Midlife Health

Every stage of life has its positives. Midlife is no exception. For many women, it’s a time to leave youth’s insecurities behind and enjoy the fruits of past labors. To get the most out of midlife, arm yourself with knowledge, healthy habits and a good partnership with your doctor.

Menopause    HRT    Osteoporosis    Urinary Incontinence


It isn’t called the change of life for nothing.

It’s a major transition, all right — one that affects not only your reproductive organs, but the rest of you as well. The changes are triggered by a reduction in your body’s production of estrogen and progesterone, two hormones essential for reproduction. As the hormone levels decrease, your ovaries stop producing eggs, and menstruation becomes irregular or infrequent, eventually stopping altogether.

Menopause usually takes place between the ages of 45 and 55, although age and duration vary. While menopause occurs naturally for most women, it can also result from surgical removal of ovaries and some types of cancer treatment.


As the production of estrogen and progesterone diminish, the body responds in a variety of ways, possibly including:

  • Hot flashes and/or night sweats
  • Racing or irregular heartbeat
  • Insomnia
  • Headaches, aches and pain in joints
  • Mood swings, irritability, depression, anxiety and forgetfulness
  • Decrease in sexual interest/responsiveness
  • Vaginal dryness and pain during intercourse


Checking with Your Doctor

Although menopause is a natural occurrence, as opposed to an illness, it’s important to consult with your doctor when you begin to experience signs, such as infrequent or irregular periods. Here’s why:

  • Your doctor can check your hormone levels to determine your stage of menopause.
  • Your doctor can use a pelvic exam to check for changes in your vaginal lining that may require medication.
  • Your doctor will help you evaluate the pros and cons of treatment for menopause.


Hormone Replacement Therapy (HRT)

HRT, the most common treatment for menopause symptoms, has been a subject of controversy for many years. Conflicting research findings and disagreements on their interpretations have added to the confusion.

Your doctor can help you sort through the issues, weighing factors such as your medical history, the severity of your menopause symptoms, how far menopause has progressed and the different types of HRT.


Current guidelines for HRT use include:

  • HRT pills are not recommended for postmenopausal women. Vaginal estrogen creams, however, may be used to treat dryness and changes in vaginal tissue both during and after menopause.
  • HRT pills may be used during early menopause by women who are at low risk for stroke, heart disease, blood clots and breast cancer.
  • The use of HRT pills should be limited to no more than five years.


To minimize the risks of HRT, your doctor may recommend:

  • The lowest effective dose of HRT pills or the use of HRT skin cream instead of oral HRT
  • Frequent checkups, including pelvic exams, Pap smears, breast exams and mammograms for early detection of health issues related to HRT use


Alternatives to HRT

If hormone replacement therapy isn’t right for you, take heart. There are other ways to treat menopause symptoms. Low doses of antidepressants and other prescription medications provide relief for many women. There are also measures that don’t involve prescription drugs, such as:

  • Limiting caffeine and alcohol
  • Dressing in layers you can remove when a hot flash hits
  • Practicing slow, deep breathing when you feel a flash coming on
  • Using relaxation techniques such as meditation or yoga
  • Using vaginal lubricants to prevent discomfort during sexual activity



What you don’t know can hurt you after all — at least when it comes to the significant loss of bone density known as osteoporosis.

It’s a condition that affects one U.S. woman in five after the age of 50, but often goes undetected because of the lack of symptoms during its early stages. As it robs bones’ strength, leaving them lacy and porous, the risk of fractures rises dramatically. That’s why it’s important to have your bone density checked with a painless diagnostic test as you approach menopause.

If you’re diagnosed with osteoporosis, or a less severe form called osteopenia, there are a number of medications your doctor can prescribe to prevent further bone loss. Your doctor may also recommend calcium supplements and vitamin D, along with weight-bearing exercise.

Urinary Incontinence

It’s the problem women don’t want to talk about. Here’s why they should.

If you find yourself racing to the bathroom or leaking each time you cough, laugh or sneeze, you’re not alone. Millions of women suffer from urinary incontinence, especially after age 50, when the muscles that form a sling across the pelvic floor begin to lose their tone.

The same weakening of pelvic floor muscles that leads to incontinence can also cause sagging of pelvic organs, including the vagina, uterus, bladder and rectum.

Now for the good news: These conditions are treatable. In some cases, specialized exercises are sufficient for significant improvement. There are also medications and surgical procedures to treat incontinence and pelvic floor disorders.