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Straight Talk from 'Dr. Stephanie' - April 2012
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  A Change of Heart at Menopause  
 En español 
 

Stephanie Coulter, MDStudies show that women recognize the positive aspects of growing older. Among them are growing more experienced and confident, having more freedom, holding on to their own opinions and speaking their mind.

Growing older also heralds menopause. Quite contrary to what one might expect based on conventional wisdom, many women view menopause as a positive as well. According to one study, most women perceive their lives – including health, career, relationships, sex life, interests, and overall happiness - are either unchanged or improved after the onset of menopause.

However, like most things in life, menopause is neither all good nor all bad. Today I am sharing things all women need to know about the impact menopause has on their health.

Hormones: Yes or No?

We’re all familiar with the negatives about menopause – hot flashes, memory lapses, depression, night sweats, and loss of libido, to name a few. These are real and treatable. Women who develop menopausal symptoms like sleeplessness and hot flashes will benefit from the use of hormones. They should be taken at the lowest effective dose for the shortest amount of time because all hormones (whether pharmaceutical or bioidentical) increase the risk of blood clots and strokes. Women who have been treated for cancer, blood clotting or vascular disease absolutely must never take any form of hormones.

Increased Heart and Vascular Risk

Put simply, your heart and vascular risk increases by at least two to fourfold at menopause. We aren’t sure what the mechanism is for this yet, but virtually all of a woman’s cardiovascular risk factors increase, even if she doesn’t change what she is doing. It is easier to gain weight. Also, blood pressure, LDL (bad cholesterol), triglycerides and glucose usually increase. Overall these changes have a negative impact on the arteries. The important thing to know is, just like your risk for heart and vascular disease before menopause, your risk during and after menopause is largely in your hands. What you can do to reduce your risk is pretty much the same, as well.
  • Exercise – It lowers all the risk factors that increase at menopause, and can reduce menopausal symptoms.
  • Maintain a healthy weight - It will take more effort to maintain or lose weight, but it’s worth it. (Do moderate exercise 1 hour a day 5 times a week, or do high-intensity exercise 30 minutes a day 5 times a week.) 
  • Have annual checkups – If you haven’t been consistent up until now, it is time to start!
  • Know Your Numbers – Keep an eye on them (blood pressure, cholesterol, etc.) and know where you stand. Learn more and track your own numbers with this free worksheet.
  • Follow your doctor’s orders – Take medications for high blood pressure and cholesterol if they are prescribed. If they make you feel lousy, work with your doctor on the dose and the type. If your doctor won’t work with you on this, find another doctor! 
  • Quit smoking – Period. If you keep trying, I know you can do it!

The same study that showed women are happier and more satisfied in virtually all areas of their lives during and after menopause also found that most women are more likely to make the very lifestyle changes they need to – like quitting smoking, even if they have tried before and failed. Making those lifestyle changes is the surest way to an active and enjoyable life, in spite of the increased risk menopause presents!

For more information about menopause, estrogen, and the heart visit the Heart Information Center Heart Smart page for women.

Until next time!
Stephanie Coulter, MD, Director of the Center for Women's Heart & Vascular Health
Stephanie Coulter, MD
 



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