Acne

Amenorrhea

Anxiety

Arrhythmia (Irregular Heartbeat)

Bipolar Disorder

Bladder Pain Syndrome

Bloating and Gas

Brain Fog

Cardiovascular Condition Hypertension (High Blood Pressure)

Cardiovascular Condition Hypotension (Low Blood Pressure)

Cholesterol Imbalance

Chronic Fatigue Syndrome

Chronic Pain Syndromes

Constipation

Cushing's Syndrome

Decreased Libido

Depression

Diarrhoea

Endometriosis

Fat Malabsorption

Gallbladder Disease

Gastroesophageal Reflux Disease (GERD)

Gestational Diabetes

Graves' Disease

Heart Disease

Heart Failure

Hirsutism (Excess Hair Growth)

Hypothyroidism

Infertility

Infertility: Symptoms

Insulin Resistance

Intestinal Inflammation

Irritable Bowel Syndrome (IBS)

Loss of Appetite

Menopause

Menstrual Cramps (Dysmenorrhea)

Miscarriage

Mood Swings

Non-Alcoholic Fatty Liver Disease (NAFLD) Resistance

Obesity

Oligomenorrhea

Overactive Bladder Syndrome

Painful Intercourse (Dyspareunia)

PCOS

Pelvic Organ Prolapse

Peptic Ulcers

Perimenopausal Depression

Perimenopause

Peripheral Artery Disease

Post-Traumatic Stress Disorder (PTSD)

Postpartum Depression

Premenstrual Dysphoric Disorder (PMDD)

Premenstrual Syndrome (PMS)

Seasonal Affective Disorder (SAD)

Sleep Disorders (Insomnia)

Stroke

Thrombosis (Blood Clots)

Thyroid Nodules

Type 1 Diabetes

Type 2 Diabetes

Urinary Incontinence

Vaginal Dryness

Varicose Veins

Vulvodynia (Chronic Vulvar Pain)

Body

Mindlessly scrolling on our phones for hours is something we’re all guilty of, but when that scrolling can bring us some education, some insights and content that helps our physical, mental and emotional health, it’s got to be worth it. Instagram is a treasure trove of great accounts and creators, with many people in varied professions from psychology to finance taking to the app to share their work with the wider world for free. And if you’re too embarrassed to learn about your body and its needs by asking others or googling it, social media accounts can be your best friend to learn about it directly from the experts. Here’s our pick of five Indian women we think deserve a ‘like, share, save’ the next time you’re scrolling through Instagram: 

An Oxford-educated embryologist, Dr Tanaya goes by the adorably innovative name “Dr Cuterus” on Instagram. In the short span of 4 years since she’s started her educational page, she’s amassed over 1.8million followers, with many of her reels crossing a million views. From information on reproductive health and unknown tidbits on our body parts to even glimpses of real surgeries and frequent sexual health AMAs, Dr Cuterus always keeps it real, helpful and most importantly, fun! She’s also a huge promoter of the HPV vaccine – one that can prevent cervical cancer – and constantly shares reasons on why as many women as possible should get the jab. With her “byeeeeee” after every video making so many viewers smile, it’s safe to say that Dr Cuterus has truly understood the pulse of the millennials and Gen-Z crowd and is here to help everyone’s sexual health or ‘is this normal?’ queries – yes, even about squirting from your “downstairs department”.

Dr Tanaya Narendra

In her own words, she’s India’s “foremost sex-positive content creator”, and a glimpse of her Instagram tells you why. With posts and reels talking about sexual intimacy, how to speak to women, healthy masturbation, sex positions, STIs, orgasms (yes, even for women), and everything else related to a healthy sexual experience, Mangaldas always keeps it real and engaging. She’s even started her own personal care brand Leezu’s, that produces oils, massagers, toys to keep the sexual experience open and healthy both for oneself and between couples. Author of The Sex Book: A Joyful Journey of Self-Discovery, Leeza’s Instagram is for those people looking for answers to all their sexual experiences and questions but are too shy to talk about it elsewhere. Discover and rediscover both your own body and your partner’s with Leeza’s truly positive page and outlook! 

Leeza Mangaldas

A licenced sex and trauma therapist, Neha posts on Instagram as @IndianSexTherapist, educating audiences on sexual trauma with a focus on healing through arts and spirituality. Her page is filled with informative posts about sexual trauma related experiences, news and views, help and recovery methods, panel discussions she’s been a part of, research and of course, promoting her own work and her brilliant book about sex and everything relating it, Unashamed (published earlier this year). “Time does not heal wounds. It just freezes them. You have to actively repair the wound,” and “Sometimes it is important to teach yourself to actually be sad,” are among some of her many hard-hitting but helpful truths that she constantly posts. For anyone looking for healing, knowledgeable information from a therapist or even just a great new mental and sexual health educational account to follow, Neha’s will not disappoint.

Neha Bhat

She’s written a book called The Art of Seduction. She’s won awards and acclaim for being ‘Sexual Health Influencer of the Year’. She’s a master storyteller (hence her handle @seemaanandstorytelling), an expert at mythology, anecdotal pieces and just great gyaan about all things sex and intimacy, especially in the Indian context. Head to her page and you’ll find fascinating Q&As answered, topics like the issue of ‘Not All Men’ and ‘tight’ vaginas addressed, and just very uplifting and engaging topical posts from a truly empowered woman. With her trademark long white mane and fabulous saris she wears in every video, combined with a powerhouse of stories and knowledge, Anand is definitely that sexual heath influencer to reckon with.   

Seema Anand

A Padma Shri Award winner, Hyderabad-based gynaecologist Dr Manjula Anagani is also an obstetrician, infertility specialist and laparoscopic surgeon, who has amassed over sixty thousand followers on Instagram through the work she does. Covering topics related to pregnancy, postpartum, periods, abortions, and everything to do with the female reproductive system and journey, Dr Anagani’s page is a source for quick but accurate content from a reputed name in the world of women’s health in India. She debunks myths about IVF and pregnancy, gives tips on what to do when visiting your gynaecologist, and also occasionally shares glimpses of her own life as a doctor and advisor to many. 

Dr Manjula Anagani

Check Out: Five Indian Sexual Health Accounts You Should Be Following On Instagram If You Aren’t Already 

>"I thought my irregular periods were just another side effect of stress. Little did I know, PCOS had been wreaking havoc inside my body,” says  22-year-old Priya*, who, like many young women, had brushed off her symptoms until they became impossible to ignore.

To gain a deeper understanding of how women are navigating life with **polycystic ovarian syndrome** (PCOS), we sat down with Priya\* and 38-year-old Meera\*, both at different stages in their journey. Through their stories, we explored the emotional and physical impact of PCOS and how they learned to manage this condition in their own unique ways.

Introduction

**PCOS** is a condition where a woman’s hormones are out of balance, particularly the ones that control her menstrual cycle and fertility. Normally, the ovaries produce a small amount of male hormones (androgens), but in **PCOS**, they produce these in excess. This causes problems with ovulation (the release of an egg), leading to irregular periods or even no periods at all. 

In women with **PCOS**, the ovaries often have many small, fluid-filled sacs called follicles (sometimes called cysts). These follicles don’t mature enough to release an egg, which affects fertility. 

Affecting [8–13% of women](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9808519/) in the reproductive stage (between the ages of 15 and 45), it was traditionally viewed as a reproductive issue. However, with more research, its broader health effects are now better understood. The **common symptoms of PCOS** include: 

*   **Irregular Periods**: Because the ovaries don’t release eggs regularly, periods can be very irregular, long, or even absent. 
    

*   **Weight Gain**: Many women with PCOS have difficulty maintaining a healthy weight, and they often gain weight easily, especially around the abdomen. 
    

*   **Acne and Excess Hair**: The higher levels of androgens can lead to acne, oily skin, and excess hair growth on the face, chest, or back (a condition called hirsutism). 
    

*   **Thinning Hair**: While there might be excess hair in some areas, the hair on the scalp can thin out, similar to male-pattern baldness. 
    

*   **Dark Patches of Skin**: Acanthosis nigricans cause dark, velvety patches of skin in areas like your neck, underarms, or groin. 
    

PCOS also increases the risk of developing other health problems like insulin resistance (which can lead to diabetes), high cholesterol, and heart disease.  

>As a woman juggling work, family, social life, and trying to fit in some "me-time," PCOS can throw a wrench in your plans. Between meetings, deadlines, and household responsibilities, who has time for complicated health issues? But that’s the thing about PCOS—you can’t ignore it!  

Beyond the physical symptoms, it can also impact mental health, leading to higher rates of anxiety, depression, eating disorders, and body image concerns.  

>To find out more about the hidden symptoms of PCOS, read our detailed blog here: [The Hidden PCOS Symptoms No One Talks About—Are You Missing These Signs?](https://www.terrapy.in/articles/the-hidden-pcos-symptoms-no-one-talks-about-are-you-missing-these-signs)

What is PCOS? (And Why Should You Care?) 

If you think you might have PCOS, the next step is to see your doctor for a complete diagnosis. Your healthcare provider will likely recommend lab tests to check your hormone levels and sonography to examine your ovaries. These tests help determine the severity of your condition and guide the best treatment plan for you. 

