Menopause and Bone Health

Menopause increases bone loss and risk for osteoporosis. Preventing bone loss is an important consideration after menopause. Research indicates that up to 20 percent of bone loss can happen after menopause, and approximately one in 10 women older than age 60 are affected by osteoporosis worldwide.
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Your doctor will determine how frequently you should receive a bone density evaluation to monitor how healthy your bones are.

It is also a good idea to make sure you are getting the calcium and vitamin D your bones need. Many women get these important nutrients through diet, supplements, or a combination of both.

Good sources of calcium

• Dairy products (select low-fat options, which are better for your heart)
• Dark green, leafy vegetables (e.g., broccoli, kale, turnip greens)
• Beans
• Seeds and nuts
• Some fish

Recommended calcium intake amounts:

• Premenopausal women: 1,000 mg of elemental calcium per day
• Postmenopausal women: 1,200 mg of elemental calcium per day

Vitamin D sources include:

• Vitamin D-supplemented dairy products (limit fat content)
• Fatty fish, (e.g., salmon, tuna, mackerel, trout, and sardines)
• Cod liver oil

Recommended vitamin D intake amounts:

• Premenopausal women: 600 IU of vitamin D per day
• Menopausal women: 600 IU of vitamin D per day
• Postmenopausal women: 800 IU of vitamin D per day

Menopause and Thyroid Health

Thyroid disease can produce symptoms that are similar to menopause. How can you tell the difference between thyroid issues and menopause? Your doctor will likely conduct lab tests to determine how well your thyroid gland is functioning. The most common test is the TSH (thyroid-stimulating hormone) test. If the TSH is abnormal, a T4 level can be helpful, as well as checking for antibodies that may be attacking the thyroid gland.

Hypothyroidism Symptoms

• Fatigue
• Sleep disturbances
• Depression
• Mood swings

Other hypothyroidism symptoms can include paleness, weakness, an intolerance to cold temperatures, joint or muscle pain, constipation, and thinning or brittle fingernails or hair.

When the thyroid produces too much thyroid hormone, hyperthyroidism will occur.

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Hyperthyroidism Symptoms

• Weight loss
• Anxiety
• Rapid heart rate
• Feeling hot and perspiring frequently
• Nervousness
• Swelling in the neck
• Muscle weakness
• Eye problems

Hyperthyroidism is usually treated with anti-thyroid drugs, such as methimazole, or rarely, propylthiouracil. Other options are to destroy the overactive thyroid with radioactive iodine or to remove the thyroid completely.

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Menopause and Heart Health

Eating a low-fat, low-salt diet helps keep cholesterol from building up inside your arteries (a condition called atherosclerosis), which can in turn lead to serious conditions, including heart attack, stroke, and heart failure, among others. Check your heart disease risk with the ASCVD Risk Estimator Plus.

Your doctor can also order a fasting lipoprotein profile test that will determine your cholesterol levels. Menopause causes the LDL cholesterol levels to increase. If your LDL cholesterol level is too high, your doctor will often prescribe a heart-healthy diet and increased physical activity to help bring that level down. When diet and exercise are not effective in lowering LDL cholesterol, medications may be prescribed.

The most common medications used to treat high LDL cholesterol are called statins.

Menopause and Diabetes

Diabetes is a condition in which the body either cannot produce enough of the insulin it needs to function, or the insulin it produces is not as effective—or sometimes both. There are three main types of diabetes. The most common type of diabetes, type 2, affects people of every age. Diabetes can be managed successfully through changes to diet and physical activity, as well as medication, when needed.

During menopause, the reduction in estrogen production increases insulin resistance, which can make managing diabetes even more difficult. Weight gain associated with menopause can also make diabetes control worse, requiring an increase in medication levels to keep diabetes under control. Hot flashes and night sweats can also make blood sugar harder to control.

Additionally, diabetes can increase the risk for vaginal and urinary infections. The risk for heart disease after menopause goes up especially if you have diabetes. To counter that increased risk, it may be necessary to add a cholesterol medication, such as a statin, to your therapy.

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Menopause and Cancer

When you are in postmenopause, you are at a higher risk for several cancers, including breast, uterine, and ovarian. If you have a longer reproductive phase of life, i.e., those with earlier menstrual cycles and later menopause, are at a greater risk for estrogen-sensitive cancers, including breast and uterine.

Breast cancer is one of the most common cancers, affecting 1 in 8 women in the U.S. Fortunately, diagnosis and treatment of breast cancer have improved dramatically even in recent years. Mammograms are usually effective at diagnosing breast cancer in its early stages, when treatments are most effective. A breast cancer screening with a mammogram is recommended.

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Menopause and Sexual Health

The loss of estrogen after menopause and testosterone levels due to aging can lead to bodily changes and a loss of interest in sex. Physical issues (such as vaginal dryness) and emotional issues can create temporary barriers to enjoying sex. Keeping the avenues of communication open with your partner can help make sex more enjoyable for you both.

Menopause and Mental Health

A vast majority of women develop significant mood issues during menopause. These mood issues may be linked to multiple sources of stress and may contribute to the incidence of depression and anxiety. Estrogen levels are erratic, fluctuating from one minute to the next producing less progesterone and serotonin, a mood-regulating neurotransmitter, leading to more mood swings.

Stress is an unavoidable part of life, but it can be kept under control. Some stress-reduction activities include:

• Conversation: Share your concerns with a family, friend, or medical professional or counselor.
• Sleep: Get an adequate amount of sleep.
• Physical Activity: Exercising is great for you, both physically and mentally. Try to exercise 30 minutes per day at least 5 days per week. You can figure out how many calories you are burning through exercise by using this calculator. Be sure to talk with your doctor before beginning an exercise plan. Keep in mind that there are many ways to fit in the activity your body needs. You certainly do not need to be an athlete to enjoy the benefits of physical activity.
• Caffeine and Alcohol Avoidance: Caffeine elevates cortisol (the stress hormone), making stress reduction harder. If you drink, do so carefully. Keep your alcohol consumption to one drink per day (a drink being equal to a 12-ounce can or bottle of beer, a 4-ounce glass of wine, or 1 ounce of liquor). If you do not drink, do not start.
• Tobacco Avoidance: Smoking is a known risk factor for serious health problems, such as heart disease and cancer. If you need help quitting, talk with your doctor or call the QuitLine at 800-QUIT-NOW (784-8669).
• Deep breathing and Meditation: Try relaxation techniques, such as yoga or deep breathing exercises.
• Healthy Diet: Maintain the right balance of calories to support an active lifestyle and a healthy weight.