Health Awareness for Postmenopausal Women

Menopause is a normal process in which your reproductive ability comes to an end. This process happens gradually over a span of months to years, usually between the ages of 48 and 55. Menopause is complete when you have missed 12 consecutive menstrual periods.

It is important to talk with your health care provider about some of the most common conditions that affect postmenopausal women, such as heart disease, cancer, and bone loss which is called osteoporosis.

Adopting a healthy lifestyle and getting preventive care can help to promote your health and wellness. Those actions can also lower your chances of developing some of these common conditions.

What should I know about menopause?

During menopause, you may experience a number of symptoms, such as:

• Moderate-to-severe hot flashes.
• Night sweats.
• Mood swings.
• Headaches.
• Tiredness.
• Irritability.
• Memory problems.
• Insomnia.

Choosing to treat or not to treat menopausal changes is an individual decision that you make with your health care provider.

What should I know about hormone replacement therapy and supplements?

Hormone therapy products are effective for treating symptoms that are associated with menopause, such as hot flashes and night sweats. Hormone replacement carries certain risks, especially as you become older. If you are thinking about using estrogen or estrogen with progestin treatments, discuss the benefits and risks with your health care provider.

What should I know about heart disease and stroke?

Heart disease, heart attack, and stroke become more likely as you age. This may be due, in part, to the hormonal changes that your body experiences during menopause. These can affect how your body processes dietary fats, triglycerides, and cholesterol. Heart attack and stroke are both medical emergencies.

There are many things that you can do to help prevent heart disease and stroke:

• Have your blood pressure checked at least every 1–2 years. High blood pressure causes heart disease and increases the risk of stroke.
• If you are 55–79 years old, ask your health care provider if you should take aspirin to prevent a heart attack or a stroke.
• Do not use any tobacco products, including cigarettes, chewing tobacco, or electronic cigarettes. If you need help quitting, ask your health care provider.
• It is important to eat a healthy diet and maintain a healthy weight.
  • Be sure to include plenty of vegetables, fruits, low-fat dairy products, and lean protein.
  • Avoid eating foods that are high in solid fats, added sugars, or salt (sodium).
• Get regular exercise. This is one of the most important things that you can do for your health.
  • Try to exercise for at least 150 minutes each week. The type of exercise that you do should increase your heart rate and make you sweat. This is known as moderate-intensity exercise.
  • Try to do strengthening exercises at least twice each week. Do these in addition to the moderate-intensity exercise.
• Know your numbers. Ask your health care provider to check your cholesterol and your blood glucose. Continue to have your blood tested as directed by your health care provider.

What should I know about cancer screening?

There are several types of cancer. Take the following steps to reduce your risk and to catch any cancer development as early as possible.

Breast Cancer

• Practice breast self-awareness.
  • This means understanding how your breasts normally appear and feel.
  • It also means doing regular breast self-exams. Let your health care provider know about any changes, no matter how small.
• If you are 40 or older, have a clinician do a breast exam (clinical breast exam or CBE) every year. Depending on your age, family history, and medical history, it may be recommended that you also have a yearly breast X-ray (mammogram).
• If you have a family history of breast cancer, talk with your health care provider about genetic screening.
• If you are at high risk for breast cancer, talk with your health care provider about having an MRI and a mammogram every year.
• Breast cancer (BRCA) gene test is recommended for women who have family members with BRCA-related cancers. Results of the assessment will determine the need for genetic counseling and BRCA1 and for BRCA2 testing. BRCA-related cancers include these types:
  • Breast. This occurs in males or females.
  • Ovarian.
  • Tubal. This may also be called fallopian tube cancer.
  • Cancer of the abdominal or pelvic lining (peritoneal cancer).
  • Prostate.
  • Pancreatic.

Cervical, Uterine, and Ovarian Cancer

Your health care provider may recommend that you be screened regularly for cancer of the pelvic organs. These include your ovaries, uterus, and vagina. This screening involves a pelvic exam, which includes checking for microscopic changes to the surface of your cervix (Pap test).