 

In some cases, medication may be needed to help balance your hormones, especially if you’re struggling with fertility or if PCOS has impacted your metabolism. Early diagnosis and treatment are key to managing symptoms and preventing further complications, so don’t delay getting the medical advice you need.  

 

>Consider adding another blog that links here -  that goes into the medical diagnosis and treatments for PCOS: what blood tests to do, what is found on sonography, what medications are given- hormonal and non-hormonal, what treatments are done for skin and hair conditions with PCOS.
 

Understanding PCOS means you can take charge of your health—whether that’s through lifestyle changes, medical treatment, or just being more aware of what your body is telling you.  

What to Do If You Suspect PCOS: Time to Visit Your Doctor

We sat down with two women navigating life with PCOS: 24-year-old Priya\*, a marketing professional, and 38-year-old Meera\*, a homemaker. Both women shared their journeys, revealing how minor tweaks helped them manage their symptoms successfully.  

**Diet and Exercise, Minus the Overwhelm**

A strict diet would never be realistic for Priya, an events manager who spends most of her day in a high-pressure office environment. "I’m always on the go, so there’s no way I could survive on a rigid eating plan," she explained. "Instead, I made small changes that fit into my routine—like swapping my usual white rice for jowar or quinoa at lunch. It keeps me fuller for longer, and I don't experience those midday energy crashes anymore." 

On the other hand, Meera found that changing her diet was about making healthier choices for the whole family. "I’m in charge of cooking for my household, so I had to find a balance that worked for everyone," she said. "I introduced more whole grains like bajra into our meals, and I’ve cut down on sugary snacks at home.” 

Both women discovered that they didn’t need to overhaul their diets completely—just a few mindful adjustments made a huge difference. "I still enjoy my sweets occasionally," Priya admitted with a smile. "But now it’s all about moderation rather than restriction."  

**Diet Tips for Women with PCOS**

*   Swap white rice for whole grains like jowar and bajra. 
    

*   Add fibre\-rich vegetables like spinach, okra, and methi. 
    

*   Include protein sources like dal, paneer, and chickpeas. 
    

*   Use healthy fats like ghee, coconut, and nuts. 
    

*   Drink plenty of water—aim for eight glasses a day. 
    

*   Eat smaller, more frequent meals to stay energised. 
    

*   Add anti-inflammatory spices like turmeric and ginger. 
    

**Fitness with a Twist**

For Priya, fitting exercise into her packed schedule meant finding a routine she could stick to without dreading it. "I’m not one for intense workouts, especially after a long day at work," she confessed. "So, I started with 30-minute brisk walks in the morning —it helps me clear my head before I start my day." 

Meera, who spends much of her day managing household chores, also found that an intense gym routine wasn’t realistic. Instead, she opted for yoga at home. "Yoga has been my saviour!  It’s something I can do whenever I get a free moment, and it doesn’t require any fancy equipment," she said.  

Both women found that finding a form of exercise they enjoyed rather than dreaded made all the difference. As Priya put it, "Consistency beats intensity every single time!” 

**Best Exercises for PCOS** 

*   **Brisk Walking**: Boost metabolism and insulin sensitivity. 
    

*   **Strength Training**: Build muscle and balance hormones. 
    

*  **Yoga**: Reduce stress and support hormone balance. 
    

*   **Cycling/Swimming**: Gentle, effective cardio for fat loss. 
    

*   **HIIT**: Quick, intense bursts for fat burn and heart health. 
    

Combine cardio with strength training for optimal results! 

**Keep Calm and Thrive: Stress Management Made Simple**

Managing stress was challenging for both women, but they approached it differently. Priya found herself overwhelmed by work deadlines and the constant pressure to perform, which worsened her PCOS symptoms. "The stress was affecting everything—my mood, my skin, and my periods," she shared. "So I started meditating for just five minutes every morning. It seemed like nothing at first, but gradually, I started feeling calmer and more in control." 

Meera found comfort in traditional remedies to manage the daily stress of family life. "Growing up, my mother always used herbs, so adding tulsi tea to my routine felt like second nature," she shared. "It’s really helped me feel calmer during hectic days, and I’ve noticed I sleep more soundly too." 


**Did You Know?** 
>Tulsi, also known as [holy basil,](https://www.msdmanuals.com/en-kr/home/special-subjects/dietary-supplements-and-vitamins/holy-basil#:~:text=Claims%20for%20Holy%20Basil,Reduce%20inflammation) is a powerful ally for managing stress and anxiety 

*   Adaptogen: Tulsi helps the body respond to stress and restore balance. 
    

*   Anti-Anxiety: Studies show Tulsi has anti-anxiety properties similar to antidepressant medications. 
    

*   Mood Booster: Tulsi can improve mood swings and promote overall well-being.)

Small Changes - Big Impact! Lifestyle Adjustments That Made a Difference 

Managing PCOS doesn’t require drastic changes—small, consistent steps can lead to big improvements in how you feel.

Whether it’s tweaking your diet, finding an enjoyable way to move your body, or incorporating moments of calm into your day, these manageable shifts add up. Managing PCOS isn’t a sprint—it’s a marathon, but with the right changes, it’s one you can win!

_**Names changed for privacy**_

**Key TakeAways:**

*   If you suspect you have PCOS, it’s important to visit your doctor. Blood tests and sonography can help determine the severity, and in some cases, medication may be necessary to help regulate hormones, especially if fertility or metabolism is affected. 
    

*   Managing PCOS is a long-term process. Small, consistent steps in diet, exercise, and stress management add up over time, helping you regain control of your symptoms and overall health. 
    

*   You don’t need a restrictive diet to manage PCOS. Swapping out refined carbs for whole grains like jowar and bajra, adding more fibre\-rich vegetables, and including healthy fats like ghee and nuts can help regulate insulin and balance hormones. 
    

*   Finding an exercise routine that you enjoy and can stick with is key. Whether it’s brisk walking, yoga, or strength training, consistency is more important than intensity when managing PCOS symptoms. 
    

*   Managing stress is just as important as diet and exercise. Practices like meditation and deep breathing can help reduce anxiety and improve overall well-being.

Final Thoughts: Controlling PCOS, One Step at a Time

I Have PCOS—Here’s How I Took Control 

Approximately [90% of couples](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC188498/) get pregnant naturally within the first year of trying. This increases to about 95% in the second year. However, if you haven’t conceived in your first few years of trying, it doesn’t indicate an inability to successfully conceive naturally. A quick check-in with your healthcare provider and a few tweaks to daily lifestyle habits can help improve your chances of getting pregnant naturally. 

Regularly tracking your menstrual cycles is the easiest way to know when you are in your fertile window and when ovulation is most likely to occur. During each menstrual cycle, there is a [six-day fertile window](https://www.bmj.com/content/321/7271/1259), where your chances of conception are the highest. This is four days before your ovulation, the day of ovulation, and the day after. Once your egg is released it lasts for 24 hours before it disintegrates. Your fertile period lasts for a week since [sperm can survive up to five days](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9321146/) leading to fertilization during ovulation. 

To track signs of ovulation look out for sticky egg-white vaginal discharge, an increase in your body temperature, and an increase in your libido. It is good to note that not all women notice these classic signs of ovulation, so regularly tracking your cycles can help to identify your unique signs. 

Irregular periods, often coupled with other symptoms of hormonal fluctuations, such as weight gain, acne, intolerance of cold, or changes in your hair growth pattern can be indicators for a requirement of fertility testing. Additionally, if you have been trying to get pregnant for over a year, checking in with your healthcare provider can give you an idea of what could be an underlying cause for your delay in natural conception.  

While this can seem overwhelming, preliminary fertility tests are frequently non-invasive and give an overall picture of health, which can be easily taken care of with simple lifestyle changes.  

Early fertility tests include evaluation of your hormones, such as FSH, LH, estrogen, progesterone, and thyroid hormones. Many doctors also recommend the anti-Mȕllerian hormone (AMH) test which helps to [assess your egg reserve](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9477988/). Other tests such as checking for hypertension, diabetes, increased cholesterol, liver, kidney, and autoimmune disease are also a part of the initial fertility screening panel. The results from these tests help to guide your next steps in getting pregnant naturally.

How can I check my fertility?

Maintaining a healthy lifestyle is the easiest way to improve your chances of getting pregnant naturally.  

A balanced nutritious diet involves more than just having your meals at home. Talking with a nutritionist, and coupling your test results (having high cholesterol or diabetes) will require specific changes to your diet. A nutritious meal high in protein, rich in omega-3 fatty acids, having sources of fiber from fruits and veggies and essential minerals such as zinc, iron, and folate are ideal for maintaining optimum fertility.  

In India, with diets rich in carbohydrates for most meals, finding this balance can be tricky. However, studies have indicated the [benefits of low-carb diets](https://onlinelibrary.wiley.com/doi/10.1155/2019/4386401) in improving your overall health, especially for women experiencing infertility with conditions such as PCOS. 

Another factor crucial to maintain for conceiving naturally is moderating your stress levels. An inability to conceive naturally is a source of stress. Additionally, other aspects of your life, such as your career, family, and finances may also be piling on the stress. However, [stress is a widely investigated source for its impact on infertility](https://jbiomedsci.biomedcentral.com/articles/10.1186/s12929-016-0253-4#Sec7). The rise in cortisol and other stress hormones appears to have some influence on reproductive hormones such as estrogen, egg quality, and ovulation. 

