Although all women need gynecological care during menopause, they don’t all need therapy. Menopause symptoms are variable; some women have very few, while others are plagued by severe hot flashes, night sweats, fatigue or other symptoms. Some develop problems like urinary incontinence or may have problems with sexual functioning.
Results from the Women’s Health Initiative study indicated that the use of hormone therapy in menopausal women might increase the risk of heart attack, stroke, blood clots and some kinds of cancer. However, new research has shown that the risks depend on a number of factors, such as the type and combination of hormones, the woman’s age, whether she still has a uterus, and where she is in the process of menopause. For example, women between the ages of 50 and 59 have a lower risk of blood clots and strokes than older women who use hormones. Hormone therapy is effective for a number of menopausal symptoms like hot flashes, but topical hormones (patches, gels, and creams) are often effective for symptoms like vaginal dryness and pose less risk. The bottom line is that women who are up to age 59 and within 10 years of menopause may be good candidates for hormone therapy; each woman should discuss this issue with her doctor.
In addition to the menopausal symptoms that may occur, menopause is a time when women do face new health issues. Estrogen protects women against heart disease. Once estrogen starts to decline in menopause, a woman’s risk for heart disease goes up. Women, in general, are at higher risk of osteoporosis (thin or brittle bones), and during the first few years after menopause, bone density decreases at a relatively rapid rate. Postmenopausal women who develop osteoporosis have an increased risk of fractures. The tissues of the vagina and urethra lose elasticity after menopause, which increases the risk of stress incontinence and urinary tract infections. Body metabolism slows down, and postmenopausal women are more likely to gain weight.
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