residual sexual tension.

It is the presence of involuntary-muscle irritability and superficial and deep venous congestion that women cannot deny, for these reactions develop as physiological evidence of both conscious and subconscious levels of sexual tension. With the accumulation of myotonia and pelvic vasocongestion, the biophysical system signals the total structure with stimulative input of a positive nature.

Regardless of whether women voluntarily deny their biological capacity for sexual function, they cannot deny the pelvic, irritative evidence of inherent sexual tension for any length of time. Once a month with some degree of regularity women are reminded of their biological capacity. Interestingly, even the reminder develops in part as the result of local venous congestion and increased muscle tension in the reproductive organs.

On occasion, the menstrual condition, through the suggestive sensation created by pelvic congestion, stimulates elevated sexual tensions.

The presence or absence of patterns of sexual desire or facility for a sexual response within the continuum of the human female’s menstrual cycle also has defied reliable identification. Possibly, confusion has resulted from the usual failure to consider the fact that two separate systems of influence may be competing for dominance in any sexual exposure. The necessity for such individual consideration can best be explained by example:

It is possible for a sexually functional woman to feel the sexual need and to respond to high levels of sexual excitation even to orgasmic release in response to a predominantly biophysical influence in the absence of a specific psychosocial requirement.

This freedom to respond to direct biophysical-system demand requires only from its psychosocial counterpart that the female’s sexual value system not transmit signals that inhibit or defer the manner in which erotic arousal is generated.

In any situation of biophysical dominance, effective sexual response requires only a reasonable level of interdigital contribution by the psychosocial system.

Conversely, it also is possible for a human female to respond to erotic signals initiated by the predominant psychosocial factors of the sexual value system, regardless of conditions of biophysical imbalance such as hormonal deficiency or obvious pathology of the pelvic organs.

A woman may respond sexually to the psychosocial system of influence to orgasmic response in the face of surgical castration and in spite of a general state of chronic fatigue or physical disability. In any situation of psychosocial dominance, effective sexual response requires only a reasonable level of interdigital contribution by the biophysical system.

Since, as far as is known, elevated levels of female sexual tension are not technically necessary to conception, the natural function of woman’s sexuality has been repressed in the service of false propriety and restricted by other unnecessary psychosocial controls for equally unsupportable reasons.

In short, the negation of female sexuality, which discourages the development of an effectively useful sexual value system, has been an exercise of the so-called double standard and its socio-cultural precursors.

Residual societal patterns of female sexual repression continue to affect many young women today. They mature acutely aware of repercussions from sexual discord between their parents and among other valued adults, so they grope for new roles of sexual functioning.

Since discomfort in the communication of sexual material still prevails between parents and their children, the young frequently are condemned, by lack of information about what is sexually meaningful, to live with decisions equally as unrewarding sexually as those made by their parents.

In other words, because of cultural restraints the members of younger generations must continue to make their own sexual mistakes, since they, like previous generations, rarely have been given benefit of the results of their parents’ past sexual experience; good, bad, or indifferent as that experience may have been.

The necessary freedom of sexual communication between parents and sons and daughters cannot be achieved until the basic component of sexuality itself is given a socially comfortable role by all active generations simultaneously.

In the face of rapidly increasing complaints of inadequacy of human sexual function, it would seem that the potpourri of cultures that influence the behavior of so many might designate some area less vital to the quality of living than sexual expression to receive and to bear the burden of the social ills of human existence.

As recently as the turn of the century, after marriage rites and advent of offspring were celebrated as evidence of perpetuation of family and race.

Woman was considered to have done her duty, fulfilled herself, or both, depending of course upon the individual frame of reference. In reality society honored her contribution as a sexual entity only in relation to her capacity for breeding, never relative to the enhancement of the marital relationship by her sexual expression.

In contradistinction to the recognition accorded her as a breeding animal, the psychological importance of her physical presence during the act of conception was considered nonexistent.

It must be acknowledged, however, that there always have been men and women in every culture who identified their need for one another as complete human entities, each denying nothing to the other including the vital component of sexual exchange.