Tackling stress can look different for everyone. A beneficial step toward this is regular exercise. Not only will you reap its benefits for managing your stress, but it will also help maintain a healthy BMI, reduce cholesterol, optimize sugar levels, and provide you with a good night’s rest, all improving your chances of conceiving naturally. While regular physical activity is advised for all women trying to conceive, it is also important to note excessive vigorous exercise can have a [negative impact on your fertility](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7614776/). Discussing your exercise regime with your doctor before starting and enlisting the help of a trainer can help provide you with a tailored plan. 

>**Community take:**
I didn’t realize that stress could affect my chances of conceiving. My periods were haphazard, I was doing everything I could to eat healthy, exercise and manage the house. But this constant worry about getting everything in order was probably hurting my chances of getting pregnant. I decided to give up trying to control so many aspects of my life. Asked for help wherever I could, and build a routine I could blindly follow. I found myself sleeping better at night when I implemented this. I feel less tired now. And also miraculously my periods have started coming on time for the past three months. I am hopeful it might help to increase my chances of conceiving.

While opting for a healthier lifestyle, cutting back on caffeine, quitting smoking and alcohol, and being mindful of the environmental toxins you are exposed to also become crucial for your fertility journey.

How can I improve my fertility naturally?

If you are trying to get pregnant, a quick check-in with your doctor, especially if you have attempts have been unsuccessful in your first year, is crucial. This can give you an idea of the areas of your lifestyle which require improvements. A nutritious diet, maintaining a healthy weight, regular exercise, adequate sleep, and tackling your stress are the simplest ways to improve your chances of conceiving naturally.

Takeaway 

How to naturally improve my fertility and chances of conception?

I always wanted to be a mother, but the scaredy-cat in me had also always been terrified of childbirth. The blood everywhere, water breaking and gushing out, the pushing a baby out of a small hole, the pain of contractions – whatever I’d read about the process of giving birth always scared me a bit, and I was a bundle of nerves even till the last month of my pregnancy. But ever since I was a child, all I would hear my Mum and all the mothers of her generation say is “Oh yes birthing hard but as soon as you hold your baby, all the pain is gone and forgotten!” So I thought I’d just have to get through that one day of pain and then be free of it. But I was in for many surprises when I gave birth almost 3 years ago, most of which I had NO clue of how they would affect me. Of course, every person’s experience depends on a multitude of factors including their own circumstances and their threshold for pain. But here are 5 postpartum experiences that truly hit me like a brick: 

Most people know that if the vagina doesn’t tear naturally, the doctor may have to surgically cut it during labour to make the hole bigger for the baby to come through. This incision – known as the episiotomy – is then stitched up as soon as the baby is delivered, and over the course of a few days the stitches dissolve on their own. What I didn’t know though, was that how truly painful it can be to walk, sit or even move without pain for over 3 weeks! Post a caesarean delivery, one is told not to lift heavy loads for 6 weeks due to the stitches on the abdomen. For a vaginal birth though, many women are told they can resume normal life even the day after pushing out their babies. But after the initial 3 days when the painkillers wore off, it hurt ALL the time. When I sat upright to feed. When I went to pee. It was a task to even walk from my bedroom to the kitchen. I spent the first month post-delivery in agony from the pain of my stitches more than anything else. It was only when I mentioned it to a relative that she said it was terribly painful for her too – I wish I knew about it before so I could have been prepared to tackle the pains.  

The pain from your vaginal stitches can be terrible

During my 3000 Google searches a day during pregnancy, I’d read that one of the perks of breastfeeding was that although you can still ovulate, your period can take 5-6months or even a year to return. My friend, who had a baby a few months before me started her period after five months. My sister-in-law’s returned after four. My cousin’s took time to return as well. But lucky me, the week after my 4-weeks of postpartum bleeding ended, I had another week of a full-blown period to deal with and immediately messaged my gynaecologist about it. “It’s normal even when you’re breastfeeding, don’t worry” came the reply. If only I knew! 

Your period can return immediately even if you’re exclusively breastfeeding

Lower back pain. Menstrual cramps. Mood swings. Feeling fatigued. Heavy blood flow. I thought it was bad before I got pregnant, but what I experience during period week (and the week before) now leaves me with debilitating pain, an irritable mood and sometimes even insomnia during both PMS and periods. Some women do get lucky postpartum as their period pain reduces or the days of flow come down, but for some, it can definitely go the other way. If not for fulfilling my chocolate ice cream cravings, each month’s period post-baby would be much harder for me to get through!       

PMS and period symptoms can be worse than they were pre-pregnancy

One minute you’re crying. The next minute you’re okay. The next you don’t even want to play with your baby, and felt guilty. The next you’re upset about everything. And then you just cry for no reason again. That’s called the ‘Baby Blues’ – the hormonal, physical and emotional changes affecting your whole system – and can start from a few days after delivery and last for 2-3 weeks. I didn’t know what to do or how to process these feelings, especially after having delivered during the heights of the Omicron wave of Covid, having almost no one at home on weekdays except a nurse to help with the baby. I had to rely on my phone to summon my village through video calls. “Eat chocolate, get some sunlight, try to move around,” was the advice from new mothers that was helpful. “Don’t be so dramatic, stop crying for nothing, everything is fine,” from others around me was not. Baby Blues can be hard to get through, even harder when people are asking you to just “be positive” – but remember that much like everything else, it’s a phase that will pass. If it doesn’t, and carries on for weeks or months, it could be postpartum depression, and it would be wise to speak to a doctor or therapist for help.   

The Baby Blues can hit you extremely hard

I exclusively breastfed my son for 17 months (he refused even pumped milk from a bottle), slowly weaning off just before he started playschool at one-and-a-half. And as the feeds dropped, so did my behaviour change. I started getting upset at small things, crying about even too many toys to clear from the floor, screaming at my husband for trivial matters, was unable to fall asleep easily, had bouts of anxiety, and had days when I did nothing but doomscrolled through my phone while crying for hours. A lot of that scrolling led me to understand what was happening – I was going through the often “understudied and undiagnosed” post-weaning depression phase. When your body has to stop producing milk after over a year, prolactin and oxytocin levels drop, leading to hormonal changes in the body. I was totally unaware and unprepared for this. It was only through a healthy support system and speaking to a licenced therapist about my feelings that I was able to manage the huge emotional upheaval that weaning my toddler off my brought with it.  



Pregnancy and postpartum experiences are different for everyone. What makes things easier is knowing about it, being prepared, openly talking about even the hard parts and most importantly – being supportive of anyone you know who may struggle with any negative physical, mental or emotional conditions through any phase of life. 

Post-weaning Depression is real

What I Learnt During My Postpartum Journey That Almost No One Talks About

When I say I suffer from PCOS, it's assumed the major problem I face is just that I don't get my period on time. But it's not as simple as that. 

It's important to understand why this happens in the first place and the answer eventually lies in hormones and insulin resistance. Now, by an extension of that, these two may not be functioning as desired in my body at the moment, but I might still be getting my period on time — since periods are affected by a lot of different factors other than PCOS. And it may be incorrect to assume that PCOS is definitely at bay. 

So, if periods are not the only ones that okay a role in PCOS, what happens after menopause then? No periods, no trouble? Unfortunately not. PCOS patients will still have issues with hormones and insulin resistance. While periods are greatly affected by it, they are still separate functions of the body. And an end to them doesn't mean the PCOS has ended too. It just means that it won't show up in the symptoms it used to. But it still does manifest differently. In fact, the metabolic and cardiovascular risks associated with PCOS can persist or even worsen after [menopause](https://drbrighten.com/pcos-and-menopause/), especially the following:  

*   Insulin resistance and type 2 diabetes 
    

*   Stroke 
    

*   Heart attack 
    

*   High blood pressure 
    

*   Metabolic syndrome 
    

*   Weight gain, specifically increased visceral adiposity (belly fat) 
    

*   High cholesterol, specifically elevated LDL and triglyceride levels </u>
    

To make it just slightly worse, women with PCOS may even experience [later menopause](https://drbrighten.com/late-menopause/) sometimes, by 2 to 5 years. And they may have more successful fertility later in life than usual because they experience a slower decline in age-related fertility. 

Don’t panic though. This sounds a bit like when you google your symptoms and its cancer every time. It's kind of bittersweet that the solution to this remains the same — healthy food, regular exercise, sleep and good mental health. And of course, to keep your doctor in loop of everything that is happening with your health, since it might be tricky to distinguish the symptoms of PCOS and premenopause. 

It's so easy to think that this problem lies in the future and that you're too young for it. I think like that so many times, it’s comforting. I know I'd not need to deal with it any time soon but it helps to still stay aware and know what's coming my way so I can be fully prepared when the time arises. 

Despite that, I often feel helpless thinking about how strange it is to have this lifelong situation that I'll have to keep managing. But somewhere, I'm also glad that I know better now than when I was first diagnosed with it. That makes it simpler. 

Rather than letting this inflict stress or worry on me, I try using it as a shield to combat the future. Some days it works, and some days it doesn't. Either way, I try again the next day.

PCOS and Menopause

Does your battle with PCOS end at your Menopause?

