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    Why Should We Care About Menopause?

    Too often, women have symptoms associated with menopause but don't know what causes them and what may make them better. I find it maddening when women go to their healthcare providers and describe their symptoms only to be given a prescription for hormone replacement therapy (HRT) without a thorough explanation of risks, benefits and alternatives.

    I hope that this column will offer an opportunity for women to learn more about their menopause so that they are empowered with information to help them make important decisions.

    Why is there so much attention today focused on menopause, perimenopause and the "golden years"? Well, the United States population is aging. The subgroup within this aging population, which is growing at the greatest rate, is post-menopausal women. While the average age of menopause (age 52 years) hasn't changed since 1850, female life expectancy has greatly increased.

    When female life expectancy was 47 years, back in 1850, women often did not live long enough to reach their menopausal years. Today, however, women can expect to live into their 80's or longer, which means they can expect to live about one-third of their lives being post-menopausal.

    Given those statistics, it is important for women to maximize their health so that their post-menopausal years remain productive and healthy. As women, we need to get our bodies into good shape and keep them that way so that they can keep up with our minds. I know I don't want to be confined to a wheelchair or nursing home secondary to osteoporotic fractures, which could have been prevented or treated.

    The common public goal, as expressed in a well-advertised makeup commercial, is "Don't lie about your age, defy it." Well, why not accept and be proud of our age and maximize our health and post-menopausal years?

    It's going to be difficult for an 80-year-old woman to defy her age for one-third of her life, regardless of genetics and plastic surgery. It should not be an impossible goal to have 80-year-old women take pride in their appearance, enjoy their favorite hobbies that may include dancing, swimming, hiking, etc., and continue to expand their minds.

    Menopause occurs when the ovaries no longer have functional eggs. This post-menopausal ovary does not produce the hormones it once did when it was functioning to produce an egg each month. Since the ovaries are the major producers of estrogen in the body, estrogen levels are very low after the onset of menopause.

    Falling estrogen levels may be associated with what are called "climacteric symptoms" including hot flashes/flushes, vaginal dryness, difficulty sleeping, and changes in mood. These climacteric symptoms may occur even before a woman becomes post-menopausal, especially in perimenopause, the period that occurs before menopause onset.

    While it is the climacteric symptoms that often bring a woman to her healthcare provider, it is the long-term effects of a decreased estrogen environment, cardiovascular disease and osteoporosis which may cause a woman long-term health problems.

    Both the short- and long-term consequences of a post-menopausal woman's decreased estrogen environment can be prevented and treated through lifestyle changes as well as standard and possibly alternative medicines.

    Women have many options for menopause management. Hopefully, this column will answer questions and enable women to make more informed choices.



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