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Menopause and Midlife Health
By Mary E. Peterson, M.D.

Midlife is a time of great change for women. It is a time to re-evaluate goals for life at work, home and play. Women focus on their families, careers and health. It is a time to be proactive in all aspects of life, and to take control of where life leads you. Unfortunately, it is also a time of great hormonal changes which can cause unwanted symptoms. The more common symptoms of menopause, hot flashes, night sweats, and vaginal dryness, are related to a decrease in estrogen levels. Some women will have few or mild symptoms, while others may have disabling symptoms If the symptoms are mild, treatment may initially start with lifestyle changes. Dressing in layers and sleeping in a light night gown or one made of a moisture-wicking material can often help with hot flashes and night sweats. Behavioral changes such as regular exercise, quitting smoking, and avoiding hot flash "triggers" – such as caffeine, red wine, strong cheeses, spicy foods - may also help. In addition stress reduction through relaxation therapy, yoga, and/or meditation can often decrease the frequency and severity of hot flashes.

For women experiencing severe menopause symptoms, lifestyle changes may not be enough. The most effective medication for the management of menopause symptoms is hormone therapy (HT). For those women that are candidates for HT, the goal of hormone therapy is to treat symptoms which a woman finds intolerable, using the smallest effective dose for the shortest amount of time needed. Many women are unable to take HT due to their past medical history. These women may benefit from one of the non-hormonal medications that have been shown to decrease hot flashes, such as certain antidepressants and neurological medications. Another option for these women is acupuncture, which has been helpful to many women with severe hot flashes.

For all women, whether they experience menopausal symptoms or not, the midlife years are an important time in which women should focus on achieving or maintaining a healthy lifestyle. Women should see their gynecologist and primary care provider annually, and stay current with their routine health screening tests such as mammogram, colonoscopy, and cholesterol and blood sugar levels. Women should also work to make exercise and a well-balanced diet priorities in their lives.

Midlife should no longer be a time associated with "crisis." Instead, think of midlife as a time for women to prepare body, mind and spirit for the next phase of life.

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