Unfortunately, whether from sexual fear or deprivation (both usually the result of too little knowledge), those who socially could not make peace with their sexuality were the ones to dictate and record concepts of female sexual identity The code of the Puritan and similar ethics permitted only communication in the negative vein of rejection.

There was no acceptable discussion of what was sexually supportive of marital relationships.

So far the discussion has focused on an account of past influences from which female sexual function has inherited its baseline for functional inadequacy.

Because this influence still permeates the current “cultural” assignment of the female sexual role, its existence must be recognized before the psycho physiological components of dysfunction can be dealt with comprehensively.

Socio cultural influence more often than not places woman in a position in which she must adapt, sublimate, inhibit or even distort her natural capacity to function sexually in order to fulfill her genetically assigned role. Herein lies a major source of woman’s sexual dysfunction.

The adaptation of sexual function to meet socially desirable conditions represents a system operant in most successfully interactive behavior, which in turn is the essence of a mutually enhancing sexual relationship. However, to adapt sexual function to a philosophy of rejection is to risk impairment of the capacity for effective social interaction.

1. To sublimate sexual function can enhance both self and that state to which the repression is committed, if the practice of sublimation lies within the coping capacity of the particular individual who adopts it.
2. To inhibit sexual function beyond that realistic degree which equally serves social and sexual value systems in a positive way,
3. To distort or maladapt sexual function until the capacity
4. Its function is extinguished, is to diminish the quality of the individual and of any marital relation ship to which he or she is committed.

When it is realized that this psychosocial backdrop is prevalent in histories developed from marital couples with complaints of female sexual inadequacy, the psycho physiological and situational aspects of female orgasmic dysfunction can be contemplated realistically.

Menopause Dryness

Dry eyes
Dry eyes can be common as we age. The signs of dry eyes are itching, a scratchy feeling, redness, tearing, tingling, and irritation. Paradoxically, dry eyes can cause excessive tearing.

Eyelashes fall out more easily as we get older and the eyes are drier.

Eyelashes or other foreign bodies may stay in the eye and cause tearing and scratches. To remove an object safely, dampen a cotton swab with salt solution and gently dab the object. If you can’t get the object out easily, go to your health caregiver, who can do so for you.

Dry eyes will tire more easily as you read, particularly at the end of the day. Dry winter air and wind, the dry air in airplanes, and certain medications that cause dry mouth and skin may also cause or aggravate dry eyes.

Allergies and sensitivity to environmental toxins such as fumes, smoke, dust, and pollution may also irritate your eyes.

Menopause Dry Mouth and Bad Breath

Although our mouths are constantly bathed in it, we don’t even give the flow of our saliva a thought until it starts to dry up.

A common short-term consequence of anxiety (such as public speaking or going for a job interview), dry mouth is a daily occurrence for 30-50% of adults over fifty-five. We’re not sure whether aging itself is a contributing factor; we do know that a major identifiable cause is long-term use of medications and drugs of many sorts including medications used to treat depression and high blood pressure.

Another reason for dry mouth is Sjogren’s syndrome, an autoimmune disorder of the lubricating glands in the mouth and eyes; it affects mostly middle-aged and older women, and may also be linked with silicone breast implants.

Other causes of dry mouth are radiation therapy, alcoholism, depression, and diabetes.

A dry mouth not only is annoying, but may lead to yeast infections, tooth decay, mouth ulcers, and bad breath because saliva washes away mouth debris, plaque, sugars, and carbohydrates, and helps prevent plaque build-up. Saliva remineralizes teeth and helps combat viruses and bacteria; it makes talking, kissing, and eating comfortable and enjoyable. If you’re bothered by bad breath, dry mouth is not the only cause.

Bad odor of the mouth is also caused by digestive problems such as constipation and tooth decay, both of which afflict older people more than younger. Tooth decay is more common in older people because of gum disease, which causes loosening of teeth and more room for bacteria to enter.

Bad breath and unusual taste may also be due to bowel problems, and indigestion, yeast overgrowth, sinusitis, and tobacco use.

Menopause Vaginal Dryness

As estrogen production diminishes, sometimes dramatically as you reach menopause and continues to dwindle as you pass into the postmenopausal years. Deprived of their customary supply of estrogen, vaginal walls tend to become thin and dry. The cervix secretes less mucus and the entrance to the vagina can actually become smaller.

