A Clinical Approach To Reproductive Health & Sexual Changes: A Comprehensive Guide

Explore the clinical approach to reproductive health and understand its importance in patient care and medical research.

Reproductive Health

When it comes to reproductive health in the body, many women will notice changes in their bodies as their menstrual periods become more or less frequent, which can affect their bodies. While menstrual changes can last between 1 and 3 years, menopause can be different for each woman with very different symptoms.

Some of the symptoms when there are hormonal changes associated with reproductive health can include:

• Insomnia
• Weight fluctuations
• Fatigue
• Joint and muscle pain

At the same time, when a woman is dealing with hormonal changes associated with their reproductive health, they are experiencing pain-like symptoms in their bodies. As the person ages, so does the body, hormones, and spinal structure. Various environmental factors affecting the body can lead to overlapping risk profiles for reproductive health and the musculoskeletal system, causing low back pain. Many individuals dealing with low back pain, especially women, are attributed to various factors like increased pain sensitivity and various menstrual cycles. (Chen et al., 2024)

Hormone Replacement Therapy

Hormone replacement Therapy or HRT is a treatment that can be used to treat some of the symptoms of hormonal changes associated with reproductive health by replacing hormones that are at a lower level. For females, low estrogen and progesterone levels can affect neuroprotective receptors in the brain, causing symptoms of inflammation and stress to impact the body. (Hwang et al., 2020) For males, low testosterone levels can cause skeletal muscle mass and strength reduction, decreased bone mineral density, and sexual dysfunction. (Barone et al., 2022) So, for males and females, taking HRT can help replenish the lost hormones in their bodies and reduce the overlapping pain symptoms.

Andropause & Menopause

When a woman between the ages of mid-40s and mid-50s deals with changes in their menstrual cycle, it is known as menopause. When a woman goes through menopause, it is a transition period where the woman’s ovaries stop releasing eggs, and their hormone levels of estrogen and progesterone decrease, thus ceasing a woman’s menstruation cycle. Within that time frame during menopause, most women will experience weight gain and have an increase of peripheral fat stored in the hips, glutes, and around the abdominals. (Ko & Kim, 2020) This extra weight around the abdominals and hips can lead to the development of musculoskeletal issues like back pain.

While males have the capability of reproduction throughout their lives after puberty, when they begin to age, they produce low testosterone levels and fewer sperm. Additionally, a majority of men can experience low levels of testosterone hormones as they start to notice a decreased libido, body hair loss, loss of muscle mass, and breast enlargement. This is known as andropause, where, like menopause in women, the testosterone hormone levels are lowered. Luckily, low testosterone levels can be tested, allowing males to be treated with testosterone replacement therapy. Testosterone replacement therapy can provide beneficial results by replenishing testosterone levels associated with reducing symptoms of decreased libido, improving skeletal muscle function, and restoring bone mineral density. (Barbonetti et al., 2020)

Testosterone Deficiency In Men- Video

Surgical & Non-Surgical Interventions

Many middle-aged adults would discuss with their partners about not wanting to have children or are finished having children. When it comes to interventions such as this, many choose surgical or non-surgical procedures. Females can have a surgical procedure known as tubal ligation. This procedure has the fallopian tubes either cut, tied, or removed to prevent pregnancy while still having their menstrual cycle until menopause, so there is no impact on the hormones. For males, they can go through a surgical procedure known as a vasectomy so that the vas deferens are cut and sealed. Both methods are 99% effective in preventing pregnancy. These outpatient procedures have different state laws and safeguards regarding sterilization surgery.

However, not many people will go on the surgical route to prevent surgery and will go on the non-surgical route. Many people will utilize birth control methods like birth control medication, condoms, and natural cycle planning. For women, many will incorporate hormonal birth control medication as part of their routine in preventing pregnancy. Some of the added benefits for women who are taking contraceptives include: (Allen et al., 2013)

• Restoring menstrual regularity
• Improving vasomotor symptoms
• Preventing bone mineral density decline

Sex Changes In Middle Adulthood

As an important part of people’s lives at any age, many individuals are sexually active through communication and healthy relationships with their partners. Many healthy couples are more comfortable communicating their wants and needs through intimacy. Additionally, as adults age, they go through sexual changes correlated with their reproductive health. Many women will notice pain within their pelvis region caused by less lubrication due to the shortening and narrowing of the vagina and thinning of the vaginal walls, which is common.

