Menopause

What You Need to Know

Menopause is a natural part of life for middle-aged women. The average American woman reaches this stage of life at age 51, though menopause may happen much sooner (late 30s or early 40s) or later (age 55 or beyond).

The process leading up to menopause actually begins as many as seven years before menstruation ceases. During this initial phase, called perimenopause, the body gradually begins producing less estrogen. Periods come more sporadically, sometimes with greater frequency and sometimes with less. They also become either heavier and more severe or lighter and milder than usual.

For some women, perimenopause provides a smooth, gradual transition with few or no side effects. For others, estrogen levels drop more quickly, causing hot flashes and night sweats (which can lead to sleepless nights, irritability and depression), vaginal dryness and/or unexpected mood swings.

Menopause brings with it a number of new health concerns, as well. Since estrogen protects bones and keeps cholesterol levels in check, the decrease in natural estrogen production after menopause increases the risk for developing osteoporosis, atherosclerosis and heart disease. Hormone Replacement Therapy (HRT) may help lessen these effects, but is not appropriate for all women. See the article below, "Hormone Replacement Therapy and You," for more details.

Though some women view menopause as an end of youth, it can actually be a glorious beginning. Thanks to better education and improved health care options, more and more women are making a smoother transition to postmenopausal life. A Gallup survey found that 52% of 752 postmenopausal women in the U.S. and Canada were actually happier and more fulfilled than they were in their 20s, 30s and 40s.

Hormone Replacement Therapy

Estrogen plays an important role in strengthening a woman's bones by slowing the natural loss of calcium. It also protects artery walls and helps keep blood cholesterol levels in check. When a woman goes through menopause, her body produces far less estrogen than before. As a result, she loses these natural defenses. HRT can help reverse this process.

In most cases, HRT involves taking estrogen and progestin, a synthetic version of the hormone progesterone. Progestin is used to counteract some of the potential side effects of estrogen, including an increased risk of uterine cancer.

HRT has many potential benefits. For starters, it protects against osteoporosis and heart disease. It also helps relieve many of the symptoms of menopause, including hot flashes, night sweats and vaginal dryness.

Of course, relief comes at a cost. Some women on HRT complain of headaches, nausea, breast tenderness, weight gain and the return of menstrual and PMS-like symptoms. Studies have shown that HRT may also increase the risk of uterine and breast cancers, though others show no such correlation, and HRT may also lead to liver tumors and gallbladder disease.

Because of HRT's possible adverse effects, doctors recommend that women who have breast, ovarian or uterine cancer, those who suffer from severe migraines and those with preexisting heart disease, blood-clotting disorders or active liver disease seek alternate treatments.