• For women ages 21–65, health care providers may recommend a pelvic exam and a Pap test every three years. For women ages 30–65, they may recommend the Pap test and pelvic exam, combined with testing for human papilloma virus (HPV), every five years. Some types of HPV increase your risk of cervical cancer. Testing for HPV may also be done on women of any age who have unclear Pap test results.
• Other health care providers may not recommend any screening for nonpregnant women who are considered low risk for pelvic cancer and have no symptoms. Ask your health care provider if a screening pelvic exam is right for you.
• If you have had past treatment for cervical cancer or a condition that could lead to cancer, you need Pap tests and screening for cancer for at least 20 years after your treatment. If Pap tests have been discontinued for you, your risk factors (such as having a new sexual partner) need to be reassessed to determine if you should start having screenings again. Some women have medical problems that increase the chance of getting cervical cancer. In these cases, your health care provider may recommend that you have screening and Pap tests more often.
• If you have a family history of uterine cancer or ovarian cancer, talk with your health care provider about genetic screening.
• If you have vaginal bleeding after reaching menopause, tell your health care provider.
• There are currently no reliable tests available to screen for ovarian cancer.

Lung Cancer

Lung cancer screening is recommended for adults 55–80 years old who are at high risk for lung cancer because of a history of smoking. A yearly low-dose CT scan of the lungs is recommended if you:

• Currently smoke.
• Have a history of at least 30 pack-years of smoking and you currently smoke or have quit within the past 15 years. A pack-year is smoking an average of one pack of cigarettes per day for one year.

Yearly screening should:

• Continue until it has been 15 years since you quit.
• Stop if you develop a health problem that would prevent you from having lung cancer treatment.

Colorectal Cancer

• This type of cancer can be detected and can often be prevented.
• Routine colorectal cancer screening usually begins at age 50 and continues through age 75.
• If you have risk factors for colon cancer, your health care provider may recommend that you be screened at an earlier age.
• If you have a family history of colorectal cancer, talk with your health care provider about genetic screening.
• Your health care provider may also recommend using home test kits to check for hidden blood in your stool.
• A small camera at the end of a tube can be used to examine your colon directly (sigmoidoscopy or colonoscopy). This is done to check for the earliest forms of colorectal cancer.
• Direct examination of the colon should be repeated every 5–10 years until age 75. However, if early forms of precancerous polyps or small growths are found or if you have a family history or genetic risk for colorectal cancer, you may need to be screened more often.

Skin Cancer

• Check your skin from head to toe regularly.
• Monitor any moles. Be sure to tell your health care provider:
  • About any new moles or changes in moles, especially if there is a change in a mole’s shape or color.
  • If you have a mole that is larger than the size of a pencil eraser.
• If any of your family members has a history of skin cancer, especially at a young age, talk with your health care provider about genetic screening.
• Always use sunscreen. Apply sunscreen liberally and repeatedly throughout the day.
• Whenever you are outside, protect yourself by wearing long sleeves, pants, a wide-brimmed hat, and sunglasses.

What should I know about osteoporosis?

Osteoporosis is a condition in which bone destruction happens more quickly than new bone creation. After menopause, you may be at an increased risk for osteoporosis. To help prevent osteoporosis or the bone fractures that can happen because of osteoporosis, the following is recommended:

• If you are 19–50 years old, get at least 1,000 mg of calcium and at least 600 mg of vitamin D per day.
• If you are older than age 50 but younger than age 70, get at least 1,200 mg of calcium and at least 600 mg of vitamin D per day.
• If you are older than age 70, get at least 1,200 mg of calcium and at least 800 mg of vitamin D per day.

Smoking and excessive alcohol intake increase the risk of osteoporosis. Eat foods that are rich in calcium and vitamin D, and do weight-bearing exercises several times each week as directed by your health care provider.

What should I know about how menopause affects my mental health?

Depression may occur at any age, but it is more common as you become older. Common symptoms of depression include:

• Low or sad mood.
• Changes in sleep patterns.
• Changes in appetite or eating patterns.
• Feeling an overall lack of motivation or enjoyment of activities that you previously enjoyed.
• Frequent crying spells.

Talk with your health care provider if you think that you are experiencing depression.

What should I know about immunizations?

It is important that you get and maintain your immunizations. These include:

• Tetanus, diphtheria, and pertussis (Tdap) booster vaccine.
• Influenza every year before the flu season begins.
• Pneumonia vaccine.
• Shingles vaccine.

Your health care provider may also recommend other immunizations.