domingo, 21 de abril de 2013

Menopause: Time for a Change | National Institute on Aging

Menopause: Time for a Change | National Institute on Aging


Menopause: Time for a Change

Staying Healthy

peapods and peasThe average woman today has more than one-third of her life ahead of her after menopause. That means the menopausal transition is a good time for lifestyle changes that could help women make the most of the coming years. You’ve already read some ways to protect or improve your health at this time of life—quitting smoking, exercising daily, and working toward a healthy weight. But, there’s even more you can do to stay healthy—other lifestyle changes plus suggestions to help you work with your health care providers more effectively.


A balanced diet will give you most of the nutrients and calories your body needs to stay healthy. Eat a variety of foods from the five major food groups. Look for foods that have lots of nutrients, like protein and vitamins, but not a lot of calories. These are called nutrient-dense foods. As you grow older, you need fewer calories for energy, but just as many nutrients.

USDA FOOD GUIDE Daily Recommendations for Women Age 50 and Older*
Grains—5 to 7 ounces, at least half of which are whole grains Vegetables—2 to 3 cups with a variety of colors and types
Fruits—1½ to 2 cups
Milk, yogurt, and cheese—3 cups of milk or the equivalent
Meat, poultry, fish, dry beans, eggs, and nuts—5 to 6 ounces of lean meat, poultry, or fish or the equivalent
*From the U.S. Department of Agriculture (USDA)
The USDA Food Guide is one eating plan suggested by the Federal Government’s Dietary Guidelines for Americans, 2005. Another eating plan also suggested in the Dietary Guidelines is DASH, Dietary Approaches to Stop Hypertension. Contact the National Heart, Lung, and Blood Institute, listed in For More Information, for more resources about this plan.
The number of calories a woman over age 50 should eat daily depends on how physically active she is. Basically you need:
  • 1,600 calories, if your physical activity level is low
  • 1,800 calories, if you are moderately active
  • 2,000-2,200 calories, if you have an active lifestyle
The more active you are, the more calories you can eat without gaining weight.
Eating the foods recommended in the USDA Food Guide or in DASH will help you get needed nutrients. But, people over 50 have trouble getting enough of some vitamins and minerals through diet alone, including calcium and vitamin D (see "Postmenopausal Health Concerns"). Just remember that these recommendations include how much of each nutrient you get from food and drinks as well as any supplement you use. Women past menopause who are still having a menstrual cycle because they are using menopausal hormone therapy might need some extra iron over the 8 mg (milligrams) recommended for women over age 50. Iron, important for healthy red blood cells, is found in meat, duck, peas, beans, and fortified bread and grain products.
Women over 50 also need more of two B vitamins. Getting 2.4 mcg (micrograms) of vitamin B12 per day will maintain the health of your blood and nerves. Some foods, such as cereals, are fortified with this vitamin. Vitamin B12 is also found in red meat and, to a lesser extent, fish and poultry. But, up to one-third of older people can no longer absorb natural vitamin B12 from their food. Furthermore, common medicines taken to control the symptoms of GERD (gastroesophageal reflux disease), also known as acid reflux, slow the release of certain stomach acids and, therefore, interfere with the body’s absorption of vitamin B12. You might need a supplement if you have GERD.
Another B vitamin, B6, helps your body breakdown proteins and make hemoglobin, a part of red blood cells. Women should have 1.5 mg of vitamin B6 daily. This vitamin is found in fortified cereals, as well as meats, legumes, and eggs.
Don’t forget to drink plenty of fluids, especially water. If you drink alcohol, do so in moderation—for a woman, only one drink a day according to the Dietary Guidelines for Americans. A drink could be one 12-ounce beer, 5 ounces of wine, or 1½ ounces of 80-proof distilled spirits.