I visited my partner's parents for the first time in October this year. They are Bengali so they really know how to do Durga Pooja. Each day of the week, we had a menu set, to make sure there was something delicious for us to eat for all three meals — and of course, for the afternoon snacks. I'm talking pakode, chilli chicken, fried rice, egg curry, mutton curry, dosa, rasagullas (of course!), sandesh. Basically, we were not joking around. 

Three days in, I felt my stomach cramp and popped a pan 40. Our dog, Coco, joined me and took medicine for his stomach too — I got to know later that he ate the same as me. And god, I swear, from then on, I had to eat one pill every day at least. And I found myself asking for dal chawal. 

So disappointing. 

This is me, every festive season. I know I'll do this on Diwali and Christmas too. I just know it. But this has the potential to ruin the celebrations for me because food is such a big part of it. 

Did you know that the universe works against us? I mean, gut [health](https://time.com/7020911/women-gut-health-ibs-ibd/) issues are more common in women because “the female hormones estrogen and progesterone have a profound effect on the GI tract in terms of motility, pain sensitization, and how the brain delivers messages to the GI tract” 

This one really pissed me off. So, keeping my partner in cohorts, I've decided to come up with some do’s and don'ts for my gut health during the festive season. And they might help you if you're anything like me. 

The way to my heart is through my stomach 

*   Drink a ton of water. It's not negotiable. Chronic dehydration can lead to gut inflammation. Water helps support beneficial gut bacteria, which are important for digestion. And I know you forget, so carry a bottle with you everywhere you go, that'll serve as a good reminder. 
    

*   Catch up on your sleep. I mean of course, we're not following a strict nighttime routine during the festivals, but don't go too many sleepless nights. Sleep helps to maintain gut health since it fosters good microbes in your gut. Two sleepless nights (or less sleep), are already too much for your [gut](https://www.sleep.com/sleep-health/how-gut-health-impacts-sleep#:~:text=Good%20sleep%20helps%20the%20gut%20%E2%80%A6&text=%E2%80%9CStudies%20have%20found%20that%20sleep,stress%20hormones%20in%20the%20body.%E2%80%9D). 
    

*   Have your meals timely. Your meals won't be the healthiest, and that's okay. But it's important to maintain the timings of your meals as you generally would. Don't skip any meals and rather than relying on a late-night snack, choose a rich dinner if you'd like. 
    

*   Have probiotics. Practically, a lot of curd! This helps balance the rich food that you're likely to have during this time.  
    

*   Begin your day with fibre. You'll thank yourself. Some of my favourites are nuts, seeds, fruits and sweet potatoes! They all help with digestion and are delicious. 
    

Do’s 

*   Skip exercise. I know, festivities are not for exercise at all. So, I don't ask you to go to the gym of course. But maybe some light yoga or stretching in the morning? It'll work wonders for your stomach! 
    

*   Overplan your food. It's not a challenge or a race to fit in all the food you can have in your festivities plan. I often get over excited and try to fit in as many favourites as I can. Because I feel way less guilty eating them during a festival. But I've never been able to get through all of it — my stomach always gives up. So if you're greedy like me, remember to be practical while planning your feasts. 
    

*   Overeat frequently. I think festivities are definitely a time for overeating. So it's not practical to advise not to do it at all, but it's important to stay mindful of how many times you're doing it. 
    

*   Forget to keep your medicine around, for the worst-case scenario. It'll bring you relief, support your gut and ensure that your stomach gets time to relax. However, it's not a cheat code! When you need a pill, it's time to slow down 
    

*   Forget to have fun! Don't feel guilty around food, and remember to enjoy it with your loved ones! It can be a beautiful bonding experience and is considered significant in almost all Indian festive rituals. Eventually, you'll be fine, don't overthink it!

Don'ts 

Managing gut health during festive season: The Do's and Don't's

Perimenopause is the transitional phase into menopause. The median [onset of perimenopause](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6082400/) is 47 years. However, you may notice symptoms of perimenopause as early as your late 30s. Perimenopause lasts for a few years before menopause arrives. For some women, symptoms can carry on for decades.  

While some symptoms are manageable, many are significantly distressing affecting your daily functioning. Knowing when to meet your healthcare provider and simple ways to manage your symptoms at home can help with your transition to menopause.

Perimenopause (_peri_- meaning around), is the transitional phase to menopause, when your periods would have stopped completely. 

So one of your first signs that you might be in perimenopause is period irregularities. This can be coupled with classic symptoms such as hot flashes, vaginal dryness, or significant fluctuations in your mood.  

However, many of these signs may not be textbook versions of what you expect. Such as recently, [actress Halle Berry spoke out about being misdiagnosed for herpes](https://abcnews.go.com/GMA/Wellness/halle-berry-doctors-misdiagnosed-perimenopause-herpes/story?id=108551685), when she was experiencing the burning sensation of vaginal dryness of perimenopause.  

_The slow decline in estrogen is responsible for the fluctuation in such symptoms, and also its differing presentations among women._  

Similarly, some women may experience a [burning sensation in the mouth](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4520363/), tinnitus (ringing in the ears), new skin reactions, heart palpitations, or recurrent UTIs as indicators for perimenopause.

What are the symptoms of perimenopause? 

Whenever you notice your first perimenopausal symptoms would be an ideal time to check in with your doctor. Your physician will assess whether your symptoms are because of declining estrogen of perimenopause or another underlying medical condition.  

An example of this possibility is the common hot flashes experienced by [85% of menopausal women](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6459071/). In some instances, [hot flashes can be reported](https://www.ncbi.nlm.nih.gov/books/NBK539827/) with certain cancers, thyroid disease, or certain medications you are taking. 

If your perimenopause symptoms affect your day-to-day functioning, your doctor can help you understand the reasons for it and suggest ways to manage your symptoms. While certain lifestyle changes can help, some women may need [hormonal supplementation](https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.122.061559) to assist with debilitating physical symptoms of perimenopause.  

Additionally, the erratic decline in estrogen during perimenopause may cause significant fluctuations in your mood. Perimenopausal women are [two to four times more likely to experience a depressed mood](https://www.sciencedirect.com/science/article/abs/pii/S187620182100037X?via%3Dihub) than women who are not in perimenopause. This likelihood increases if you have had depression in the past.  

Any feelings or emotions you cannot cope with should prompt you to reach out for professional help. 

>**Community take:** 
I never had PMS mood changes. What women described as irritability, anger, and frustration before their periods just never happened to me. And then one day I was angry all the time. Even in situations I had no reason to be. I thought it was PMS, since I was still having my periods, even though it was not so regular. When it was starting to affect my interactions at home, I thought I’d see professional help. My doctor explained that all these changes (I was also having hot flashes which I ignored) were perimenopausal and related to my hormones. I talk to a therapist once a week, and that has helped provide a third person’s view to what I’m experiencing. If you feel different and are in your 40s, talk to a doctor. It is often not just in your head.

When should I see a doctor for my symptoms?

While you may not know exactly when you are going to transition to menopause, knowing the symptoms and how they might affect you can prepare you for perimenopause.  

In your 30s (not a bad idea to start in your 20s), optimize your nutrition and exercise regularly to encourage healthy aging. With the hustle of daily life, these are the first things to falter, causing the most damage to our physical and mental health. Additionally, routinely adding more [strength training workouts](https://pubmed.ncbi.nlm.nih.gov/36675477/), along with supplementing your diet with sources of iron, [magnesium, and calcium](https://jmscr.igmpublication.org/home/index.php/archive/214-volume-11-issue-07-july-2023/10716-a-comparative-study-of-serum-calcium-and-magnesium-in-post-menopausal-and-pre-menopausal-women) is beneficial for reducing the severity of perimenopausal symptoms and long-term negative effects of declining estrogen levels. 

Another key is managing your stress levels during perimenopause. While the symptoms of perimenopause can be worrisome, [added stress](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7840006/), and a consistently elevated cortisol level can worsen symptoms. Tackling your stress, through exercise, meditation and even regular therapy helps tremendously through perimenopause.

What are some routine practices to follow for my perimenopausal symptoms?

Perimenopause is a transitional phase in a woman’s life. Hallmark of perimenopause is the fluctuation in physical and mental health symptoms, which can worsen affecting daily functioning during this transitional phase. Consider checking in with your doctor for help, along with incorporating simple routine practices to favor healthy aging.

Takeaway

Onset and symptoms of perimenopause: When should I see a doctor and other practices. 

The World Health Organization records most women going through menopause between 45 to 55 years of age. In 2011, 96 million Indian women were estimated to be above 45, according to the Office of the Registrar General and Census Commissioner. This number is projected to be [401 million in 2026](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5320842/#ref17), most of them likely going through menopause.

During this transitional phase, knowing your unique symptoms can help you seek the support you desire for menopause. Additionally, surrounding yourself with people who will understand and ease your transition can help with healthy aging through menopause. 


According to a survey taken by Ipsos in 2018, only [24% of Indian women visit a doctor](https://www.statista.com/statistics/913376/india-frequency-of-visits-to-obstetricians-gynecologists/) once a year. Approximately 50% cited less often or never as their responses. 

