The beginning of the end? Or too much ado about the end of menses?
There’s no shortage of myths and misconceptions about menopause-which begins at the one-year mark after a woman’s final period, says Mary Marnach, M.D., an obstetrician-gynaecologist at Mayo Clinic Women’s Health Clinic in Rochester, Minn. “A lot of women worry that they’re past their prime,” says Dr. Marnach. “But it really marks the beginning of women’s second adulthood, a chance to live life to the fullest.” This second stage of life is relatively new for American women, says Dr. Marnach. The average age of menopause is between 51 and 52. In 1900, an American woman’s life expectancy was 48 years-so menopause was a marker of life’s end. Today, most women can expect to live into their 80s. “It’s important to consider how we want to spend those three to four decades,” says Dr. Marnach. While menopause doesn’t signal the beginning of the end, it is time to make choices that affect your long-term health. Dr. Marnach advises women to learn about the myths and realities of menopause. Myth: It’s all about hormones. The menopause milestone is about hormones-and much more. After menopause, your ovaries no longer release eggs. Your body’s production of oestrogen and progestin is greatly reduced. When hormone levels decrease, it can cause menopausal symptoms: hot flashes, night sweats or disrupted sleep. The changes in hormones also increase the risk of some chronic health conditions, such as heart disease and stroke. And heart disease, not cancer, is the No. 1 killer of American women. The risk of hypertension, osteoporosis, dementia and arthritis also increases as menopausal women age. Myth: Hormone replacement is bad. Not necessarily. Previously, oestrogen therapy was widely recommended for menopausal women to help prevent osteoporosis and heart disease. But results from a large clinical trial called the Women’s Health Initiative changed that. This study found that women taking a particular combination of oestrogen and progestin were at increased risk of blood clots, and at a slightly increased risk of heart disease, breast cancer, stroke and dementia. For these women, most of whom were in their 60s when they began taking hormones and well past the age of natural menopause, the risks of hormone therapy appeared to outweigh the benefits. Because of those results, doctors are more conservative in prescribing hormone therapy. But hormone therapy is still an option-and an effective one-for treating hot flashes, vaginal dryness and other menopausal symptoms. Researchers are learning more about hormone therapy all the time. Studies are under way to evaluate if oestrogen, when started early in menopause, helps reduce the risk of cardiovascular disease, stroke and other age-related health concerns. Myth: I’m going to gain weight. Many women gain five to 10 pounds post menopause, but weight gain isn’t inevitable. Because your metabolism slows as you age, you may have to exercise more or eat less to maintain your weight. Postmenopause, most women can maintain their weight on 1,500 to 1,600 calories a day. Eating more calories may lead to weight gain. Myth: Forgetfulness is forthcoming. With age, forgetfulness becomes more common-for women and men. Forgetfulness and an inability to concentrate may be due to declining hormone levels. Major stresses or life changes-caring for aging parents, a death in the family, retirement and empty nest-can also put your brain in overload and may contribute to memory problems. Myth: My sex life is over. Women in menopause may experience vaginal dryness, pain with intercourse and decreased desire. A recent study of women ages 18 to 59 found that 43 percent had some sexual dysfunction. Past menopause, this percentage may rise to 80 percent. But sexuality needn’t be over-unless women want it to be. Your doctor can help with treatments to relieve symptoms. Hormone therapy is one option. For many maturing women and men, staying emotionally intimate and connected improves overall well-being. But a satisfying sex life may take more effort. Health problems may make sexual intimacy more difficult for women and men. Certain medications may affect sexual function. Myth: It’s all downhill from here. Maybe it is downhill, but the choices you make control the slope. Aging is more graceful if you take care of yourself: Lose weight if necessary. Maintain a healthy weight.Exercise 30 to 45 minutes nearly every day.See your health care provider for appropriate screenings for heart disease, cancer and other health concerns.Minimise stress. Rest. Get adequate sleep.Do things you’ve always wanted to do, but couldn’t because of work, children and other responsibilities.Stay connected and keep your brain engaged in challenging activities.Enjoy yourself for the second go-round!