This is 40: Let’s Talk Libido, Mammograms, & Menopause

Thank you to our partners at Essentia Health for writing and sponsoring this article, and providing their expertise on this helpful topic.

gynecologist in fargo

As we get older and our bodies change, we have different questions during our annual exam. By our forties, our questions start to range from menopause to bladder weakness and low sex drive.

Unfortunately, some of these topics are still considered “taboo” in our society. We don’t always ask the important questions or bring up these concerns during a check-up.

It shouldn’t be this way. 

Local gynecologists in Fargo know that getting the correct information can put women in the driver’s seat of their own health.

So we asked Essentia Health OBGYN Stefanie Gefroh Ellison, along with certified nurse-midwives Denise Powell and Amanda Swanson, to answer a few of the most common questions that women aged 40 and older have during wellness visits.

What can I expect during menopause?

I like to explain menopause as the opposite of puberty. Once you have gone an entire year without a period, you are officially menopausal. The average age is 51 and the average time for perimenopause (the transition to menopause) is one to two years of changes and symptoms leading up to your periods stopping. Some women experience symptoms of hot flashes, night sweats or irritability even after their periods have stopped. (Dr. Gefroh Ellison)

How do I know if I’m experiencing perimenopause?

Many women start to see changes with their periods during perimenopause. Some women may start to experience other symptoms such as hot flashes, night sweats or mood swings. So if you are noticing any of these symptoms, this may be signs of perimenopause. (Dr. Gefroh Ellison)

What should I do about low sex drive?

Low sex drive is a very common concern for patients. Sex drive is complex and many factors impact it. These include our upbringing, history, relationship intimacy, and physical factors such as hormones or pain. So if you are experiencing low libido, it is important to talk to your gynecologist in Fargo about treatment options, which may include medications to help. (Dr. Gefroh Ellison)

gynecologist in fargo

Intercourse has become painful. What can I do?

Decreasing estrogen levels after menopause can make the vaginal tissues dry and inelastic, leading to painful intercourse. Using a good lubricant with sex can be important. Over-the-counter vaginal moisturizers can also be used daily. If these are not helpful, we commonly use vaginal estrogen to treat just the tissues affected. This can help improve the elasticity and moisture for most women. (Denise Powell)

Is it normal to experience urinary or fecal leakage?

Many people experience leaking of urine, especially with stress such as coughing, sneezing or laughing. This is typically due to a weak pelvic floor. Strengthening the pelvic floor through exercise or physical therapy can improve these symptoms for most people. But, leaking of stool is not normal and should be evaluated by a GI specialist. Pelvic floor physical therapy may help with this as well. (Denise Powell)

When should I start getting mammograms?

Women who are not at high risk for breast cancer should begin mammograms at age 40. Women with risk factors such as personal and family history, genetic mutation or history of chest radiation often require earlier and more frequent screening. This should be discussed with your provider to develop an appropriate screening plan. (Amanda Swanson)

Is there anything I can do to reduce my risk of breast cancer?

Many of the risk factors for developing breast cancer – such as family history, ethnicity and breast-tissue density – are out of our control. However, there are some things you can do to reduce your risk. Decrease your alcohol and tobacco use; alcohol consumption and smoking can increase the risk for breast cancer. Discuss with your provider the use of hormone-replacement therapy and hormonal contraception; combined estrogen/progesterone medications can be associated with increased risk for certain breast cancers. Finally, maintain a healthy lifestyle and weight; obesity has been linked to an increased risk for breast cancer in menopausal women. (Amanda Swanson)

If you want to learn more about Essentia Health gynecologists in Fargo and need to make a well-check appointment, please call (701) 364-8900 or visit
essentia powell, denise
Denise Powell, APRN, Certified Nurse Midwife
essentia obgyn
Dr. Stefanie Gefroh Ellison, OBGYN
gynecologist in fargo
Amanda Swanson, APRN, Certified Nurse Midwife

Words by Kelsey Mix. 

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