WHAT’S HAPPENING? WHAT DO I DO?
DECIDING ABOUT YOUR MENOPAUSE
While I cannot tell you what you should do, I can offer some guidelines to help in your decision making. While I do not suggest that any particular approach to menopause is right for all women, I do think that all women should develop a plan for themselves -- with the help of their health care professional.
Of course, some women do nothing and live to be over 100. But unless you have such lucky genes, it’s better to do all you can to maintain your health. Here are the main elements of a personalized menopause plan:
Calcium and vitamin D supplements should be started beginning in the thirties. If you are one of the many women who didn’t, you can start now. Even women with strong bones should take these supplements.
Assess your risk for osteoporosis by getting a DXA bone scan as soon as you have any menopause symptoms but no later than age 50. If your bones are OK – you’ll need medical help in interpreting the report; they were designed by computer jockeys and are needlessly complex – then stay on the supplements and get a repeat DXA at least every 5 years.
If your bone density is low, you may need treatment to prevent further bone loss and restore some of what you have lost. Estrogen is one option but a group of medications called bisphosphonates (Fosamax® and Actonel®) work at least as well. They are unrelated to estrogen but for that reason do not help with menopause symptoms. They are only to help your bones. Calcium and vitamin D by themselves will not fully prevent bone loss.
Women are not exempt from heart disease; in fact over half eventually die from it. Check if you have specific risk factors. Family history can’t be changed but cholesterol levels, high blood pressure, smoking, and diabetes can. If you do have risk factors, take action to correct them: lower cholesterol with diet or medication or both, be sure your blood pressure is normal or get it normal, if you have diabetes, have it treated aggressively with the new medications which actually work.
Get a yearly breast exam and mammogram but also do monthly breast self-exam yourself.
Now you’ve done the standard things to protect your long term health. The next decision is based on symptoms – how you feel. If symptoms are uncomfortable you can try soy and supplements. If these do not give adequate relief, you may want to consider HRT.
Here are some of the things HRT does: reduce hot flashes and night sweats, improve sleep, help mental quickness and memory, decrease discomfort in skin and muscles and joints, maintain vaginal tissues and lubrication. These are significant benefits and are the reason millions of women do choose to go on HRT. If you cannot enjoy your life without HRT that is a good reason to take it. On the other hand, if you feel perfectly fine without it, there are other ways to get the same long term health benefits as I discussed above.
Finally, if you decide to start HRT, you are not committed to taking it for life. You can always reassess and change your mind whenever you like. If you do decide to stop, then you need to consider other ways to protect bones and heart.
What is Menopause?
Help for Hormone Problems
Question of the Month
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