Modern Clinical Approach Strategies For Reproductive Health & Sexual Wellness

Uncover how a clinical approach to reproductive health can guide effective treatment and support for reproductive challenges.

Reproductive Health

As their menstrual cycles increase or decrease in frequency, many women may see physical changes that may impact their reproductive health. Each woman will experience menopause differently, with varying symptoms, while monthly alterations might last anywhere from one to three years.

When there are hormonal changes related to reproductive health, some of the symptoms may include:

• Restless nights
• Weight variations
• Muscle and joint discomfort and exhaustion

Women who are coping with hormonal changes related to their reproductive health also experience physical sensations that resemble pain. Hormones, the body, and the spinal structure all change with age. Low back pain may result from overlapping risk profiles for the musculoskeletal system and reproductive health caused by a variety of environmental variables that impact the body. Many people who suffer from low back pain, particularly women, relate it to a variety of variables, such as different menstrual cycles and greater pain sensitivity. (Chen and colleagues, 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

A significant aspect of people’s life at any age, sexual activity is practiced by many via communication and wholesome partnerships. Many happy couples find that closeness helps them express their needs and desires. Adults also experience sexual changes that are connected to their reproductive health as they become older. Due to the common vaginal walls being thinner and the vagina becoming shorter and narrower, many women may experience discomfort in the pelvic area, which is caused by decreased lubrication.

Men also experience changes in erection performance as they age, particularly if they have health and wellness-related comorbidities. For older men, erectile dysfunction, or ED, which is characterized by trouble achieving an erection, is one of the most prevalent alterations. (Leslie & Sooriyamoorthy, 2025) When environmental circumstances cause risk profiles to coincide, ED may develop as a symptom. Fortunately, there are methods for treating ED that include altering one’s lifestyle and taking care of interpersonal or psychological problems. (Lowy & Ramanathan, 2022) Men may find it challenging to talk about it with their physicians, but it is crucial for their overall health and welfare.

Final Thoughts

In terms of sexual and reproductive health, many people who suffer from discomfort and musculoskeletal problems might benefit from a personalized treatment plan. Adding a different routine, such as eating more vegetables and lean meats, exercising for 30 minutes, or getting a wellness check-up, can help manage pain-like symptoms related to environmental factors and support an individual on their health journey. Even small changes to a routine can have long-term benefits.

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. doi.org/10.1503/cmaj.121280

Barbonetti, A., D’Andrea, S., & Francavilla, S. (2020). Testosterone replacement therapy. Andrology, 8(6), 1551-1566. 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). 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. 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). 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). doi.org/10.3390/nu12010202

Leslie, S. W., & Sooriyamoorthy, T. (2025). Erectile Dysfunction. In StatPearls. 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. doi.org/10.18773/austprescr.2022.051

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