By the time you reach menopause, you have probably visited your gynecologist a few times over the years for routine check-ups. Making your current gynecologist, someone well aware of your medical history, the ideal choice for you during menopause.  

>**Community take:** 
In my late 40s, it had been years since I visited a gynecologist. I had my babies in my late 20s and 30s. Now and then I would go in for a pap smear, but regular check-ins rarely happened. And here I was drenching in sweats and overnight insomnia. I thought it was something I had to go through at this age. But when I talked to my gynecologist, I felt reassured. She guided me through the expected changes in this time, and what can help me. She provided me with some supplements and asked to check back in a few months. Having someone to talk to, and know I need help has been a game-changer during perimenopause.
 
With strides in telemedicine, doctors are now accessible online. So even if this means you have to find a new physician (especially if you have never consistently been to one before) there are some factors to keep in mind. 

Enlisting expert help: How to choose the right physician for you?

Understanding your unique menopause symptoms and how they affect your daily functioning is a _first step_. This can help guide your initial interviews in finding the right physician, by feeling at ease to relay your symptoms to your physician without concern of being dismissed for what you are experiencing during menopause. 

Knowing what you need help with

If you have not visited the same gynecologist over the years, talk to your friends or peers about their experiences with their physician. You can also do some research on gynecologists specializing in menopause in your locality, making it easier for routine menopause visits. If you have a gynecologist you visit yearly, you can start discussing what to look out for during perimenopause leading to menopause. Based on your medical history your doctor can advise you on lifestyle steps for nutrition, stress, and exercise required for the transition. 

Get some referrals or start talking menopause with your OB-GYN 

A Female Founders Fund survey, highlighted [32% of their respondents](https://blog.femalefoundersfund.com/suffering-in-silence-the-biases-and-data-gaps-of-menopause-e5f131b4b581) experiencing a lack of confidence in the knowledge and openness of menopause discussions with their healthcare providers.  

This indicates that there is still significant stigma surrounding perimenopause, and its symptoms leading up to menopause. In India, most women still believe that physical changes related to their menstrual cycles and hormones should be coped with in silence. However, universally the dialogue on menopause is progressing. Individually, if you are suffering from your symptoms seek a physician who will listen to you. You should not be dismissed for what you are experiencing as a normal part of aging.  

Ideally, the right doctor will listen, be accessible, and provide individualized care to suit your unique symptoms and lifestyle for better health during menopause.

Advocate for your health during menopause 

During menopause, both physical and psychological changes can impact your daily quality of life. While your doctor can guide you, it becomes vital to form a support system that is easily accessible to help you through this transitional phase.  

Community participation and having a sense of community have been [linked](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8953512/#sec4-ijerph-19-03261title) to improving quality of life and mental health, promoting healthy aging.  

Whether it is a local support group, your kitty party, or an online forum, finding your safe space with women going through a similar journey can be as important as having the right physician for menopause. Such groups often provide practical advice on dealing with symptoms during menopause. This can include tips on nutrition, with local ingredients available, or even enlighten on groups meeting up for discussions. 



>**Community take:** 
No one ever spoke to me about menopause. I thought it was something women go through in their 50s. Basically, their periods stop. When I had night sweats and started packing on weight, I was so confused. While my doctor explained these (and more changes) would happen during perimenopause, the discussion seemed so technical. When I researched online, I found a local group of women who met once a month and regularly talked about their concerns. It was that day I stopped feeling alone. I realized that talking to everyday women removes the isolation from your perimenopause symptoms. I have also received some practical tips that have worked when it comes to managing those pesky hot flashes that come in the day!

A [2023 review of literature](https://www.mdpi.com/2673-4184/4/1/5) showcased that women forming high social support for themselves, through family, friends, and communities experienced a reduction in the severity of their psychological and urogenital menopause symptoms. A key dynamic is the increased education on menopause by both the women and their families which promotes better health outcomes during menopause.

Harnessing the power of community: how to build the right support system for yourself 

Going through perimenopause to menopause and beyond is a long journey, which can often feel lonely if you don’t have the right support. Talking to different physicians about their experience with menopause, and openly discussing your symptoms can help you assess if your healthcare provider is right for you. Do not hesitate to take some time, while talking to several doctors before finding the right one for you. Once you reach perimenopause, start seeking and building your support system, of friends, family, and women themselves going through menopause who can help you transition into this new phase of your life. 

Pausing for menopause: Finding the right physician, building your community, and knowing when to seek help

Menopause might mark the end of a woman’s monthly cycles, but who says it has to be the end of your sex life as well? Spoiler alert: It’s not! 

While a [third of women](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6780739/#:~:text=Sexual%20function%20worsens%20with%20advancing,adverse%20effects%20and%20personal%20preferences.) in perimenopause or menopause experience sexual difficulties, such as low desire or trouble having an orgasm - many have found ways to cope with the sudden changes thrown at them. The problem is - nobody’s really talking about it! And that silence leaves too many women feeling alone in this journey.

It’s time to get real and dig into what happens to **sex during menopause**—the good, the bad and the ugly. Because intimacy doesn’t have to end; it just evolves

Every woman experiences the symptoms of menopause differently. For some, they hit without warning, while for others, they creep in slowly, causing small but significant physical changes. 

During menopause, a woman's body stops producing the hormones driving the menstrual cycle. The main player here is estrogen. As estrogen levels drop, a ripple effect occurs throughout the body. This causes:  

**Vaginal Dryness:** 

Estrogen keeps the vaginal tissues moist and elastic. With its decline, [25-30% of women](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6780739/#:~:text=Sexual%20function%20worsens%20with%20advancing,adverse%20effects%20and%20personal%20preferences.) experience dryness and thinning of the vaginal walls, which can make sex uncomfortable or even painful. 

**Lowered Libido:** 

A dip in estrogen also means a dip in testosterone—a hormone that women have, too - and it’s directly linked to sexual desire. This shift makes [40-55% of women](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6780739/#:~:text=Sexual%20function%20worsens%20with%20advancing,adverse%20effects%20and%20personal%20preferences.) experience a drop in their sex drive during menopause.  


Did you know? Upto [45% of women](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6780739/#:~:text=Sexual%20function%20worsens%20with%20advancing,adverse%20effects%20and%20personal%20preferences.) experience dyspareunia or pain during sex as they go through menopause.

The Science Behind It All: Understanding Menopause 

While hormones get the most blame, they’re not the only factors affecting intimacy. This life stage also brings changing emotions that also play a role in the sexual changes experienced during menopause.  


_Only [half of women in their 50s](https://www.hopkinsmedicine.org/health/wellness-and-prevention/how-sex-changes-after-menopause#:~:text=How%20does%20menopause%20affect%20sexuality,which%20affect%20the%20sex%20drive.) report having sex. It’s clear that menopause isn’t just a hormonal change—it’s a whole-body and whole-life transition that has a natural impact in the bedroom as well._  


**1.  Mental Health:**  
    

Menopause is often accompanied by mood swings, anxiety, and even depression. These shifts can make it hard to feel emotionally connected or in the mood for intimacy. 

**2.  Body Image:**  
    

Weight gain, hot flashes, and other changes during menopause can impact how a woman feels about her body. When self-esteem takes a hit, feeling desirable or open to intimacy can be tough. 

**3.  Stress and Relationships:**  
    

Menopause doesn’t happen in a vacuum. Stressors like career changes, family demands, and evolving relationships can complicate how a woman feels about herself and her partner.  


Factors Impacting Sexual Function During Menopause: 

*   Low Estrogen: Causes dryness and discomfort. 
    

*   Emotional Changes: Anxiety, mood swings, and stress. 
    

*   Health Issues: Higher risk of chronic conditions. 
    

*   Physical Pain: Joint aches and discomfort. 
    

*   Body Image: Self-confidence struggles. 
    

*   Relationship Stress: Changing roles and life pressures. 
    


While sex during menopause can be a struggle, it’s not ALL bad! Let’s look at some of the advantages that age brings to a woman’s intimate experiences

Beyond Hormones: The Emotional Side of Sex During Menopause

**1.  Liberation and Confidence**
    

For many women, menopause can feel like the beginning of a new chapter in their sexual journey. Without the worry of pregnancy, there’s a sense of freedom that wasn’t there before.  

>After menopause, I felt like a weight had lifted off my shoulders. No more periods, no more pregnancy scares. It made me more open to exploring what intimacy meant for me,” says Naina\*, 57. 

**2.  Prioritising Emotional Intimacy** 
    

As the body changes, so do a woman’s perspectives on intimacy. For many post-menopausal couples, emotional connection becomes the cornerstone of their relationship. Without the same physical urges, couples find room to focus on connecting mentally and emotionally. 

>My husband and I started talking more. It wasn’t just about sex anymore; we explored different forms of closeness. Sometimes, it was just holding hands in silence that felt incredibly intimate,” shares Rashmi\*, 61. 

**3.  Quality Over Quantity** 
    

As women go through menopause, their approach to intimacy changes. It’s less about “how often” and more about savouring and enjoying each experience. 

>I stopped worrying about whether I was doing it ‘right’ or if we were having sex ‘enough.’ It became more about experimenting with what made us feel closer, like trying a sensual massage or just laying close together,” says Meera\*, 54.

