Women in Motion

Susan Blatt, MD

Menopause is defined as the time when women stop having menstrual periods. Although it usually occurs around the age of 50, it may occur at a much earlier age. Menopause is caused by a waning of the natural hormones in women’s bodies, especially estrogen. Besides natural menopause, for many women menopause is caused by surgical removal of the ovaries.

For a year or two before menopause, most women have menstrual irregularity.  When there have been no periods for a year, pregnancy cannot occur and birth control is not needed.  Symptoms of menopause include hot flashes, urinary incontinence, and sleep problems.  The vagina lacks moisture, which may cause discomfort with intercourse.  There also may be dry skin, increased wrinkles, and sagging of the skin.  Mental problems may include mood swings and memory loss.

It is now known that estrogen supplementation does not prevent heart disease, stroke, or Alzheimer’s disease.  The use of estrogen slightly increases the risk of breast cancer.  Estrogen is only recommended for women who have severe symptoms such as hot flashes, sleeplessness, and other distress.  They should only take the supplements for a few years.

A natural effect of aging in women is that bones become thinner.  Osteoporosis leads to fractures in elderly women, particularly involving the wrist, hip, and spine. Fractures of the spine cause older women to have a stooped posture. To prevent osteoporosis women should take calcium, vitamin D, get plenty of exercise, stop smoking, and consider taking medication such as raloxifene.  These medications are similar to estrogen, but do not increase the risk of breast cancer.

For older women, there is an increased risk of heart disease after menopause.  Women should reduce risk factors by taking the following steps:  increase exercise, stop smoking, lose weight (if overweight), treat high blood pressure, and treat high cholesterol.

It is not entirely clear if menopause causes mood swings, memory loss, or depression.  These problems may occur at any time of life and they may result from environmental factors such as marital difficulties, family problems, or poverty.  Women who stay mentally and physically active, often continue to function well into the later years of their lives.