Menopause usually arrives accompanied by a heavy narrative: that something is ending, that the body stops responding, that intimate life fades away, that certain discomforts are the inevitable price of age. But this outlook is not only incomplete; it can also leave many women alone when facing symptoms that do have an explanation and, in many cases, management alternatives. The question is not how to avoid a natural stage of life, but how to go through it without losing the relationship with our body, our intimate health, and our sense of identity.
Dr. Rocío Palma, a specialist in obstetrics, regenerative and functional gynecology, fertility, gynecological control, and treatments to alleviate discomfort associated with menopause, proposes a fundamental idea: menopause is not a brief episode or a footnote in a woman’s life. It can appear, ideally, between the ages of 45 and 55, although there are also cases of premature ovarian failure. If we consider that many women live until 75, 80, or 85 years of age, this stage can occupy almost half of their life. It is not a closure. It is a long stage that deserves clear information, medical follow-up, and a language less loaded with fear.
Our co-founder and CEO Ursula Pfeiffer proposes dismantling an established idea: menopause is not a “boogeyman” that comes to damage, scare, or steal femininity. It is a natural stage within the experience of being a woman. Rocío agrees and observes that many patients still react with fear when they hear the word perimenopause, even if they are still menstruating. “Perimenopause can begin up to 10 years before the period stops definitively,” she explains. Menopause, on the other hand, is diagnosed when 12 months have passed without menstruation.
Understanding this difference matters because many signals begin before the period disappears. A woman can have regular cycles and still be going through hormonal changes. Among the first signals, a sleep alteration may appear: difficulty falling asleep, waking up in the early morning, the need to go to the bathroom during the night, or the impossibility of returning to sleep easily. Rocío warns that even some women who say they sleep anywhere might not be resting well; they may be accumulating fatigue because their sleep is not truly restorative.
Another frequent signal is brain fog. Small forgetfulness, difficulty remembering tasks, a feeling of less clarity or having less control over daily memory. In a life where many women sustain work, family, home, emotional responsibilities, and permanent decisions, it is not always easy to distinguish between stress, exhaustion, and hormonal changes. Ursula introduces a key point there: although female labor participation has grown steadily, the distribution of domestic, administrative, and emotional burdens has not always changed at the same rate. The result is a body that often lives in alert.
Rocío explains that when cortisol is elevated, the patient may appear tired, anxious, with difficulty losing weight, and with metabolic signals that should be evaluated. Therefore, a serious consultation should not be limited to reading a laboratory result in isolation. One must observe the patient, listen to her concrete life, review her sleep, her diet, her anxiety, her muscle mass, her physical activity, her glucose, her insulin, and other indicators within a clinical context. “The hormonal profile can come out normal and we can be perimenopausal quite comfortably,” she warns.
This precision is important because many women receive partial answers. They have tests done, the values appear within the laboratory range, and they leave the office thinking that “everything is fine,” even though they continue to feel strange, inflamed, exhausted, or less connected to their body. Rocío emphasizes the importance of a functional gaze: it is not enough to know if a value falls within a wide range; one must also interpret what is happening in that specific woman, with that history, that pace of life, and those symptoms.
In this map of changes, female intimate health deserves a conversation of its own. Vaginal dryness and pain during sexual relations are not minor discomforts or matters that should be endured in silence. When estrogens drop, the vagina can lose thickness, elasticity, and lubrication. Rocío explains that vaginal tissue, which used to be thicker, rougher, and prepared to tolerate friction, can become thinner, smoother, and less flexible. The introitus can also narrow. This can make penetration, a gynecological exam, or even certain daily activities cause discomfort, burning, or pain.
Ursula adds a necessary reflection: many times loss of desire is discussed without first looking at the experience of pain. “What desire are you going to have if it hurts?” she poses. Desire does not occur in a vacuum. If the body anticipates pain, it can protect itself by withdrawing. It is not always about lack of love, routine, or disinterest. Sometimes it is a bodily response to an experience that has become threatening. And when that experience is not discussed, intimacy can transform into a territory of tension.