The Good

**1.  Physical Challenges**
    

As explained earlier, menopause brings real physical changes that can impact a woman’s sexual experience. Vaginal dryness and thinning of the vaginal walls often lead to discomfort or pain during sex, making some women dread intimacy.  

>Sex became uncomfortable. I’d never had that issue before, but suddenly, it was like my body wasn’t cooperating. It was frustrating, and I started avoiding intimacy altogether,” explains Shalini, 52. 

**2.  Psychological Impact** 
    

Women experience feelings of unattractiveness, self-consciousness about their bodies, and even shame over their changing libido. This can create emotional distance between partners and lead to a cycle of avoidance and guilt. 

>I put on weight and felt unattractive. I couldn’t look at myself in the mirror, so how could I expect my husband to find me desirable? I withdrew, and it took a toll on our relationship,” recalls Priya, 56.

The Bad

**1.  Cultural Silence** 
    

In many cultures, talking about a woman’s sexual life after a certain age is still taboo. The idea that older women, especially post-menopausal women, still want and deserve a fulfilling sex life is often dismissed.  

This leads to feelings of isolation and embarrassment when dealing with sex and menopause.  

**2.  Miscommunication in Relationships**
    

With so many changes in a woman’s body and emotions, clear communication becomes crucial.  

Misunderstandings and assumptions can drive a wedge between partners, leaving each person feeling unheard or unsupported. 

>I assumed he didn’t care anymore because he wasn’t initiating, and he thought I wasn’t interested because I was distant. We were both wrong, but it took months to have that conversation finally,” shares Seema, 58.

The Ugly

Navigating sexual changes during menopause often requires a multi-faceted approach. Women experiencing pain or  discomfort during sex can consider the following options: 

**1.  Vaginal Moisturizers and Lubricants:**  
    

Declining estrogen levels can lead to vaginal dryness, making intercourse painful. Using water-based or silicone-based lubricants can reduce friction, while vaginal moisturisers can help restore tissue hydration over time.  


Around [70% of women](https://pmc.ncbi.nlm.nih.gov/articles/PMC6487289/) experienced relief from symptoms after using a vaginal moisturiser. The vaginal health index (VHI) improved by [about 30%](https://pmc.ncbi.nlm.nih.gov/articles/PMC6487289/) [](https://pmc.ncbi.nlm.nih.gov/articles/PMC6487289/)on average, and dryness scores dropped by over 60% after treatment, showing a big improvement in comfort. 

**2.  Hormone Replacement Therapy (HRT):**  
    

For those experiencing more severe symptoms of menopause, HRT might be an option. By supplementing declining hormones, HRT can help alleviate symptoms like decreased libido, vaginal dryness, and mood swings.  

**3.  Counselling and Therapy:**  
    

Seeking the help of a therapist or counsellor experienced in sexual health can provide valuable tools for navigating libido challenges during menopause.  

**4.  Body Confidence Practices:** 
    

Engaging in activities that promote body positivity, like yoga, meditation, or even dance, can help reconnect with the body. Regular exercise also improves blood circulation, which is key to arousal and sexual satisfaction. 

**5.  Regular Check-ins:** 
    

Couples who set aside time to discuss their feelings and experiences related to intimacy are often better equipped to handle changes. Practical Tip: A scheduled weekly or monthly ‘relationship check-in’ can provide a safe space for partners to express concerns or desires without judgment. 

**6.  Expanding the Definition** 
    

Menopause offers an opportunity to expand the definition of intimacy beyond traditional intercourse. Penetration is only one aspect of a broad spectrum of sexual expression. Women often find fulfilment in other forms of connection. 

Activities like mutual touching, cuddling, sensual massage, and oral intimacy can be incredibly satisfying. Focusing on these forms of non-penetrative connection allows couples to explore new experiences and discover what feels pleasurable post-menopause. 

**7.  Self-Discovery** 
    

Menopause can be a time of rediscovering and redefining sexual identity. For many women, this includes embracing self-pleasure and exploring their bodies in new ways. Masturbation can help women reconnect with their changing bodies and identify what feels good post-menopause. Scientific Insight: [Studies show](https://my.clevelandclinic.org/health/articles/24332-masturbation#:~:text=People%20assigned%20female%20at%20birth,decreased%20pain%20during%20sexual%20intercourse.) that masturbation can promote vaginal health by increasing blood flow, maintaining elasticity, and preventing dryness.

Practical Tips to Navigate Sexual Changes 

Instead of menopause hitting the break on your sex life- think of it as hitting the “refresh’ button instead. Now’s the time to own your sexual health. Chat with your doctor about sex during menopause, explore your options and most importantly—don’t be afraid to ask for what you need.

This chapter is yours to write, so go ahead and make it a good one! 

**Key Takeaway Points:**

1.  While menopause brings hormonal changes, many women discover newfound freedom and confidence in their sex lives. 
    

2.  Declining estrogen levels cause physical changes like dryness and reduced libido, but emotional shifts also play a significant role. 
    

3.  Up to 70% of women reported improved comfort and reduced dryness with regular use. 
    

4.  Exploring non-penetrative activities, such as sensual massage or mutual touching, can enhance connection and pleasure. 
    

5.  Honest conversations with partners and embracing self-discovery can help women reclaim intimacy post-menopause.

In summary- Flip the Script!

Sex After Menopause: How to Keep the Spark Alive When Your Body’s Changing 

Hair is manly. No, I’m not the one saying this. It’s the Vikings, Samurais, Mayas. And the research paper from [Brandeis University](https://www.brandeis.edu/writing-program/write-now/2021-2022/azevedo-ligia/index.html) that was published in 2021.

When I grew hair on my face and body, thicker than usual, a medical professional told me I could be suffering from PCOS. She explained that one of the symptoms was that you’d grow hair “like a man”.

When I was diagnosed with PCOS, I learnt that it’s called Hirsutism. When I discovered more about PCOS and its risks, it was heartbreaking to learn what its seriousness had been reduced to 

For a long time in my life, I felt so out of place with any hair on my body. Women around me had the cleanest, smoothest skins and I’d naturally grow hair pretty quickly, outside of PCOS too. I think my school teacher noticed it and privately recommended to me that I get waxed. So I did.

It hurt so much. And whenever I waxed new parts of my body, like my underarms, it hurt worse. I shared it with my mother and she said, waxing is important to stay “clean”. So I continued. My cousin sister, who also started waxing pretty close to when I did, would complain a lot and ice her body after. She’d always ask me “Doesn’t it hurt you?” because I had a pretty neutral expression to it. And I told her it did but “what can we do about it?” She was still fighting it, I think I had just accepted my fate.

When I grew up a little more, I began deconstructing this beauty norm, taking strength from those around me like my cousin who hadn’t stopped complaining. Waxing wasn’t supposed to clean me. In fact, it was ‘cleaner’ to have hair on me because they protected my skin. It protected me from the dirt and sun.

And little by little, all hypocrisy came to light - all my male friends who would joke about women with hair, calling them mard, to glorifying Anil Kapoor’s chest hair (which look disgusting, by the way. Great actor though!)

And in more recent times, Prachi Nigam, who topped Class 10 Board exams but was mocked for her facial hair all over the internet.

But again the question arises, why just women — why not men? I've done my research and I've come to just one real conclusion. I think it all began with the infantilization of women and has just stuck around. So this would begin with Ancient Egypt where hairless bodies were clean and then in the Victorian era when hairlessness was for the Elite class. And porn and fashion magazines in the 19th century didn't do us any favours either.

I never participated in “Januhairy”, a trend on the internet that all women came together to let their hair grow out in 2018. Because I won't say I have been able to go past it. but when the pandemic came around in 2019 and none of us could wax anymore like we used to, I realised it could be way less frequent than usual.

Now I stick to waxing when I feel like it's time. I also grow thick hair on my body and face which I try to remove when I feel like it. Which I understand, is also governed by this taboo, but I've learnt to remember that I always notice them more than others around me, because I've been taught to.

And I've learnt that, a long sleeve and relaxed jeans can always save the day.

Wait, Hair me out!

Social taboo around Hirsutism that occurs from PCOS

Menopause is a significant life transition that affects more than just a woman’s
body—it can have a profound impact on emotional well-being, self-identity, and
relationships, particularly in the area of sexual intimacy. For many women, the
physical and hormonal changes associated with menopause lead to changes in
sexual desire, arousal, and comfort. These shifts can be confusing, and maintaining
a fulfilling sexual relationship may require both partners to adapt and support each
other in new ways.

Menopause doesn’t have to signal the end of a satisfying sex life. In fact, it can be an
opportunity for couples to grow closer, communicate more openly, and explore new
ways to maintain intimacy. Let’s talk about how both partners can navigate this
period together, ensuring sexual wellness and a healthy, supportive relationship.

During menopause, a woman’s body undergoes several changes due to a significant
drop in estrogen levels. This decrease can lead to physical symptoms such as
vaginal dryness, discomfort during sex, and a reduced libido. For some women,
these changes can cause anxiety or frustration, while others might feel a loss of
sexual identity or femininity. It’s important for both partners to understand that these
feelings are normal and can be addressed with empathy, patience, and
communication.

For men, it can be confusing to witness these changes. Partners may wonder why
sex is no longer as spontaneous or why their once sexually confident partner is now
feeling hesitant or uncomfortable. Many men struggle to understand what’s
happening, and this lack of understanding can lead to feelings of rejection or
frustration. This is why education and communication are essential.