The blood supply to your entire genital area decreases.

All these changes explain why intercourse can become uncomfortable and sometimes painful, even if you are able to have sexual feelings and achieve a climax.

Some women are simply uncomfortable with dry, delicate tissues, which become easily irritated with or without intercourse; in some women dry vaginal tissues tend to become infected more easily with yeast and bacteria.

Some believe that, in addition, estrogen contributes significantly to sexual desire and that low estrogen would therefore also affect our sensations during intercourse in another way. That’s because being sexually aroused is a prerequisite to producing the lubrication that bathes the vagina with the fluids that make intercourse smooth. When these juices don’t flow copiously, intercourse can become painful, and achieving an orgasm is more difficult because dry stimulation of the clitoris just hurts and is less likely to produce a sexual “excitation.”

The clitoris is more likely to respond to a well-lubricated penis or finger stimulating it. The conventional treatment for a dry vagina is estrogen cream. The cream, which you apply to the vagina and vulva, is very effective in many women; you should notice a difference in 1 or 2 weeks.

Estrogen cream will help thicken your vaginal walls, and it usually solves your lubrication problem, but some women find they still need to use one of the lubricating creams or gels mentioned below. Although many women are satisfied with the results, there are a few problems with using the cream.

If you have a dry vagina, it usually indicates that you have low levels of estrogen throughout your body, including your brain and heart and not just your vagina.

Since your sexual hormones affect all of your tissues, this suggests that the health of all your tissues may be suffering as well. Some women may feel that they don’t “need” vaginal health or that estrogen cream is all they need if vaginal thinning or dryness is their main or only problem.

The estrogen in the cream is applied directly to the vagina, most of the hormone stays right there; however, some of the estrogen (about 25-50 percent) will still enter your bloodstream.

Estrogen cream is not to be used as lubrication before intercourse,

It was not designed for this and the estrogen may be absorbed into your partner’s bloodstream too. Although estrogen cream does help and seems relatively safe, for those who cannot or prefer not to use hormones, there are other alternatives to explore.

Menopause Vaginitis

Your vagina and cervix are anatomically designed to secrete fluids. These fluids vary according to the phase of your menstrual cycle, sexual excitement, and whether or not you are pregnant.

A vaginal discharge is not necessarily a sign of illness.

However, you should be aware of any changes in your normal vaginal secretions: the amount, the consistency, color, and odor, as well as any other symptoms such as inflammation and itching. Such changes are indications that you have vaginitis, which is an overgrowth of micro-organisms.

Certain conditions can change the balance of normally present micro-organisms in the vagina and encourage the overgrowth of one type over another. Menopause is one of them; so is a weakened immune system (for example, from stress or overwork), medications that cause a hormone imbalance, use of products such as spermicidal creams and jellies that contain irritating chemicals, certain foods, and others.

There are several types of vaginitis, caused by different organisms, and characterized by a variety of symptoms.

Vaginal yeast infections are probably the most common.

They are due to the overgrowth of yeast or organism which normally exists in smaller quantities on our skin and in our intestinal tracts and vaginas. They are often triggered by an excess of sugar in the diet; in some women, even fruit or white bread can cause yeast overgrowth.

A yeast infection of the vagina is characterized by a thick whitish discharge that may look like cottage cheese; sometimes it smells like baking bread and sometimes it smells acrid. Yeast infections also can be maddeningly itchy and the external genital tissues become red and irritated.

Yeast may grow out of control after a woman has been treated with a course of antibiotics for a bacterial infection because the drugs also wipe out beneficial vaginal bacteria that kept the normally present yeast in check. Bacterial infections may be due to an overgrowth of a variety of different bacteria.

This type of vaginitis is often referred to as nonspecific vaginitis

Results in a white or yellow discharge.

Burning with urination, itching, and an odor.

Chlamydia and gonorrhea are sexually transmitted bacterial infections that you should have identified through a professional examination; they can have serious consequences if not diagnosed and treated.

Trichomonas infections involve a tiny parasitic organism and are characterized by a thin, foamy yellowish or greenish discharge that smells offensive.

Trichomonas is sometimes sexually transmitted and requires a professional examination to identify; however, it is not serious.

