Menopause: Lifestyle Issues and Prevention
Women have many choices in the ways they can treat symptoms of menopause. All women, however, should aim for a healthy lifestyle: Eat a healthy diet, including 1500 mg of calcium daily, lower the amount of fat in your diet, and the right balance of calories to maintain an active lifestyle; if overweight, weight reduction is advisable.
Quit or try to cut down on smoking;
Use alcohol moderately;
Exercise for 30 minutes at least three times a week;
Avoid stressful situations; and
Have a yearly mammogram and breast examination by a health professional.
Preventing disease will be a major concern after you go through menopause. Your risk of bone loss, bone fractures, heart disease, and other conditions increases as you age.
To prevent bone loss:
Maintain a healthy diet and exercise. Other treatments for preventing bone loss and osteoporosis (severe loss of bone) include calcium tablets and Vitamin D. These can be taken separately or combined in a pill.
Other bone treatments require a prescription:
The hormone calcitonin is used to block bone breakdown.
The bisphosphonate family of drugs blocks the breakdown of bone and results in an increased amount of bone. Commonly prescribed bisphosphonates include risedronate and alendronate.
Hormone therapy is effective at preventing bone loss and fractures, but you should weigh the risks against the potential benefits.
The "designer estrogens" (SERMs) tamoxifen and raloxifene also help to prevent bone loss; tamoxifen is also used to prevent breast cancer and its recurrence.
Parathyroid hormone is used to add bone in severe cases of bone loss.
To prevent heart disease:
A healthy diet and regular exercise can help to keep your heart healthy as you age. If your cholesterol is high, however, you may need cholesterol-lowering drugs. These drugs are called the "statin" drugs, such as lovostatin, simvastatin, and pravastatin.
Tamoxifen and raloxifene help to lower levels of bad cholesterol (LDL), which can block blood vessels and cause heart disease.
The role of estrogen in preventing heart disease is being debated by scientists. Recently, the American Heart Association announced that no woman should take estrogen only to prevent heart disease. Right now more studies are being conducted to learn whether estrogen prevents heart disease and stroke. Recent reports indicate that combined estrogen plus progestin do not reduce the risk of heart disease in women with or without previous heart disease, and may actually increase the risk of heart disease and stroke.
Preventing other diseases:
Some studies have shown other preventive roles for estrogen. More studies are needed to learn how effective estrogen might be in preventing these diseases. For example:
Estrogen loss may be linked with Alzheimer's disease. Taking estrogen may help to prevent this disease after menopause. However, data from the WHI (Women's Health Initiative) suggest that women who initiate estrogen treatment at age 65 or older may not have improvement and may even have some mild cognitive decline and dementia. Whether this is the optimal age to initiate estrogen treatment, or whether the results would have been different if estrogen had been started at the time of the menopause remains to be determined.
Taking estrogen may lower the risk of developing colon cancer.
Taking estrogen may lower the risk of developing age-related macular degeneration, a degeneration of the retina of the eye.
Robert B. Jaffe, MD
Fred Gellert Professor of Reproductive Medicine and Biology
University of California, San Francisco; San Francisco, CA
Last Review: January 2004
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