Taking care of your reproductive health

What are the signs of menopause?

Women may have different signs or symptoms at menopause. That’s because estrogen is used by many parts of your body. So changes in how much estrogen you have can cause assorted symptoms. But that doesn’t mean you will have all, or even most, of them. In fact, some of the signs that happen around the time of menopause may really be a result of growing older, not changes in estrogen.

• Hot flashes. These are very common around the time of menopause because they are related to changing estrogen levels. They may last a few years after menopause. A hot flash is a sudden feeling of heat in the upper part or all of your body. Your face and neck become flushed. Red blotches may appear on your chest, back and arms. Heavy sweating and cold shivering can follow. Flashes can be as mild as a light blush or severe enough to wake you from a sound sleep (called night sweats). Most hot flashes last between 30 seconds and 10 minutes.
• Problems with the vagina and bladder. Changing estrogen levels can cause your genital area to get drier and thinner. This could make sexual intercourse uncomfortable. You could have more vaginal or urinary infections. You might find it hard to hold urine long enough to get to the bathroom. Sometimes your urine might leak when you exercise, sneeze, cough, laugh or run.
• Sex. Around the time of menopause, you may find that your feelings about sex have changed. You could be less interested. Or you could feel freer and sexier after menopause. You can stop worrying about becoming pregnant after one full year without a period. But remember, you can’t ever stop worrying about sexually transmitted diseases (STDs) such as HIV/AIDS or gonorrhea. If you think you might be at risk for an STD, make sure your partner uses a condom each time you have sex.
• Sleep problems. You might start having trouble getting a good night’s sleep. Maybe you can’t fall asleep easily or you wake too early. Night sweats might wake you up. You might have trouble falling back to sleep if you wake during the night.
• Mood changes. You might find yourself feeling moodier, irritable or depressed around the time of menopause. It’s not clear why this happens—is there is a connection between changes in estrogen levels and emotions or not? It’s possible that stress, family changes such as growing children or aging parents, or always feeling tired could be causing these mood changes.
• Changes in your body. You might think your body is changing. Your waist could get larger. You could lose muscle and gain fat. Your skin could get thinner. You might have memory problems and your joints and muscles could feel stiff and achy. Are these a result of having less estrogen or just related to growing older? We don’t know.

What about my heart and bones?

Two common health problems can start to happen at menopause and you might not even notice.

• Osteoporosis. Day in and day out, your body is busy breaking down old bone and replacing it with new healthy bone. Estrogen helps control bone loss. So losing estrogen around the time of menopause causes women to begin to lose more bone than is replaced. In time, bones can become weak and break easily. This condition is called osteoporosis. Talk to your health care provider to see if you should have a bone density test to find out if you are at risk for this problem. Your doctor can also suggest ways to prevent or treat osteoporosis.
• Heart disease. Heart disease is the number one killer of women in the U.S. and it is often preventable. After menopause, women are more likely to have heart disease. Changes in estrogen levels may be part of the cause. But so is getting older. As you age, you may develop other problems like high blood pressure or weight gain that put you at greater risk for heart disease. Be sure to have your blood pressure and levels of triglycerides, fasting blood glucose, LDL, HDL and total cholesterol checked regularly. The American Heart Association recommends that soy products be included in a diet that includes fruits, vegetables, whole grains, low-fat dairy products, poultry, fish and lean meats. Omega-3 amino acids found in flax seeds and fatty fish are also reported to stave off heart disease¹; if you are pregnant, Omega-3’s may play a role in the brain development and visual acuity of your unborn baby. Talk to your health care provider to find out what you should do to protect your heart.

How can I stay healthy after menopause?

Staying healthy after menopause may mean making some changes in the way you live:

• Don’t smoke. If you do use any type of tobacco, stop—it’s never too late to benefit from quitting smoking.
• Eat a healthy diet. It should be low in fat and high in fiber with plenty of fruits, vegetables and whole-grain foods as well as all the important vitamins and minerals.
• Make sure you get enough calcium and vitamin D. You can get them by eating the right foods or by taking multivitamins.
• Find out what your healthy weight is. Once you’ve achieved it, make sure you maintain it.
• Do weight-bearing exercise such as walking, jogging or dancing at least three days a week for healthy bones. But try to be physically active in other ways for your general health.

Other things to remember:

• Take medicine to lower your blood pressure if your doctor prescribes it for you.
• Use a water-based vaginal lubricant (not petroleum jelly) or a vaginal estrogen cream or tablet to help with vaginal discomfort.
• Get regular pelvic and breast exams, Pap tests and mammograms. You should also be checked for colon, rectal and skin cancer. Contact your doctor right away if you notice a lump in your breast or a mole that has changed.