We're taught the basics about the female body in sex ed. But after milestones for women like getting your period and giving birth, many women feel uninformed about the basics of their reproductive system -- especially as they age.
Just like aging is visible outside of your body, many don’t realize their internal organs are also going through a transition.
Dr. Jennifer Ashton, ABC News' chief medical correspondent, breaks down four things all women should know about their reproductive system.
"When we look down the road, it should be with optimism and understand that everyone will get through it," Ashton said. "Just like we all got through puberty."
First, it’s important to understand that the full female reproductive system is more than just the vagina and ovaries.
"We’re talking about the whole external and internal urogenital system," Ashton explained, which also includes the bladder, urethra and vulva.
The ovaries are responsible for the production of the hormones estrogen, progesterone and a portion of the body’s testosterone, all of which decrease as a woman approaches menopause.
Estrogen is a major hormone responsible for affecting change in a woman’s body.
"Everything in the pelvic, genital area is affected by a decrease in estrogen levels," Ashton said. "Dropping estrogen levels are responsible for hot flashes, vaginal dryness, weakening of bones -- you name it and estrogen is likely involved."
A decrease in estrogen levels in the pelvic and genital areas causes the tissues to become weaker and more fragile. This can make this region of the body more susceptible to injury and infection.
Meanwhile, a decrease in progesterone levels can affect mood and also lead to memory loss, while a decrease in testosterone can be related to a decrease in a woman’s libido.
"A lot of people don’t realize that women have testosterone as well," Ashton said. "That drop in testosterone level in a woman is responsible for the dreaded, 'I don’t understand why I am gaining weight while I’m still exercising and eating well.'"
As the strength and elasticity of muscles in the pelvic region decrease, problems such as incontinence and prolapse of pelvic organs, such as the bladder, uterus and rectum, may occur. A prolapse is when organs fall down or slip out of place
"Any of those organs can prolapse or protrude through the vagina, in most severe cases, outside of a woman’s body, but most of the time just into the vagina," Ashton said.
Women who have had many vaginal deliveries can be at higher risk of pelvic organ prolapse, but chronic coughing and obesity are also associated causes. Though women of any age can experience issues related to a weak pelvic floor, it is more common in older women.
"The most common symptom is the sensation of pressure," Ashton explained. "Some women will feel a lot of pelvic pressure and some women might have to urinate more frequently."
She notes that medical devices, such as the Yarlap, can strengthen and tone pelvic floor muscles, helping women regain control over their bladder and work to prevent pelvic organ prolapse.
"One thing women should focus on is the importance of the pelvic floor when it comes to the reproductive system," MaryEllen Reider, co-founder of Yarlap, said. "It’s a muscle that hasn’t gotten a lot of recognition and women shouldn’t be ashamed to talk about any issues."
Menopause is defined as one year without a menstrual period.
According to the Mayo Clinic, menopause can happen in women in their 40s or 50s, but the average age is 51 in the U.S. Ashton explained that factors such as family history, smoking and medical conditions can affect the age when a woman begins through menopause.
Common symptoms leading up to menopause include mood swings, memory loss, hot flashes, an increase in body fat, a decrease in bone density and irregular vaginal bleeding, but not all women will experience all of the symptoms.
"In some women, as they approach menopause, their period will just fade off into the sunset and bleeding will completely stop," Reider said. "In other women, bleeding can become more irregular. In some cases, heavier and closer together. There is really no way to predict, it's very individual."
Although menopause is something many women dread, Ashton said women have something to look forward to.
"For many women it might feel like the worst thing ever, but there are treatments and ways to manage it," she said. "Women are now living a third of their life after menopause and those can be really vital and vibrant years."
