Aging and sex: What are the factors that lead to loss of sexual desire in women?

Uterine atrophy at the age of 45 may be related to factors such as ovarian function decline, decreased estrogen levels, endometrial lesions, pelvic inflammatory disease, surgical injury and other factors. Uterine atrophy usually presents with symptoms such as decreased menstrual flow, amenorrhea, and vaginal dryness. The cause needs to be determined through a combination of gynecological examination and hormone level assessment.

1. Decline of ovarian function

When women enter perimenopause around the age of 45, their ovarian function gradually declines, leading to a decrease in estrogen secretion. Estrogen is a key hormone that maintains the shape and function of the uterus. Decreased levels of estrogen can cause the endometrium to become thinner and the muscle layer to atrophy. This type of physiological atrophy is usually accompanied by menopausal symptoms such as hot flashes and night sweats, which can be alleviated by hormone replacement therapy. Drugs such as estradiol valerate tablets and conjugated estrogen tablets must be used under the guidance of a doctor.

2. Decreased estrogen levels

In addition to natural menopause, long-term malnutrition, excessive dieting, or pituitary dysfunction may also lead to insufficient estrogen synthesis. A low estrogen state causes uterine muscle fibers to degenerate and reduce in size. Patients may have osteoporosis or dry skin, and serum estradiol testing is required to confirm the diagnosis. Phytoestrogens such as soy isoflavones can be supplemented when necessary, but the risk of hormone-dependent tumors must be ruled out.

3. Endometrial lesions

Repeated uterine operations, tuberculous endometritis and other diseases may damage the basal layer of the endometrium, leading to intrauterine adhesions and uterine atrophy. This type of pathological atrophy is often accompanied by periodic lower abdominal pain or infertility, and hysteroscopy can confirm the diagnosis. Treatment requires intrauterine adhesions separation, and postoperative estrogen and progesterone sequential therapy to promote endometrial repair, such as Bujiale combined with progesterone capsules.

4. Pelvic inflammation

Chronic pelvic inflammatory disease can cause fibrosis of the tissues surrounding the uterus, and traction on the uterus can lead to morphological changes and volume reduction. Most patients have a history of lower abdominal pain and abnormal leucorrhea, and gynecological examination can reveal reduced uterine activity. In the acute phase, antibiotics such as ceftriaxone sodium injection and metronidazole sodium chloride injection need to be used in a standardized manner, and in the chronic phase, pelvic floor rehabilitation can be used.

5. Surgical injuries

Myomectomy, uterine artery embolization and other procedures may affect the blood supply of the uterus, leading to ischemic atrophy. After surgery, the uterine volume can be reduced by more than one-third, but there is usually no functional impairment. In such cases, regular ultrasound examinations are required to monitor the recovery. If necessary, Chinese patent medicines that promote blood circulation and remove blood stasis, such as Guizhi Fuling Capsules, can be used to improve microcirculation.

It is recommended that 45-year-old women undergo annual gynecological examinations and ultrasound screenings, maintain a balanced diet, and supplement with appropriate amounts of calcium and vitamin D. Avoid long-term bathing or use of alkaline lotions to clean the perineum, and perform moderate Kegel exercises to strengthen the pelvic floor muscles. If abnormal vaginal bleeding or urinary discomfort occurs, you should seek medical attention promptly to rule out organic diseases.