Invites you to understand more about...Menopause 
What you should know. What you can do.

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Millions of female baby-boomers are hitting menopause; tens of millions will follow in the coming decade. All these women are on the verge of losing their biggest resident protector against heart attacks: estrogen. It shields younger women's hearts in a myriad of ways, such as boosting levels of so-called good cholesterol and keeping "bad" cholesterol relatively low. When menopause hits, that protection evaporates. The good news: Women get heart attacks on average ten to 15 years later than men. The bad: Over the course of a lifetime, heart attacks become an equal-opportunity killer.

Menopause is a gradual change

Menopause is the end of menstruation (monthly periods) and the fertility ( your ability to become pregnant).  Your ovary's  supply of eggs runs out and your ovary's production of estrogen and progesterone is diminished.

Estrogen and progesterone are the two hormones that regulate your menstrual cycle each month.

As your ovaries begin to produce less and less estrogen and progesterone, your menstrual cycle becomes increasingly irregular and eventually you stop having a monthly period.

This change doesn't happen overnight.  It can take months, or even years, for your periods to stop completely.

Menopause causes real symptoms

Menopausal symptoms vary from woman to woman. You may have no symptoms at all or you may have symptoms so severe that your health care provider will recommend some form of treatment.

HOT FLASHES.  No one knows exactly why hot flashes occur during menopause.  But some researchers believe that a hormonal change may disturb the function of the hypothalamus - that part of the brain that controls body temperature.

During a hot flash, small blood vessels in the skin dilate (open), sending an increased amount of blood to the skin's surface.  This produces a sensation of heat in your face, neck, and chest and causes reddening of the skin as well as perspiration.

Hot flashes may be mild to severe, prolonged, or very short.  They may happen for only a year, or go on for more than five years.  Some women experience only one hot flash a day, while others may have more than 20 a day.

NIGHT SWEATS.  The nighttime version of hot flashes, known as night sweats, often cause perspiration that's so excessive it often interferes with sleep.

VAGINAL CHANGES.  With less estrogen, vaginal walls may become thin and dry and lose their elasticity.  This is called atrophic vaginitis. If changes are severe enough, intercourse may become painful and you may be more vulnerable to vaginal injury and infection.

MENOPAUSE SPEEDS UP BONE LOSS.  Everyone loses some bone mass ( bone thickness) after age 40.  But menopausal women lose bone mass faster than pre-menopausal women.  Estrogen deficiency is responsible for at least 75% of the bone lost in the first 20 years after menopause.  This accelerated loss can lead to osteoporosis.

Osteoporosis affects approximately one in four postmenopausal women.  It is a thinning of the bones which makes them weaker and allows them to break more easily.  The bones of the spine, wrists, and hips are affected most often.

Some women are more likely than others to develop osteoporosis.  

In addition to advanced age, you're at higher risk for osteoporosis if you:

-    are female

-    are Caucasian or Asian

-    are slim build and small frame

-    are a cigarette smoker

-    have family history of osteoporosis in a mother, sister, or aunt.

-    early menopause, often because their ovaries were
      removed during an operation (surgical menopause).
-    eat a low calcium diet
-    have an inactive lifestyle

There is no cure for osteoporosis, but there are measures to help prevent it.   

The good news is that osteoporosis can be prevented. Diet and lifestyle changes can prevent bone loss.  Exercise and a calcium-rich diet in childhood build strong bones that will help to prevent osteoporosis when you are 65.
-   Eat a balanced diet that is rich in calcium and vitamin D.
-   Do regular weight bearing exercises such as brisk walking
    or running  for an hour, two times a week can slow down
    or prevent further bone loss.
-   Live a healthy lifestyle - limit use of alcohol and don't smoke.
-   Have a bone density test and take medication when appropriate.
Doctors have recognized that estrogen plays an important role in helping to prevent osteoporosis.  Therefore, in addition to a high calcium diet and regular exercise, your Gynecologist may prescribe hormone replacement therapy (HRT) for you.

Some cautions about hormone replacement therapy (HRT)

-   It is not recommended for all women.
-   You should not have HRT if you know or  suspect that you
    are pregnant.
-   Estrogen can harm your unborn baby.
-   Estrogen increases the risk of cancer of the uterus in women
    who have gone through menopause.
-   Estrogen should not be used in individuals with unusual
    vaginal bleeding, known or suspected cancer of the breast or
    uterus, and circulation problems or abnormal blood clotting.
-   Women should inform their physician if they have heart
    disease before beginning HRT.
-   Estrogen should be taken in the lowest dose that works.
-   Estrogen can cause side effects.
-   If you take estrogen during menopause, please be sure to see
    your physician regularly, at least once a year, for checkup.

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