Menopause marks the transition into midlife for women. It is a natural process that all women will face but has remained a taboo topic until recently. Today, menopause is discussed more openly, in part because of the amount of research available on the health issues facing older women—and it’s about time. On average, US women reach menopause at age 51 and have a life expectancy of 80.4 years. Many will live up to 40% of their lives after menopause.
Menopause does not happen overnight, though many women wish it did. During perimenopause, the first stage of the process that can begin two to eight years before official menopause sets in, the ovaries produce less and less estrogen, eventually leading to the end of menstrual periods. You have reached menopause when menstrual periods have stopped for one year.
Estrogen is the hormone that regulates everything from menstrual cycle to vaginal lubrication in women. It also has been shown to play a role in heart and bone health. Drastically decreased estrogen levels cause many typical menopausal symptoms (such as hot flashes, mood swings, and vaginal dryness) and increase the risk for heart disease, accelerated bone loss and osteoporosis, and some cancers.
To ease menopausal symptoms and lower disease risk, women should consume a healthy, calcium-rich diet that includes plenty of fruits, vegetables, and grains. They should get regular exercise to improve circulation, increase muscle strength and flexibility, and fight the mid-section weight gain that is directly linked to increased heart disease risk. Women should also stop smoking and limit alcohol intake.
Hormone therapy (HT), which replaces the hormones no longer made by the ovaries with synthetic hormones, is an effective option for treating hot flashes and other symptoms of menopause. ACOG recommends HT be taken in the lowest dose necessary to relieve symptoms for as short a time as possible. Estrogen-only HT is associated with an increased risk of endometrial cancer, heart attack, blood clot, and stroke, and combined estrogen and progestin HT has been linked to an increased risk of breast cancer in women with a uterus. If you are at risk for these conditions, you should not take HT.
Several screening exams are recommended for the first time or more often after age 50; therefore, see your doctor regularly to make sure you are current on the necessary tests. Because you can still get pregnant until you have reached menopause, this is also a good time to reevaluate your birth control needs.
For more information, the Patient Education Pamphlet “Midlife Transitions: A Guide to Approaching Menopause” is available at www.acog.org/publications/ patient_education.