Insufficient vaginal lubrication during sexual activity can make intercourse uncomfortable or painful. Some women report a decreased interest in sex and a decline in sexual activity with menopause that are not due to vaginal problems. Psychological symptoms may include depression , mood swings, weepiness, and other emotional flare-ups, as well as memory lapses. Although declining levels of estrogen may play a role in these symptoms, a number of other factors and stresses need to be considered as well. Excess alcohol, caffeine, or sugar may stress the adrenal glands and decrease the amount of adrenal androgens available for conversion to estrogen, thereby lowering estrogen and making menopausal symptoms worse.
Smoking decreases estrogen production by the ovaries, leading to earlier menopause and osteoporosis.
Stressful life events that may contribute to the emotional symptoms at the time of menopause include children leaving home and caring for aging parents. Administered as oral tablets, skin patches, or vaginal creams or suppositories, HRT alleviates symptoms of menopause and may increase verbal memory. It also may counteract some serious health problems associated with menopausal women. For instance, osteoporosis , in which bones become brittle and vulnerable to fractures, is caused by calcium loss. Calcium loss accelerates in women for three to seven years after menopause.