For men, erection functioning changes occur as they age as well, especially if they have comorbidities affecting their health and wellness. One of the most common changes for older males is erectile dysfunction or ED, which is defined as difficulty getting an erection. (Leslie & Sooriyamoorthy, 2025) ED can become a symptom correlating with overlapping risk profiles from environmental factors. Luckily, there are ways to treat ED through lifestyle changes and addressing psychological or relationship issues. (Lowy & Ramanathan, 2022) It may be difficult for men to discuss it with their doctors, but it is essential for their health and well-being.

Final Thoughts

Overall, when it comes to reproductive health and sexual wellness, many individuals dealing with pain and musculoskeletal issues can utilize a customized treatment plan for their health and wellness. Making minor adjustments to a routine can be beneficial in the long haul, and slowly adding a different routine, like eating more vegetables and lean meats, exercising for 30 minutes, or getting a wellness check-up, can help alleviate and manage pain-like symptoms associated with environmental factors and help a person on their health journey.

Injury Medical & Functional Medicine Clinic

We associate with certified medical providers who understand the importance of assessing individuals dealing with reproductive and sexual health associated with body pain. When asking important questions to our associated medical providers, we advise patients to implement various approaches to their reproductive and sexual health associated with their pain. Dr. Alex Jimenez, D.C., utilizes this information as an academic service. Disclaimer.

References

Allen, R. H., Cwiak, C. A., & Kaunitz, A. M. (2013). Contraception in women over 40 years of age. CMAJ, 185(7), 565-573. https://doi.org/10.1503/cmaj.121280

Barbonetti, A., D’Andrea, S., & Francavilla, S. (2020). Testosterone replacement therapy. Andrology, 8(6), 1551-1566. https://doi.org/10.1111/andr.12774

Barone, B., Napolitano, L., Abate, M., Cirillo, L., Reccia, P., Passaro, F., Turco, C., Morra, S., Mastrangelo, F., Scarpato, A., Amicuzi, U., Morgera, V., Romano, L., Calace, F. P., Pandolfo, S. D., De Luca, L., Aveta, A., Sicignano, E., Trivellato, M.,…Crocetto, F. (2022). The Role of Testosterone in the Elderly: What Do We Know? Int J Mol Sci, 23(7). https://doi.org/10.3390/ijms23073535

Chen, D., Zhou, J., Lin, C., Li, J., Zhu, Z., Rao, X., Wang, J., Li, J., Chen, H., Wang, F., Li, X., Gao, M., Zhou, Z., Xi, Y., & Li, S. (2024). A causal examination of the correlation between hormonal and reproductive factors and low back pain. Front Endocrinol (Lausanne), 15, 1326761. https://doi.org/10.3389/fendo.2024.1326761

Hwang, W. J., Lee, T. Y., Kim, N. S., & Kwon, J. S. (2020). The Role of Estrogen Receptors and Their Signaling across Psychiatric Disorders. Int J Mol Sci, 22(1). https://doi.org/10.3390/ijms22010373

Ko, S. H., & Kim, H. S. (2020). Menopause-Associated Lipid Metabolic Disorders and Foods Beneficial for Postmenopausal Women. Nutrients, 12(1). https://doi.org/10.3390/nu12010202

Leslie, S. W., & Sooriyamoorthy, T. (2025). Erectile Dysfunction. In StatPearls. https://www.ncbi.nlm.nih.gov/pubmed/32965924

Lowy, M., & Ramanathan, V. (2022). Erectile dysfunction: causes, assessment and management options. Aust Prescr, 45(5), 159-161. https://doi.org/10.18773/austprescr.2022.051

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