person roller skatingEating well, exercising, and not smoking are things you can do for yourself to stay healthy as you get older. It is also important to discuss your goals for healthy aging with your doctor. He or she may be able to help you prevent health problems or recognize problems early when they are probably easier to manage.
See your doctor. Continue to visit your doctor regularly. When you meet with any doctor, be prepared to discuss your family medical history. You might be at increased risk for certain diseases, like diabetes or heart disease, if other close family members had them. Knowing about this family history will help your doctor decide whether you need any screening tests, like cholesterol or blood sugar tests, more often or earlier than other people your age.
You should have routine screening tests, pelvic and breast exams, and a Pap test for cervical cancer. After age 50, you need to be checked for colon cancer, and don’t forget your mammogram every 1 to 2 years, especially if you are still using menopausal hormone therapy. And remember to talk to your doctor about whether or not you are at risk for osteoporosis and what types of physical activity are best for you.
Skin. Check your skin every month for unusual blemishes, especially moles that seem to change size, shape, or color. Have your doctor look at your skin during checkups. Use sunscreen, SPF 15 or higher, when you are outside during the day. Try to stay out of the sun when it is strongest—from about 11 a.m. until 3 p.m.
Teeth and mouth. See your dentist once or twice a year. Not only will he or she clean your teeth, but the dentist will also check for cavities and gum disease. If you have dentures, you should still see a dentist periodically to check their fit and to look for gum problems.
fruit slices and cherriesEyes. As you age, reading may become harder. You may need to hold things farther away in order to see them clearly. Reading glasses might help. Start regular visits to an eye care professional, who can check for glaucoma. This eye problem becomes more common after your forties. In glaucoma there is increased pressure on the optic nerve. The pressure can permanently damage your vision before you realize you have glaucoma. Special eye drops often control it.
Medications. Make sure all your doctors know which medications you are taking. This includes vitamins, minerals, other dietary supplements, and over-the-counter medicines like aspirin, antacids, or antihistamines. Some of these may change how your prescription medicines work; others might not be safe for you to use at all.
If your health care professional prescribes a medicine, take it as directed. Make sure you understand the possible side effects of the prescribed medicines. Some drug stores or mail order services keep a computer file of all your prescriptions so they can check for possible drug interactions if a new medicine is added. That is a benefit of getting all your medicines from the same place. But the pharmacist still doesn’t know what nonprescription medicines and supplements you are taking, so it is important to keep your doctors informed.
Get vaccines. If you are over age 50, you should get a flu shot every fall, especially if you have other health problems. The Centers for Disease Control and Prevention (CDC) recommends that people over age 65 get the pneumococcal pneumonia vaccine—most need it only once. You should also have a tetanus shot every ten years, or sooner if you have an injury that puts you at risk for getting tetanus. Tetanus or lockjaw is a serious, painful infection that causes muscles all over the body to tighten.
A vaccine to prevent shingles is now available. Most adults 60 years and older should get one dose. Check with your doctor to see what you should do.
Listen to your body. Don’t wait for your next checkup if you notice any suspicious changes in your body—swelling, unexpected weight loss or gain, persistent pain, unexplained fevers, a cough that won’t go away, or recurring headaches, for example. Check with your doctor about any of these symptoms.
Know the warning signs of a heart attack, although the signs are sometimes less clear in a woman. They include:
  • Pain or an uncomfortable feeling in the center of your chest
  • Pain or discomfort in other parts of the upper body, including the arms, back, neck, jaw, or stomach
  • Other symptoms, such as shortness of breath, breaking out in a cold sweat, nausea, or light-headedness
Call 9-1-1 if you feel chest discomfort, especially with any of the other signs. If 9-1-1 emergency service is not available where you are, call the operator or get someone to drive you to the hospital.
You should also know the warning signs of a stroke. In the case of a stroke, one or more of these signs come on very suddenly.
  • Numbness or weakness, usually in the face, arm, or leg, and often on just one side
  • Strong headache for no reason
  • Confusion or trouble speaking or understanding
  • Problems seeing with one or both eyes
  • Trouble walking, feeling dizzy, losing balance or coordination
There are drugs that can help if you get to an emergency room fast enough. Call the ambulance and get medical help as soon as possible, so you can get treatment that may lessen the damage.
Ovarian cancer (cancer of the ovaries) is rare and difficult to diagnose in its early stages, making it hard to treat. Ovarian cancer is more common in women who:
  • Are older
  • Have a family history of this disease
  • Are overweight
The early symptoms are often similar to signs of other illnesses. They might include:
  • Pain in the abdomen or pelvis
  • Urinating often or needing to urinate quickly
  • Feeling full more quickly than usual when eating
  • Frequent bloating in your abdomen
Normally these symptoms are nothing to worry about. But, talk to your doctor if they happen frequently, perhaps more than twelve times a month, or if they continue for more than a few weeks.