Sexuality, however, does not belong solely to the couple nor is it reduced to penetration. Rocío recalls that sexual life can have an impact on communication, emotional well-being, pelvic floor health, rest, and the relationship with oneself. She also mentions masturbation as a valid practice for women with or without a partner, especially when it helps maintain bodily connection, pleasure, and relaxation. The point is not to turn sexuality into an obligation, but to recognize it as a legitimate dimension of adult life.
For this reason, it is very important to review the language with which many women have learned to live intimacy. For generations, there has been talk of “fulfilling” the partner, as if the female body existed to sustain someone else’s desire even when there is pain. Ursula questions it clearly: intimacy should be a space for mutual care, not a task that a woman endures to preserve a role. Penetration cannot be the only center of intimate life, and the well-being of both should be part of the couple’s conversation.
When a woman stops having vaginal activity for years, especially without hormonal support or without strategies for hydration and tissue mobility, more tightness and pain can appear. Rocío tells that some patients arrive at consultation after long periods without intimacy and do not even tolerate the placement of the speculum. In those cases, the evaluation must be done with calm, respect, and time. It is not about forcing the body, but about accompanying it so that it feels safe again.
Alternatives exist, but they must be indicated according to each case. Rocío mentions hormone replacement therapy when the patient is a candidate, the use of moisturizers, gynecological laser, dilators, therapeutic devices, sex toys used with clinical criteria, and pelvic floor physical therapy. She also points out the importance of including the partner when appropriate, not to displace the woman’s decision, but so that they understand that the process requires patience, communication, and respect for the body’s rhythm.
Pain, in this context, must be listened to early. There is no need to wait for it to be unbearable. Burning after intimacy, discomfort with friction, pain during a gynecological exam that did not hurt before, itching without evident infection, changes in the vaginal mucosa, urinary urgency, or an increase in nighttime trips to the bathroom can be signals that something is changing. Rocío insists on something essential: if the patient feels it, you must believe her. A woman’s perception of her own body is valuable clinical information.
It is also important to choose well how and with whom to go to consultation. Rocío recommends that if a woman does not feel completely free to speak in front of her partner, mother, friend, or companion, she should go alone to her first gynecological evaluation. In a consultation, one can talk about desire, pain, lubrication, intimacy, masturbation, anxiety, sadness, or loss of bodily confidence. For that conversation to be useful, there must be honesty. And for there to be honesty, there must be a safe space.
This point connects with a broader need: to create places where women can receive serious information without shame or dramatization. For this reason, this August 22nd, Yuriyana Club will offer the limited-capacity in-person workshop “Pelvic Floor, Menopause and Intimate Comfort,” led by pelvic floor physiotherapist Nataly Burgos. The workshop is aimed at women who wish to better understand the changes of this stage, recognize signals of tension or discomfort, learn practical resources, and regain confidence in their bodies.
The proposal starts from a simple and urgent idea: pain is not normal. Giving up on our stage as a woman is not normal. There are solutions and tools to regain comfort and well-being in the body, intimacy, and the couple’s connection. The workshop will address topics related to the pelvic floor, menopause, and intimate comfort, with a practical and educational focus. To receive more information, you can write “MUJER” by direct message to Yuriyana Club or contact via WhatsApp at +51 924 763 419.
Rocío leaves a final idea that should be held without unnecessary adornment: perimenopause and menopause are natural stages, but that does not mean they should be lived without support. They can bring emotional, physical, intimate, and metabolic changes. They can also open a more frank conversation with family, with the partner, with the doctor, and with oneself. “We are not alone,” she recalls.
Perhaps the deepest change is not hormonal, but cultural: to stop looking at menopause as the disappearance of the woman and start seeing it as a stage that requires another form of care. We don’t have to live it as an internal mourning for something that left. We can live it as a transition that needs a name, information, and presence. The body changes, yes. But changing does not mean losing oneself.