Noninfectious vaginitis may be due to irritation from chemicals, (such as douches or spermicide), sexual activity, or a tampon particularly if it has been inadvertently left in. Your vagina becomes red and swollen and may produce a discharge to rid your body of the irritation.

Changes in the hair are common as people age. Scalp and pubic hair gets thinner and loses body; simultaneously, hair may sprout and thicken in unaccustomed and undesirable places such as the chin, the upper lip, and the abdomen!

Hair Loss or Hair Growth

Excess hair in women is usually due to a higher proportion of the sex hormone testosterone as compared to the hormone estrogen.

Both men and women have a small amount of the other sex’s primary sex hormone. As women age, their estrogen loss raises the testosterone to estrogen ratio in their bodies, and because of the hair-growing effects of testosterone, hair pops up in new places and may thicken in the armpits and groin.

Thinning hair, on the other hand, is usually due to a decreased thyroid effect or other hormone imbalance.

Estrogen treatments to try to reverse or prevent hair loss, however, seem to be ineffective. Anorexia also can result in hair loss, as can anemia and vitamin and mineral deprivation, emotional stress, and disturbed estrogen production.

Temporary and reversible hair loss can also result from chemotherapy, anesthesia, oral contraception, and other medications such as cortisone, blood thinners, and drugs or treatments meant to reduce thyroid output. Amphetamines (speed or “uppers”), chemical toxicities and sensitivities, and autoimmune problems have also been associated with hair loss.

Menopause Skin, Wrinkles

Certain skin changes are inevitable as we get older, so far as we know. Decreased hormones in both female and male hormones play a role.

As hormone levels diminish, our skin gradually gets thinner, drier, and secretes less oil.

The aging process itself causes us to lose fat from under the layers of skin, allowing the skin to become looser and for any wrinkles to become more apparent. As with other body changes, the role of aging and hormones is heavily influenced by lifestyle and environmental factors. You may be surprised to learn that much of the wrinkling and sagging, the blotches, roughness, and “age spots” that accompany aging may put in an earlier appearance or are aggravated primarily by sun and cigarettes, two factors that are usually under our control.

Smoking literally starves your skin of oxygen and nutrients by constricting blood vessels. Recent research indicates that smoking ages skin two to three times faster than normal. Our bodies need sunlight to form vitamin D, but in excess, the sun’s rays cause our skin’s outer layers to become thick and leathery, and they damage the DNA in our skin cells, setting the stage for cancer.

Too much sun also damages the under layers, causing them to lose their elasticity and allowing our skin to become lined and sag. Light-skinned women who freckle and burn easily have the highest risk for skin damage. Black women have less trouble with the sun than those who are fair because their skin contains more melanin.

Melanin protects them from the worst effects of the sun’s radiation, and tanning increases our skin’s supply as a protective mechanism. But that doesn’t mean dark-skinned women or fair-skinned women with tans are completely safe from skin cancer. It’s vital that all women of all ages avoid overexposure to the sun.

If you don’t believe in the power of the sun and other elements, just compare your face with the skin on other parts of your body that have been less exposed, such as your buttocks and undersides of your breasts.

Menopause Weight Gain

It’s no secret that women tend to gain weight around the time of menopause. But is this inevitable and unhealthy? When it comes to middle-aged spread, the evidence so far shows us that while it is possible to be too thin, being lean, even leaner than average is healthier overall than being pleasantly plump.

There are figures show that 52% of all American women aged fifty to fifty-nine are overweight. This is higher than other age groups. Surveys also show that the average weight of the typical American adult has gone up by 8 pounds since 1985; and that 32% of Americans are considered to be obese, compared with 25% in 1980 and 24% in 1962.

It may be small consolation, but teenagers are getting fatter, too. So we’re all getting heavier, clearly, it’s not just our fluctuating hormones! The real culprit is too little activity in relation to too much fat and refined carbohydrate in our diets.

We all need to eat less and exercise more; as we age, our metabolism gradually slows down, meaning that unless we make some lifestyle changes, we’ll gain even more. But how unhealthy is it to be heavy? High blood pressure, hardening of the arteries, diabetes, gallbladder disease, heart disease, and increased risk of many types of cancer including cancer of the breast, colon, and uterus are all associated with obesity.