person wearing hatAfter menopause, some women may think they needn’t worry about sexually transmitted diseases. But, any woman, regardless of her age, who is not in a long-term relationship with a faithful partner and has unprotected sex, is at risk of sexually transmitted disease. If you have more than one sexual partner or have recently begun dating again, you need to be aware of the risk of these diseases and take necessary precautions to make sure you don’t become infected.
The list of familiar and unfamiliar sexually transmitted diseases includes syphilis, gonorrhea, Chlamydia, genital herpes, human papillomavirus/genital warts, and HIV/AIDS (human immunodeficiency virus/acquired immunodeficiency syndrome). Some can be cured—Chlamydia, syphilis, and gonorrhea. But some—genital herpes, human papillomavirus/genital warts, and HIV/AIDS—can’t. Being informed about HIV/AIDS is critical because an HIV infection that develops into AIDS is life-threatening. HIV/AIDS can be treated, although not cured, and new drugs enable people to live longer with HIV/AIDS.
HIV is found in body fluids such as blood, semen, and vaginal secretions. The virus can enter your body through any opening in the skin. Postmenopausal women are at special risk because of the fragile tissues of the vulva (the external female genital area around the opening of the vagina) and the lining of the vagina. These delicate tissues may be more susceptible to virus-infected fluids.
Don’t be afraid to talk to your partner or potential partner about HIV/AIDS. Ask if he or she has been tested for HIV recently. There are other ways women can protect themselves. Check with the FDA and the CDC. Contact the FDA and CDC, listed in For More Information, to learn more. Be sure you are making safe choices.


This new phase of your life can be as busy and fulfilling as you would like to make it. Stay active—not only physically, but also mentally. If you don’t work outside of the home, you might consider getting a part-time job or volunteering with a nonprofit organization. You might find a hobby or learn to play a musical instrument. Maybe you would enjoy taking a class at a local community college or even working toward a degree. You could join a book group or learn to garden. This is the time to do something you always wanted to try, but never had the time before. Or maybe now is a good time to reconnect with an interest you had when younger.
While exploring new things and keeping active, try to avoid adding stress to your life. Stress can make it harder to deal with the symptoms of menopause. Mid-life can be a complex time for many women. For example, if you have a family, there are probably changes at home—maybe you now have an “empty nest” because your children are leaving home for college, work, or marriage. Maybe you have young children who are still in need of attention, which can be extra challenging if you are tired because you aren’t sleeping well at night.
Other possible stresses come from outside the home. If you work, you may be taking a different look at your career, starting to think about retirement, or feeling challenged by younger coworkers. Or, your parents may be having health problems that now need your attention. Maybe a combination of such challenges is causing you stress.
How do you know you are feeling stressed? Perhaps you feel overwhelmed by life, depressed, or anxious. Do your shoulder muscles feel tight? Do you sometimes realize your hands are clenched? Do you wake up with a sore jaw because you are grinding your teeth or tightening your jaw as you sleep? Do you have headaches, stomach problems, fatigue, trouble sleeping, or high blood pressure? These can be signs of stress.
Avoid stress as much as possible. That might be very hard to do if you are a caregiver—whether of a child or an adult. Try to identify the times when you feel overwhelmed so you can try to keep those situations to a minimum. Take time to relax, eat well, exercise regularly to release tension and feel better overall, and keep in touch with family and friends. Try to find activities that may help get your mind off things that stress you. Maybe even try relaxation breathing (see box in "What Can You Do for Hot Flashes and Other Menopausal Symptoms" section) or meditation. Get enough sleep. Don’t be reluctant to ask for help when you need it—from family or friends or even from a professional counselor.
Keep in mind the possibility of saying no when asked to do something that you think will add to your stress, and try not to feel guilty afterward. Some women find accepting the fact that there are some things in life that they can’t change is helpful. Set realistic goals for what you want to get done.
Talk to friends or family members who might be going through similar life changes. Sharing ideas about how to handle common new responsibilities like taking care of aging parents might be helpful to everyone.

Would you like to help with medical research?

Research is ongoing in many places. One way people can help with medical research is to take part in a clinical study or trial. A clinical study or trial is specially designed, health-related research involving humans. Scientists often seek participants for their research studies. Some are people with the illness being studied, called “patient volunteers.” Sometimes participants are “normal or healthy volunteers” who are not sick. Scientists learn a lot by comparing and contrasting the two groups, especially if both have received the same treatment. Are you interested in taking part in a clinical study—either because of a health problem you have or so you can contribute to medical research? Consider volunteering for a clinical trial. Learn more at where you will see a listing of current clinical studies and trials.


The menopausal transition is a natural stage for every woman who is in her forties or fifties. If you have no symptoms or if you aren’t bothered by the symptoms you have, there is nothing you need do. But, if hot flashes, night sweats, or vaginal dryness are making you uncomfortable, talk to your doctor about ways you can get relief.
Mid-life can be an exciting period in your life. It is a time of change—physical changes, of course, but possibly emotional and social adjustments, too. It might also be a time of acceptance—of these changes and of your evolving roles in life. This is also a time of opportunity and promise—a chance to make healthy changes in your lifestyle that will allow you to get the most out of the rest of your life.
So, don’t look back. This is the time to explore your world, expand your horizons, and learn more about yourself. It’s time to enjoy yourself, friends and family, and your life!

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