Understanding the Impact of Menopause on Sexual Wellness

Open communication is the cornerstone of maintaining intimacy during menopause.
Many couples find it difficult to talk about sexual health, but menopause makes these
conversations even more crucial. It’s important to create a safe space where both
partners feel comfortable discussing their feelings, concerns, and needs without fear
of judgment or rejection.

For women, it may be challenging to admit that sex has become painful or that their
desire for intimacy has changed. For men, it may be difficult to express feelings of
confusion or frustration without sounding unsupportive. However, when both partners
approach the conversation with empathy, it opens the door for mutual understanding
and solutions.

The Importance of Communication

- Be Honest About Feelings: Both partners should express their emotions openly.
Whether it’s about discomfort, insecurity, or a changing libido, talking about these
feelings helps eliminate misunderstandings.
- Listen Without Judgment: Approach these conversations with compassion.
Listening to your partner’s experience without trying to "fix" it immediately fosters a
deeper connection and mutual respect.
- Be Patient: Sexual intimacy during menopause may require patience. Both partners
should understand that it may take time to adjust to these changes and find what
works best for them.

Tips for Open Communication:

One of the most common physical changes during menopause is vaginal dryness,
which can make intercourse uncomfortable or even painful. This often leads to a
decrease in sexual desire, as women may begin to associate sex with discomfort.
While this can be discouraging, there are several ways to alleviate these symptoms
and keep intimacy enjoyable.
1. Use Lubrication: Vaginal dryness can be easily managed with the use of lubricants
during intercourse. Opt for water-based or silicone-based lubricants, as these tend to
be the most gentle and effective.

2. Consider Vaginal Moisturizers: Unlike lubricants used during sex, vaginal
moisturizers can be applied regularly to maintain moisture in the vaginal tissues,
reducing overall dryness and discomfort.

3. Explore Hormone Replacement Therapy (HRT): For women who experience
severe menopausal symptoms, HRT may help. This therapy helps to restore some of
the hormones that are lost during menopause, which can improve libido, reduce
vaginal dryness, and enhance overall sexual wellness. It’s important to consult with a
healthcare provider to determine if this option is suitable.

4. Go Slowly: Sexual arousal and response times can change during menopause,
and what once felt natural or spontaneous may now require more time and attention.
Slow down and focus on foreplay, which can help ease discomfort and increase
arousal.

Addressing Physical Changes Together

For many women, menopause brings about emotional changes such as mood
swings, anxiety, or depression, all of which can affect sexual desire. It’s essential for
partners to recognize that emotional intimacy is just as important as physical
intimacy. When emotional connection is strong, it often translates into a healthier
sexual relationship.
Ways to Strengthen Emotional Intimacy:
- Spend Quality Time Together: As life becomes busy, especially with the added
pressures of midlife, it’s easy to lose touch with each other outside of the bedroom.
Make an effort to spend time together in ways that foster emotional closeness—
whether it’s going for a walk, cooking a meal together, or simply sitting down for a
meaningful conversation.
- Practice Mindful Touch: Physical touch doesn’t always have to lead to sex.
Engaging in non-sexual touch, like holding hands, hugging, or cuddling, can help
maintain a physical connection and build emotional closeness. This kind of touch can
reduce stress and anxiety, making both partners feel more comfortable and
supported.
- Share New Experiences: One way to reignite passion and intimacy is to explore
new activities or experiences together. Trying something different, whether it’s a
hobby or an adventure, can help both partners feel connected and revitalized.

Fostering Emotional Intimacy

Menopause may change the dynamics of a couple’s sexual relationship, but it
doesn’t mean that intimacy has to fade. In fact, many couples find this period of life
to be an opportunity to explore new ways of connecting that don’t rely solely on
intercourse. Intimacy can take many forms, and it’s important for both partners to
remain open to exploring these options.

1. Expand Your Definition of Sex: Sexual wellness doesn’t always have to be about
penetrative sex. Many couples find that focusing on other forms of intimacy, such as
oral sex, mutual masturbation, or simply touching and caressing each other, can be
just as fulfilling.

2. Try Sex Therapy: If menopause is causing a significant strain on your sexual
relationship, consider seeking help from a sex therapist. A professional can help both
partners navigate the emotional and physical changes, offering tools and techniques
to maintain a satisfying sex life.

3. Focus on Pleasure, Not Performance: As menopause changes the body, there
may be times when intercourse isn’t feasible or comfortable. Shifting the focus from
performance to pleasure allows both partners to enjoy intimacy without the pressure
of achieving a certain outcome.

4. Maintain Humor and Playfulness: Sometimes the best way to relieve tension is to
embrace humor. Menopause can bring some unexpected moments, and laughing
about these changes can create a sense of camaraderie between partners.
Playfulness in the bedroom can also reduce pressure and help couples stay
connected.

Redefining Intimacy and Exploring New Ways to Connect

Menopause is a shared journey, and supporting one another is crucial. It’s important
to approach these changes as a team, recognizing that both partners may feel
vulnerable at times. Men can support their partners by being patient, empathetic, and
proactive in finding solutions. Women, in turn, can support their partners by expressing their needs openly and allowing themselves to be vulnerable in these
moments.

Both partners should take the time to educate themselves about menopause,
understanding that it’s not just a physical change, but an emotional and
psychological one as well. By working together, communicating openly, and
embracing new ways of connecting, couples can not only maintain sexual intimacy
during menopause, but potentially deepen their relationship.

Supporting Each Other Through the Transition

Menopause may bring about changes in a woman’s body, but it doesn’t have to
diminish intimacy. With patience, communication, and a willingness to explore new
paths to connection, couples can navigate this transition together, emerging stronger
and more in tune with each other’s needs.

Have you and your partner faced challenges in your sexual relationship during
menopause? What strategies have helped you stay connected? Share your thoughts
and experiences in the comments below—we’d love to hear from you.

Conclusion: Building a Stronger Relationship Through Menopause

Navigating Sexual Wellness and Maintaining Intimacy During Menopause: Steps for Both Partners

Whilst it’s not altogether unexpected, when menopause eventually arrives it can be
surprising, unpleasant, and more than a little emotional. “Hot flushes” have always
headlined the stages of menopausal transition but as many of us are discovering,
there’s so much more to it. From physical pain to mental and emotional distress,
women are swinging between irritation, confusion and tears.

Struggling to maintain relationships. Struggling with their mental health. Struggling to
keep their careers. And a huge one: struggling with their self-identity.

The aging process is no easy pill to swallow. While we all agree that getting old is the
goal, it can still be discombobulating to see an older face in the mirror and yet feel so
young inside. Or struggle to move as easily as we once did not so long ago. We
could be regretting the dream we didn’t pursue. Maybe, life just didn’t turn out the
way we thought it would.

It’s a highly personal journey and compounded with the menopause transition, we
become sensitive and emotional, and often withdraw. Our partners meanwhile, are
scratching their heads wondering what they’ve done “wrong”. We all turn inwards
and self-soothe from time to time, but if we’re not communicating with our other
halves, there can be a lot of hurt feelings, cross-words and misunderstandings.
It can be a tough time for women, but can be equally as tough on the men who care
about them. The woman may not even realise that she’s in perimenopause until she
puts the pieces of the puzzle into place, perhaps with a little help from Dr Google and
YouTube. Let down also by health practitioners from a lack of information, a lack of
diagnosis, and in some cases, an outright denial of symptoms, if we don’t even
understand what’s going on with our bodies, how could our partners possibly know?
What’s Actually Happening to Her?

The menopause transition is a normal life stage for anyone born with ovaries. It’s a
time when their hormones change and estrogen levels drop, signaling that the
reproductive years will soon be over. During perimenopause (the lead up to
menopause), the ovaries prepare to stop releasing eggs. At menopause, the body
stops releasing eggs entirely.

This usually happens between the ages of 45 – 55, and while symptoms can and do
vary (some women experience very few symptoms, others a lot), one thing is certain
– it can significantly affect our relationships, in particular, those with our partners.
What might start out as mild fatigue, the occasional sleepless night or a hot flush
here and there (symptoms will vary), can gradually develop into a whole range of
worsening symptoms including weight gain, migraines, sleep disturbance, hot
flushes, bladder issues, loss of libido, mood changes and breast or joint pain.

From puberty and getting periods to mid-life and menopause, the stories are similar:
hormonal changes, mood swings, and physical pain. Except, where once we were
dreading the period leaks and stains, now we’re dreading hot flushes, headaches,
breast lumps and cervical issues. All just as confusing as once upon a time, back in
our youth...welcome to “reverse puberty!”.

The Psychological Adjustments of Menopause

According to “The MATE survey: “men’s perceptions and attitudes towards
menopause and their role in partners’ menopausal transition”*, “63% (284/450) of
survey respondents reporting that their partner’s symptoms had personally affected
them. Specifically, men affected by menopausal symptoms noted that the symptoms
put an emotional strain on their relationships (34%; arguments, unappreciated,
tension, etc), reduced the frequency of sex/intimacy (33%), and contributed to
trouble sleeping (10%).