Although there is an accepted definition of “obesity” as being 20% over your “desirable” weight, the definition of “desirable” is not carved in stone. And even women who are not “obese” are at higher risk of premature death from all causes.

One study involving 115,000 middle-aged women shows that the lowest death rates occurred among the leanest women, including that 15-20% below average weight. It also showed that even middle-aged women of average weight have a 30% greater risk than those 20 pounds lighter.

Being overweight is second only to cigarette smoking as a cause of premature death. The study corrected for participants who were smokers and who had existing heart disease, diabetes, or cancer. On the other hand, it is possible to be too thin, especially if you’re an older woman.

For one thing, eating a low-calorie diet makes it virtually impossible to consume the nutrients you need to maintain strong healthy bones. And it’s definitely unhealthy to go on a crash diet to lose 20 or 30 pounds to reach a more desirable weight.

For another, women who carry around a bit more fat tend to have fewer menopausal difficulties, probably because fat cells take over the production of estrogen when the ovaries stop. In addition, the added weight puts good stress on the bones which strengthens them.

Menopause Insomnia

Almost everyone has trouble falling or staying asleep once in a while or wakes up tired in spite of having spent “enough” hours in bed. However, insomnia often increases in women who are going through menopause. Nearly one-fourth of all midlife women reported that they have trouble sleeping, twice as many as young women. You may take longer to fall asleep, wake up one or more times during the night, or sleep lighter and more fitfully than when you were younger.

Sleep problems may be the result of hormonal changes, but may also relate to psychological stress. If stress and depression are accompanying this life change for you, your sleep patterns will probably be different.

Other possible factors include physical changes such as night sweats, muscle cramps, and aches and pains. If you suspect any of these might be at the root of your sleep problem, turn to the sections of this book that deal with these problems. And don’t discount an unsatisfying sex life as a possible contributing factor.

A lot of menopausal women live with men who are experiencing prostate problems at this time.

These men need to get up to go to the bathroom many times a night and may disturb the sleep of their partners. If the guy you sleep with keeps you up at night by his disturbed sleep, try to move into another room or let him know that there are very successful natural treatments for benign prostate enlargement and that he might consider.

In natural medicine systems such as homeopathy, sleep is one of the important components a person needs to restore and maintain physical and mental health. New studies show that chronic sleep deprivation which may be due to insomnia affects your immune system, slows healing, and limits your ability to stay alert and concentrate. Inadequate sleep may be responsible for poor productivity, irritability, and a large portion of accidents on the road, on the job, and at work.

It is only now discovering how important healthy sleep is and how widely requirements vary from individual to individual. Some people can thrive on 4 or 5 hours while others need 9 or even more hours to feel and do their best. Insomnia can become a chronic and infuriatingly vicious cycle.

The loss of sleep you get, the less well you are able to deal with stress, and the more difficult it is to fall or stay asleep. If you need an alarm clock to wake up every day, or awaken exhausted rather than refreshed, don’t delay in setting things straight.

Menopause Fatigue

Although low energy and fatigue are often viewed as inevitable signs of aging, a healthy body at any age supports a healthy, active mind.

Fatigue and low energy are often signs of our bodies crying out for help and are frequently helped by nutritional support and botanical agents such as herbs.

Some of the physical reasons for low energy and fatigue are insomnia. Many women report sleep disturbances around the time of menopause triggered by hormonal changes that affect the sleep center of the brain.

Other reasons for frequent waking in the menopausal years are the need to urinate more often, and the night sweats.

Much fatigue and low energy in middle-aged and aging people come from mental stress, overstimulation, overwork, depression, or under-stimulation. Just as our bodies can get too much or little nourishment, we can think of these factors as malnourishment of the spirit. We need to feel nourished and emotionally rewarded for the efforts we make in our daily lives. There are many reasons why middle-aged women may not feel this satisfaction and we can only mention a few of them here.

One reason is that so much of what we do as middle-aged women take care of others. Our jobs are by no means done just because our kids may be out of the house (indeed, they may be home, again, given the expense these days of maintaining their own households and the difficulty of finding well-paying jobs).

