Menopause and healthy aging
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(Part of the “Strong Women… Strong Community” monthly column)
By Dr. Margaret Boozer
UAB Dept. of Obstetrics and Gynecology
Menopause is a normal stage in every woman’s life. It marks the time when a woman’s body stops releasing eggs and her monthly period ends, marking a transition for women from a reproductive to non-reproductive stage of life. This change happens naturally and does not mean anything is wrong or needs to be corrected.
As women get closer to menopause, the ovaries slowly decrease production of the estrogen and progesterone hormones. For this reason, the hallmark sign of menopause is increased spacing of previously monthly menstrual cycles before they stop completely. Clinically, menopause is defined as the absence of menstrual bleeding for 12 consecutive months.
Common Symptoms
Some of the common symptoms women experience as hormone production decreases are hot flashes, night sweats, vaginal dryness, “brain fog,” and fatigue. Women may experience some of these symptoms at first in perimenopause, the start of the menopausal transition. However, some women may not have significant symptoms in either perimenopause or menopause.
Many of the symptoms that are often associated with perimenopause and menopause are also part of the natural aging process and may therefore be inappropriately attributed to declining hormones. The average age of menopause is 51, but can range from early 40s to late 50s.
What Happens After Menopause
Menopause symptoms are usually strong during the first 2-3 years as ovarian function and hormone levels decrease. Symptoms may persist, but typically become less frequent and less disruptive over time.
In menopause, lower hormone levels can affect long-term health. Women may experience bone loss (which can lead to weaker bones), vaginal dryness and resulting discomfort during sex, and sleep disturbance. It is important to recognize that menopause is a new stage of life, not one that is completed. Once women become menopausal, they remain in that stage for life.
Managing Symptoms and Staying Healthy
Although menopause is a natural life transition and does not need to be fixed, there are treatments and lifestyle choices that can help make the transition easier:
- Medicine: During perimenopause, some doctors may prescribe birth control pills to help balance hormone levels. After menopause, some women may benefit from hormone therapy (HT), which generally includes estrogen and progesterone. These treatments can help with symptoms but may have risks, such as increased breast cancer risk and risk of heart disease or stroke. Your doctor can help you decide what is best based on your overall health, risk factors and degree of symptoms. In the absence of significant risk factors, many women enjoy symptom relief with hormone therapy in the initial years of menopause, but hormone therapy is not intended for long-term use or as preventive medicine.
Lifestyle Changes: Other lifestyle changes such as exercise and diet can help, too. Exercise, for example, has been shown to decrease the frequency of hot flashes and has many other benefits for healthy aging such as joint mobility, bone strength, balance, and core strength. A multivitamin with vitamin D is recommended for maintaining bone health. Avoiding potential symptom triggers such as alcohol can be helpful, as well, since alcohol intake is associated with a higher frequency of hot flashes. Layering clothes and bed linens and keeping a fan nearby are other practical tips.