Some men (11%) noted that it was upsetting or frustrating to see their partners going
through this transition. Most men affected by menopausal symptoms believed the
symptoms had a very or somewhat negative impact on them (77%), their
relationships (56%), or their partners (70%). Approximately 10% of men thought the
symptoms had a positive influence on them, their relationships, and partners.”
In another study, “Husbands’ support of their perimenopausal wives”, most of the 96
participants said they had some information about menopause (mostly gained from
their wives), but more than 1 in 4 knew little or nothing. One third of the husbands
didn’t think they were supportive, but the majority said they provided mostly
emotional support. They reported numerous stressors in their lives, including work
and financial problems and declining health and sexual response. Lack of
information, negative effects of their wives’ menopausal transition, and their own
stresses may have interfered with husbands’ ability to provide social support.
In a third study, “Attitude towards menopause among married middle-aged adults”, it
was the wives who generally expressed a more positive attitude towards menopause
than their husbands, and with more symptoms than their husbands thought they
were having. For both women and men, a more positive attitude towards
menopause was associated with women who reported fewer symptoms.

It would be easy (and unfair) to generalise by saying that men just need to show a
little more understanding and compassion, but it’s not that simple. Clear
communication really does benefit both parties and is the responsibility of both. All
relationships go through tests and trials, and many can come through the other side
stronger than before. The fact is, menopause has a huge impact on a woman’s
physical and mental health, and even her life expectancy, so it certainly pays to
make the effort.

Tips to help your support your partner through menopause


What is the Impact of Menopause on Male Partners?

Learn as much as you can about perimenopause and menopause to understand her
experience.

Menopause causes changes in the female body, mainly through the decreased
production of estrogen. Some women have very few symptoms and it’s over quickly,
while others can be hit with a host of unpleasantries that last a long time.
Understanding the symptoms can help you recognise them as they arise, and
anticipate how they will affect your partner.

Education

Ask your partner directly how they are feeling, and how you can support them.
Understand that their mood swings may be driven by the changes in their hormones,
and be erratic and disproportionate to the issue at hand. Try to stay compassionate
and supportive rather than reactive.

Talk

A lot is going on “down there” for her, much of which she may not want to open up
about. She may have lost her libido or sex may even have become painful.
Be patient. There are other ways to enjoy intimacy in the meantime.

Sexual Issues

Encourage (and model) healthy lifestyle changes and activity such as strength
training, walking, dancing or yoga – or suggest an activity you could do together. Try
to keep some playfulness and fun in your together time; suggest something new to
break out of stale routines and unhelpful habits.
Be prepared to suggest some professional help if necessary. Be open and sensitive
with her about what you’re seeing and ask if she thinks a professional opinion might
be helpful.
Keep in mind that mental health conditions often begin or worsen in the menopausal
transition, and that this is the peak age group for suicide in women. If she has
worrying mental health signs then she may need your support to access care
quickly; start with her usual GP.
Partners should seek support for themselves too. You’re not the only one struggling
to work out what’s going on with a menopausal partner, so why not try opening up
that conversation with friends at similar life-stage and see what happens. You might
feel pleasantly validated.

Support

Because you care about her, so her well-being matters. Because she’s the other half
of the team. Because she needs your support right now, navigating this
uncomfortable time. You can make a huge difference to her experience simply by
being alongside her for the journey.

There is help available for your partner during this time: knowledgeable health
professionals, lifestyle modifications, daily movement, nutrition, supplements, and
hormonal and non-hormonal treatments can all help alleviate symptoms, and
improve future health.

She’ll work it out, and if you remain engaged and supportive you’ll come through it
together, perhaps even stronger than before.

Why is this so Important?

How to support your partner through menopause

While in your 40s, almost overnight you may have noticed period irregularities coupled with drenching sweats at night and erratic changes in your mood. All clues to a journey toward menopause.

Over a [billion women are expected to be postmenopausal by 2025](https://pmc.ncbi.nlm.nih.gov/articles/PMC10347781/), yet we know so little about the early signs of perimenopause. Identifying your symptoms early, having open conversations, and enlisting the help of your health experts can guide you toward better health during perimenopause. 

The median [onset for perimenopause is 47 years](https://pmc.ncbi.nlm.nih.gov/articles/PMC6082400/). However, some women can start experiencing symptoms as early as their late 30s. The length of perimenopause can also vary anywhere from a few months for some to years for others.

While it is relatively common to expect irregular periods to be one of the first signs that menopause is around the corner, perimenopause symptoms can vary. 

A widely known, and experienced symptom of perimenopause is hot flashes. It describes a sudden “flash” of warmth followed by drenching sweats. For [one-third of women](https://pmc.ncbi.nlm.nih.gov/articles/PMC4834516/), hot flashes can be debilitating. Hot flashes usually subside in a year or two after they first appear, however, for some women it could last decades. 

Changes to your vagina and urinary tract are among other perimenopausal symptoms reported. The most common among these is vaginal dryness, experienced by around [27% of women](https://pubmed.ncbi.nlm.nih.gov/15531125/). It is not always easy to identify this perimenopausal sign. Vaginal dryness can be felt as new and persistent vaginal irritation or as a decline in lubrication during sex, making the symptoms more troublesome as you progress toward menopause. In addition to dryness, you may also experience changes in your urinary frequency during perimenopause. 

A key reason for symptom onset and its fluctuations during the years toward menopause is the decline in the levels of estrogen. Since you are born with all the ovarian follicles you will use during your lifetime, in your late 30s, and 40s this follicular reserve declines. At its lowest levels, follicles release a limited amount of estrogen, your protective hormone. Since some estrogen is still being released, symptoms vary, with some being worse than others.

>**Community take:**
I was unable to explain why I was getting irritable so often. I would lash out at my children for small things I previously overlooked and regret it later. At that moment I felt incapable of controlling my emotions. Even though I started having hot flashes a year ago, I didn’t think perimenopause was responsible for these dark clouds changing my mood.

Along with the physical symptoms from estrogen decline, you might also see fluctuations in your mood. [Depression prevalence was 42.5% among Indian](https://www.sciencedirect.com/science/article/abs/pii/S187620182100037X?via%3Dihub) perimenopausal and postmenopausal women according to one meta-analysis. Both the declining hormones and the psychological stressors of perimenopause are linked to mood symptoms.

Additionally, during perimenopause, you may also experience migraines, insomnia, weight gain, changes in sex drive, fatigue, joint pains, and brain fog all coupled with erratic periods as indicators of perimenopause. 




How do I know if I’m in Perimenopause?

“Peri-” translates to around, so perimenopause is used to describe the years leading up to menopause. 

[Menopause defines](https://www.ncbi.nlm.nih.gov/books/NBK507826/) the absence of periods for 12 consecutive months. 

Many of the symptoms we have seen above start during perimenopause and can persist during menopause, because of the slow decline of hormones. It is only after a few years into menopause that you will experience relief from many of the troublesome perimenopause symptoms. However, since menopause signifies the natural decline of estrogen, it is also a phase where you are exposed to an increased risk of other health conditions, such as osteoporosis, cardiovascular disease, and Alzheimer’s. 

Estrogen provides a [protective effect](https://academic.oup.com/biolreprod/article-abstract/67/5/1379/2683434?redirectedFrom=fulltext) from these conditions during your reproductive years. Speaking with your healthcare provider can help you understand how your estrogen decline is impacting your perimenopause symptoms and if hormone replacement has any benefit for you.

Are perimenopause and menopause the same?

Staying healthy during perimenopause can require an individualized approach, as symptoms are not the same for every woman.

Topping the list would be a nutritious diet which should supplement your hormone fluctuations helping moderate troubling symptoms of perimenopause. Diets rich in fiber, omega-3 fatty acids, lean protein, and probiotics are proven to be most helpful. Some vegetables contain [phytoestrogens](https://pmc.ncbi.nlm.nih.gov/articles/PMC6390141/), a natural source of estrogen, that can help ease the transition to menopause. Soybeans, flax seeds, fruit, garlic, and sweet potatoes are some of the natural sources of phytoestrogens. 

Some studies have also shown some [benefits in herbal supplementation](https://pubmed.ncbi.nlm.nih.gov/17454163/), such as with chaste-tree berry and black cohosh, in relief of perimenopausal symptoms. A [small study](https://pubmed.ncbi.nlm.nih.gov/10623319/) on the use of St. John’s wort showed similar results for its impact on the psychological symptoms of menopause. Any supplements you wish to take should be through the guidance of your healthcare provider.

Finally, regular exercise, incorporating regular strength training, and adequate sleep are crucial during perimenopause. Strength training has [proven to improve bone density](https://pmc.ncbi.nlm.nih.gov/articles/PMC9864448/#sec4-jcm-12-00548title) which declines as menopause progresses. It also tackles inflammation, significant hormone fluctuations and can help you get a good night’s rest.

>**Community take:**
I feel sleep is the most overlooked and most important thing to heal during menopause. With hot flashes, night sweats, and mounting stress, sleeping was difficult when perimenopause started for me. But soon I built a nighttime routine that worked for me. Dinner 3 hours before, no screens for 2 hours, reading, meditation, journaling, all kids in bed, and one hour before bed just for me. It took me some time to find this balance, but on the nights I sleep well, I am able to handle my symptoms better.



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