We may also be caring for our elderly or infirm parents. Even if not physically taking care of them, we have a great many decisions to make about their welfare. It still seems to be true that the daughters and daughters-in-law, not the sons and sons-in-law, take over these responsibilities.

Of course, physically caring for elderly relatives would make you physically tired, but it’s more than that. It could be emotionally draining if you are worrying again about someone else’s well-being and neglecting your own needs, just as you probably did when your kids were young. The difference is that now you feel it’s your turn to get something back for those earlier years of self-sacrifice and physical labour, but it seems not to be happening. Making matters worse, many midlife women are joining the “sandwich generation” juggling between taking care of both elderly parents and their adult children.

There are so many other things that also might cause stress in the middle years. Maybe a woman worrying about a deteriorating relationship with a spouse or partner after many years together. Maybe financial worries and lack of employment opportunities or underemployment are getting you down. Perhaps health worries or fears of possible future ill-health bother you.

Loss of self-esteem is another significant cause of low energy at this time of life. It hardly seems worthwhile to drag yourself around if you feel no one cares about you or appreciates who you are and what you stand for.

Another tragic and insidious cause of low energy is lack of stimulation. Because they have to care for an ill spouse or aged parents, some women simply take themselves out of circulation. Or they may drop out because they’re afraid to meet new people or take on the additional responsibilities that might be a part of joining a new organization or social group.

Unfortunately, some people move to a new town for their retirement years, only to discover they’re bored out of their minds in this new low-stress place. Boredom can be a sign of depression. Or they may find that they don’t much like the new crowd and miss their old pals more than they dreamed they would.

The effects of all this may be that you just don’t do enough and can’t get excited by your life. Your energy runs low because none of us outgrows the need for stimulation and excitement. We can’t thrive and our brains won’t maintain their synapses if we’re just sitting there in front of the TV or keeping ourselves out of the loop.

Menopause Incontinence

As you make your way through menopause, you may find yourself going to the bathroom more frequently or even leaking small amounts of urine. As your estrogen level decreases, your bladder tissues begin to change. They may become thin, dry, or inelastic. Pelvic and abdominal muscles which help support the bladder often weaken, especially if you’ve had several children. Any one or a combination of these circumstances can result in incontinence, that is, the sudden and involuntary release of small amounts of urine.

About a third of all women over forty experience stress incontinence, at some point in their lives. In this form, a physical reaction–such as coughing, sneezing, jumping, or laughing at a friend’s joke–causes an involuntary release of urine. Another common type of incontinence in women is urged incontinence, in which you frequently feel the need to urinate, sometimes so strongly that you don’t always make it to the bathroom in time.

Some women become extremely embarrassed and self-conscious about incontinence; it becomes an inconvenience and forces them to change their day-to-day lives to avoid circumstances that provoke it. Happily, there’s a better alternative. There are a number of safe and natural ways by which you can prevent or reduce incontinence, and the disruptive effect that it can have on your lifestyle.

Menopause Libido

Although some women going through menopause find their libido takes an upswing, about half say they feel less lusty than they used to. Estrogen may be at least in part to blame. But our minds and bodies are not that simple.

Another hormone, progesterone, may also be involved.

A third hormone, testosterone, which is secreted by the ovaries and adrenal glands, is the principal-agent influencing female sexual desire.

Testosterone is considered a “male” hormone because men produce much higher levels. However, research shows that when levels of testosterone in women decrease after menopause, sexual drive also may decrease. Testosterone is still produced in lesser amounts in aging and elderly women’s ovaries and adrenal glands.

After a hysterectomy, many women say they find sex is less pleasurable.

There are psychological and physiological reasons for this. In a total hysterectomy, removal of the ovaries also removes a woman’s primary source of testosterone and estrogen.

And with her uterus and cervix gone, she has lost a body organ that is a source of sexual pleasure when it is stroked and pressed against by, for instance, a penis or a finger.

There are many other reasons for a lack of sexual desire or arousal difficulties besides hormonal changes and hysterectomy. Loss of sexual desire may be a sign of a physical problem and should always be discussed with your health care professional. Fatigue is a frequent cause of decreased sexual drive, and fatigue is the end product of many physical problems and diseases.

