Older women need gynecological care even if they have never had children or are not sexually active. Many problems with the reproductive system begin after menopause.

Menopause

Menopause happens when a woman has not had a menstrual period for 12 months. The average age of menopause is 51.

Menopause is a process, not a single event. It often begins in a woman’s 40s, when the ovaries make less estrogen, a hormone that affects many parts of the body.

The time before menopause is called perimenopause. During this time, periods may become irregular and eventually stop.

Menopause can affect health and daily life. For example:

• About 1 in 4 women develop pelvic floor problems after menopause. These problems can cause urine or stool leakage and happen when pelvic muscles become weak.
• Up to 4 in 10 women have pain during sex or frequent vaginal infections. This is often caused by vaginal atrophy, which means thinning and dryness of the vaginal walls.

Transgender Healtlh

Transgender people also need gynecological care:

• Transgender women need cancer screening if they had surgery to create a vagina.

• Transgender women who still have a prostate need prostate exams.

• Transgender men who have a cervix need cervical cancer screening.

Last Update May 2026