Menopause is defined as the absence of menstrual periods for 1 year.  The average age is 51.  “Perimenopause”, the time before menopause, is a common time for menopausal symptoms and changes in periods.  Having a bit of knowledge may ease this passage.  Changes in cycle length or amount of menstrual flow are common.  You should talk to your doctor or nurse if you have erratic bleeding.

• Talk with your doctor or nurse when you first begin to notice changes in your body.  You may notice hot flashes, problems sleeping, vaginal dryness or depressed mood.
• Hormones are one option that can help treat symptoms and protect against osteoporosis.
• Learn about other non-drug treatments and talk with your doctor or nurse about them.

Osteoporosis is the major cause of hip fractures in adults older than 65.  After menopause, women begin losing bone density at a faster rate.  This is seen because of the loss of estrogen.

Calcium, vitamin D and regular weight-bearing exercise can protect against bone loss. 

Risks for osteoporosis increase with anorexia, smoking, thyroid disease, alcohol, steroid use, or low body weight.

• Eat plenty of milk and dairy products and dark, leafy greens.  Enjoy sunshine.
• You need 1200 mg of elemental calcium a day, first by eating calcium rich foods (4-5 dairy servings) or through a supplement.
• Take 400–800 IU of vitamin D a day (in multivitamins), especially in winter months. 
• Perform weight-bearing exercise to prevent bone loss. 
• Get a bone mineral density test if you are at increased risk or you are over 65.
• Talk to your health care provider about hormones or other medicines to prevent further bone loss.

Breast Cancer. By the age of 65, one in 275 women will have breast cancer.  This number goes up if the woman has a mother, sister or daughter with breast cancer.  All women should be involved in early detection of breast cancer.  This can be done by doing self-exams and by having exams by your health provider.

• Do monthly self breast exam.
• Watch for a firm, discrete lump; a lump above or below your collarbone or underneath your arm; nipple or skin changes around the breast; and bloody nipple discharge.  Call your doctor if you notice any of these symptoms.
• Get a mammogram every 1-2 years.

Heart Disease.  Heart disease is the most common cause of death in women over 50.  Risk factors for heart disease include high blood pressure, high cholesterol, diabetes, smoking, obesity and a family history of heart disease.

• Exercise at least 30 minutes a day, 3 days a week.  It is best to do more intense exercise such as walking 2-3 miles in 30-40 minutes, 5 days a week.  Weight bearing exercise helps build strong bones.
• Eat healthy.  Choose foods low in fat with varied food groups.
• Do not smoke.
• Keep your stress down.  Stress can play a part in many physical symptoms and disease.  If stress is a problem for you, talk with your doctors or nurses. 
• Tell your doctor right away if you notice any chest pain, pressure, pain around your shoulder or neck, lightheadedness, sweating, nausea or shortness of breath.

Obesity.  50% of Americans weigh too much.  If you are obese, you are at increased risk for high blood pressure, high cholesterol, heart disease, diabetes, and arthritis.

• Eat a healthy low fat diet.  Include plenty of fruits and vegetables.  Consume foods from all food groups.  Eat regular meals.  Eat a high fiber diet and include plenty of fruits, vegetables and grains low in fat.  Eat less sodas, sweets, salty snacks, alcohol, and starchy carbohydrates.  Eat lean meat. 
• Exercise.  Keep active.
• Maintain a healthy body weight.

Urinary Incontinence.  This is common as women age.

• Ask your doctor how you can perform simple exercises (Kegel’s) to prevent or improve bladder leakage.  Your doctor may suggest ways to reduce your symptoms.

Colorectal Cancer (ColonCancer).  Colorectal cancer is cancer of the large intestine and rectum.  It develops from a growth called a polyp that is not cancer, but can become cancerous.  It is a preventable disease.  With screening, colorectal cancer can be prevented and treated if found early.

• Screening is the only way to detect polyps and then treat them before they turn cancerous.
• Do not wait for symptoms to get screened.  You can have the disease and not even know it.

Smoking.  Smoking has a major impact on your long-term health.  It can increase your risk for heart disease, vascular disease, strokes, lung cancer, emphysema and other cancers.

• Don’t Smoke.  Ask your doctors or nurses about ways you can stop smoking.  There are medicines and programs to help you quit.

Alcoholism.  Many people in this country have a problem with excess drinking.  If you drink more than 1-2 drinks a day or greater than 7 drinks a week, this may be a problem for you.  Drinking too much alcohol can cause heart problems, hepatitis, cirrhosis, pancreatitis, and dementia as well as social and family problems.

• Talk with your doctors and nurses about program to help you stop drinking. 

Depression is very common in women.  It may worsen during perimenopause.  Common symptoms include changes in mood, changes in sleep patterns, apathy, increased or decreased appetite or many other physical symptoms.

Your General Health

• Use seat belts in cars.  Use helmets with bicycles and motorcycles.  Avoid driving if you have had any alcohol or drugs.
• Seek help for sexual, physical or emotional abuse.
• Practice safe sex.
• Avoid staying out in the sun for long amounts of time.  If you cannot avoid being in the sun, wear clothing to cover your skin or use sunscreen.
• Visit a dentist every 6 months to a year.

Preventive Health Service

Date/test results

Mammogram

(every 1-2 years)

Pap smear and pelvic exam (every 1-3 years)

Blood Pressure

(yearly)

Cholesterol

(every 5 years)

Bone Mineral Density screening

Optical colonoscopy (every 10 years) or Virtual colonoscopy (every 5 years) or Flexible sigmoidoscopy (every 5 years) or Immunochemical fecal occult blood test (iFOBT) (every 1 year)

Tetanus shot

(every 10 years)

Flu shot (yearly)

Pneumonia vaccine (if 65+ or at risk)