The psychological conditions that negatively affect a woman’s sex drive are primarily depression and anxiety. Loss of sexual desire may be one of the few symptoms that indicate a masked depression. Anxiety is much more overt and nearly everyone knows when they’re anxious, but not everyone knows that one of the ramifications of anxiety can be a loss of libido.

Menopause and Period
Most women experience some form of discomfort 1-2 weeks before or during their menstrual period. As they get closer to menopause, both psychological and physical symptoms may intensify. Cramps, back pain, bloating, swollen and tender breasts, food cravings, acne, mood swings, irritability, crying spells, insomnia, and fatigue are some of the symptoms from which you may suffer each month.

Premenstrual Syndrome (PMS)
Begins at or after ovulation (usually around the middle of the menstrual cycle) and may continue until the beginning of menstruation. Many women continue to experience symptoms such as cramps during menstruation.

Some women experience a lessening of their symptoms as their periods gradually diminish. Others may experience stronger cramps because of heavy menstrual bleeding or PMS that drags on forever because their periods are farther apart. While PMS has often been brushed off as being “all in our heads,” there are clear hormonal, structural, and metabolic causes of PMS.

Some estimate that PMS affects more than 90% of all women at some point in their lives. In some women, the condition is so severe that it disrupts work and social relationships. Most women with PMS have too much estrogen relative to progesterone. This can be due to too much estrogen, or too little progesterone, and there can be many causes of either.

These hormones invariably affect almost all organ systems. The ratio of estrogen to progesterone governs emotions, electrolyte and water balance, vitamin B-6 metabolism, and blood glucose levels, triggering a cascade of related physical symptoms that are characteristic of PMS.

PMS Relief
Most conventional medicines for PMS fall under the category of aspirin or ibuprofen and anti-inflammatory drugs, which interfere with prostaglandins, a natural substance produced by our bodies and which is associated with inflammation.

Inflammatory chemicals increase the pain, local swelling, and cramping associated with PMS. Some doctors prescribe diuretics, which address bloating by reducing excess water in the tissues through increased urination. Most of these medicines have potentially serious side effects.

There are more natural substances, such as vitamins and herbs, which decrease inflammation and act as diuretics. You can build your own natural prescription based on your specific symptoms, and you will likely find that many of your symptoms disappear.

Menopause Cause Breast Lumps and Tender Breasts

Breast lumps are very common in women, and it may appear to be more common or prominent as we grow older. That’s because our breasts are made of fat and connective tissue, and as we age, the composition changes. Some areas of the breast start to feel denser because there is more connective tissue and less fat. This thickening of the tissue is common and usually not a problem.

The medical term for this is fibrocystic breast disease, but we feel a better term is fibrocystic changes. Only rarely is it associated with an increased risk of breast cancer. However, lumpy breasts make it more difficult to feel cancers in the breast.

Breasts feel swollen and tender, ebbing and flowing with the menstrual cycle. Breast tenderness that accompanies hormonal cycles may temporarily worsen during perimenopause, when any hormone imbalance may become extended as the premenstrual period is longer in less frequent cycles.

This eventually diminishes after menopause, and you should not be aware of breast tenderness in the absence of any trauma to the breast such as from an accident. Although it may be alarming to feel a lump in your breast, 80-90% is benign and need no treatment at all once cancer is excluded from the diagnosis.

Menopause and Heart Palpitations

Some women experience heart palpitations during menopause. Although this can be frightening and uncomfortable, a racing heart does not usually indicate heart disease. The rapid or irregular heartbeat up to 200 beats per minute that some women experience during or after menopause can be related to the same vassal mechanisms that produce hot flashes. They can also accompany hot flashes.

A hormone imbalance is implicated in both since your endocrine system interacts with your nervous system and together they are sometimes referred to as the neuroendocrine system.

Nerves and muscles control the width of your blood vessels, and the fibers of the muscles surrounding your blood vessels contract, closing off the arteries, or relax, allowing them to open. This is controlled by the vasomotor center in your brain stem and by local hormonal factors which regulate blood pressure and heart function.

