Menopause; Facts to Know

NWHRC Health Center - Menopause, March 16, 2006

Before they turn 50, women are less likely to have a heart attack than men. Ten years after menopause, however, their heart attack risk is close to men's. Women can protect themselves against heart disease by not smoking, eating a healthy diet and getting regular exercise.

Osteoporosis -- a disease in which bones become thin, brittle and more likely to fracture -- affects one in four women after menopause.

In a 1998 Gallup survey sponsored by the North American Menopause Society, more than half (51 percent) of American women between the ages 50 and 65 who had reached menopause said they were happier and more fulfilled than when they were in their 20s, 30s, or 40s.

The same Gallup poll revealed that 16 percent of women surveyed said their sexual relationship had improved since menopause, while 17 percent said it had gotten worse and more than half (51 percent) said it had remained unchanged.

Most women in the 1998 Gallup poll said they discussed menopause with a friend or someone from their own generation, compared to a smaller percentage who said they discussed it with someone from their mother's or daughter's generation.

Some studies find a diet high in soy products can reduce postmenopausal hot flashes.

Some women continue to experience premenstrual syndrome (PMS) symptoms as they approach menopause. These symptoms can include swollen or tender breasts, bloating, nausea and moodiness.

Fertility decreases gradually as menopause approaches. However, you can still get pregnant, even if your periods are irregular. The second highest unintended pregnancy rate is for women between the ages of 40 to 44. Thus, the need for reliable contraception remains important.

As estrogen levels decline, vaginal tissue and tissue in the lower urinary tract become thinner, drier and less supple, which can cause painful intercourse and more frequent urinary tract infections. Osteoporosis and heart disease are other consequences of declining estrogen levels in the decades following menopause.

As you approach menopause, you may notice that you feel more irritable and moody than usual. Some researchers believe this moodiness is due to the changes in your estrogen levels, but others think it may be more the result of the other symptoms that accompany menopause, such as hot flashes and fatigue, coupled with other stressors that often plague women in middle age. Severe depression, however, is not a symptom of menopause.

References

"NIH Asks Participants in Women's Health Initiative Estrogen-Alone Study to Stop Study Pills, Begin Follow-up Phase." National Institutes of Health. http://www.nhlbi.nih.gov. March 2, 2004. Accessed March 2004.

Effects of Estrogen plus Progestin on Health-Related Quality of Life. J. Hays et al. NEJM, May 8,2003; Vol. 348, No. 19.

FDA Approves Lower Dose of Prempro, a Combination Estrogen and Progestin Drug for Postmenopausal Women. FDA News (press release). March 13, 2003. http://www.fda.gov

Risks and benefits of estrogen plus progestin in healthy postmenopausal women: principal results From the Women's Health Initiative randomized controlled trial. JAMA. 2002 Jul 17;288(3):321-33.

FDA Orders Warning on all Estrogen Labels. New York Times. Jan. 9, 2003

FDA Approves new Labels for Estrogen and Estrogen with Progestin Therapies for Postmenopausal Women Following Review of Women's Health Initiative Data. FDA Talk Paper. Jan. 8, 2003

Grady D, Herrington D, Bittner V, et al, for the HERS Research Group. Heart and estrogen/progestin replacement study follow-up (HERS II): Part 1. Cardiovascular outcomes during 6.8 years of hormone therapy. JAMA 2002;288:49-57.

Hulley S, Furberg C, Barrett-Connor E, et al, for the HERS Research Group. Heart and estrogen/progestin replacement study follow-up (HERS II): Part 2. Non-cardiovascular outcomes during 6.8 years of hormone therapy. JAMA 2002;288:58-66.

Writing Group for the Women's Health Initiative Investigators. Risks and benefits of estrogen plus progestin in healthy postmenopausal women: principal results from the Women's Health Initiative randomized controlled trial. JAMA 2002; 288:321-333.

"Women's Health Initiative," National Heart, Lung and Blood Institute. http://www.nhlbi.nih.gov. Updated July 9, 2002; accessed August 2003.

AACE Medical Guidelines For Clinical Practice For Management of Menopause. American Association of Clinical Endocrinologists. http://www.aace.com. Accessed July 2001.

The North American Menopause Society (NAMS). http://www.menopause.org. Updated August 2003; accessed August 2003.

"Best Clinical Practices: Chapter 13[sup.2] from the International Position Paper on Women's Health and Menopause: A Comprehensive Approach" http://www.nhlbi.nih.gov. Accessed August 2003.

"Cancer Facts." National Cancer Institute. http://cis.nci.nih.gov Reviewed May 2003. Accessed August 2003.

"Estrogen and Cardiovascular Disease in Women," American Heart Association. http://www.americanheart.org. Accessed August 2001.

Lacey, James V., et al. "Menopausal Hormone Replacement Therapy and Risk of Ovarian Cancer." JAMA 2002. Vol. 288:334-341.368-369. Marchbanks, P.A, et al. "Oral Contraceptives and the Risk of Breast Cancer" NEJM 2002. Vol. 346:2025-2032, No. 26 "Menopause." National Institute on Aging. National Institutes of Health. http://www.niapublications.org. Sept. 2002; accessed August 2003.


 

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