Thoughts for My 50-Year-Old Self

I have a big birthday coming up in March. No, not 50-big, but I am on my way there. And while there are lots of lessons that I would like to impart to my children, I believe that it is ok to be a bit selfish -- in this case, to worry about myself. Many of us read -- and write -- letters to our children or retroactively pen notes to our younger selves, but we rarely think about what we want to take with us into our futures.

As I begin the final stretch to 40, I am acutely aware that I am more confident and more comfortable with who I am today than I ever was as a younger person. I have worked hard to become strong -- physically as well as emotionally. I don't sweat (pardon the pun) the ridges or bumps on my body; they tell the story of my life experiences. But as I say that, I have come face to face with mixed messages. I have read the stories of women older than me; I have become all too familiar with the stereotypes of menopausal women, complete with hot flashes, night sweats and mood swings. 

I don't want to be one of those women who transitions from fierce and fabulous into forgettable or forgotten. I know that my sexuality may evolve; I know that my body will change in ways that I may or may not be immediately pleased about. But sex (and sexuality) is important throughout our lives and the idea that it simply could end is not something I am willing to take lightly. 

Now don't get me wrong, I am not ignorant. I recognize that some changes I may not have control over. But I want to give myself (and because he's involved, my partner) the best shot at having a meaningful (and yes, evolved) sex life.

Sure, some of the symptoms we hear and read about are scary to consider: lower desire, lack of vaginal lubrication, or pain. 1 But what is rarely discussed is that many of these symptoms have treatments available for them. For example, painful sex may be due to something called postmenopausal vaginal atrophy, 2 and while that sounds terrifying, it is a treatable medical condition -- like, prescription-medication treatable. 2 (Wouldn't it be cool to see that issue and related conversation modeled in a television show or movie?) As anything else in life that is medical-related, this is a discussion that I should be having with my health care providers, learning about all the risks and benefits of what is out there. Truth is, we all should; it may be difficult, but our health care providers are involved, too.

I've been giving a lot of thought to this because women today are spending one-third of their lives in postmenopause. 3 (Consider this: the average age of menopause is 51 and many women live into their 80s.) 3,4 I spend most of my professional life talking to children and teens about puberty, but who is talking to the over-50 crowd about the changes experienced later in life? 

There is nothing better than seeing the face of a child who figures out that they are not broken, that their feelings or bodies are normal. I want that for my postmenopausal friends and family, too. I want them -- and me, eventually -- to own the changes that a depletion of estrogen may cause and work beyond them. I don't want a change in life to define me and, in turn, my sex life. 

Women are the incredible storytellers. We talk about everything. We overshare -- with the best of intentions -- because we know that our experiences have the potential to help someone else. Whether we are girlfriends, sisters, mothers, aunts, or grandmothers, we have a responsibility to support and guide one another through all of life's challenges and opportunities. 

As I enter my 40s and then into menopause, I plan to do it with a sisterhood of confidants, supportive medical providers willing to listen to my concerns and collaborate on solutions, and with a partner who understands that no matter what potential challenges may emerge I will prioritize my needs (which in turn takes care of our needs). And, importantly, I won't allow a loss of naturally-occurring estrogen to dictate how fierce and fabulous I am.

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References:
Nappi, R.E. and Kokot-Kierepa, M. Vaginal Health: Insights, Views & Attitudes (VIVA) - results from an international survey. Climateric 2012;15:36-44.
Kaunitz AM. Sexual pain and genital atrophy: breaking down barriers to recognition and treatment. Menopause Manag. 2001;10(6):22-32.
The North American Menopause Society. Menopause Guidebook 7th edition. Mayfield Heights, OH: The North American Menopause Society; 2012.
CDC Health United States 2011. National Center for Health Statistics. Health, United States, 2011: with special feature on socioeconomic states and health. 2011.

Dr. Logan Levkoff is a recognized expert on sexuality and relationships and works to create an environment where people feel comfortable asking (and getting answers to) their most personal questions. Dr. Levkoff served as a paid spokesperson for Pfizer in connection with a women's health event, and wrote this post based on the discussion.