Misread signals from the nerves to the brain may also be responsible for the sensations of itchy, crawly skin, and numbness and tingling in the extremities that some women experience during this time of life.

Heart palpitations may also indicate anxiety or stress; metabolic problems such as low calcium, magnesium, or potassium; caffeinism; thyroid or adrenal imbalance; or a surge of adrenaline due to toxicity, food allergy, or environmental sensitivity.

Menopause Cause Heavy Periods or Menorrhagia

Changes in your menstrual cycle are often the first sign of approaching menopause. The time between your menstrual periods may become longer or shorter. Some women’s flow becomes lighter; others experience menorrhagia, the heavy, excessive menstrual bleeding which often occurs during the years preceding menopause (perimenopause).

Moderately heavy menstrual bleeding can prove both physically annoying and emotionally stressful to any woman. But you may find it particularly troublesome if you have had regular, mild periods during your twenties and thirties. As early as your late thirties or early forties, you may begin to have excessive bleeding for a day or two each month.

Heavy bleeding
May even be accompanied by other symptoms, such as dizziness, weakness, and cramping. Some women experience the symptoms of temporary anaemia owing to the loss of oxygen-rich red blood cells.

The important thing to remember is that all this is part of your body’s way of coping with natural hormonal changes. Irregular and somewhat heavy bleeding is a normal physiological reaction to the prolonged release of the hormone estrogen from your ovaries, without ovulation actually taking place.

Ovulation
Is delayed because, as you grow older, the remaining follicles in your ovaries become resistant to FSH (the follicle-stimulating hormone) secreted by the hypothalamus gland in your brain. Either that or they don’t develop an egg, and thus no progesterone is produced. Without progesterone, the estrogen is “unopposed” and keeps building up the lining of the womb.

The menstrual fluid which you normally shed during your period never gets the signal to stop thickening. It keeps growing and sheds irregularly. Because of the extra thickness, the bleeding is unusually heavy. Less frequently in this age group, the irregular bleeding is due to too little estrogen.

While most cases of hemorrhagic are due to normal hormonal changes preceding menopause, you should see your doctor to rule out other underlying causes if the bleeding persists.

There are many steps that you can take to make yourself as comfortable as possible as you pass through this natural change of life.

Menopause Cause Irregular Periods

Irregular periods are a ubiquitous sign of approaching menopause. You’ll probably begin having unpredictable periods and even skip some for as long as 2 or 3 years before you stop altogether, but remember that everyone is different. Some women’s periods end quite suddenly, and others begin skipping periods 5 or 6 years before the last one.

Periods
Become irregular because you’re ovulating irregularly. As explained in Heavy Periods, when you don’t release an egg, only estrogen (although perhaps in lower amounts) is stimulating the lining of your uterus; progesterone levels are way too low to cause the lining to shed. It may take several months for the lining to break down and create a menstrual flow.

The most common pattern is that of unusually heavy periods, in which you may see large clots of blood, accompanying some irregularity.

Irregularity may mean that instead of having a period every 28-36 days (whatever your usual cycle), you’ll start having them quite unpredictably, perhaps one time 40 days after the last, and another, 28 days, and the next, 52 days. Then you may skip a couple of cycles altogether, then go back to your regular pattern, and then skip three or four cycles. None of this is unusual or indicative of a problem, as your health care professional will probably tell you.

Annoying as irregular periods are in and of themselves, you should know that if you tend to experience PMS, symptoms may drag on for weeks or months at a time, because there is no menstrual flow to bring on relief. You should also know that even if your periods are still appearing at least once every 6 months, even if they are spotty and brown.

Menopause and pregnancy
And even if you’re 55, you can still get pregnant.

Whether you will retain the fetus is another story since you may not be producing high enough levels of hormones to give the developing fetus a sufficiently nourishing uterine lining.

To prevent unwanted pregnancies, use serious birth control all the time until you have not had a period for a whole year. You can then assume that menopause has occurred, and you’re no longer ovulating. Even so, birth control isn’t guaranteed, and irregular periods can be quite nerve-racking.

It may help if you keep these guidelines in mind: If you do skip a period and have unusual symptoms such as breast tenderness and nausea, it’s quite possible you’re pregnant; on the other hand, if you have menopausal.