11 Steps to Take As You Reach Menopause


At what age is it normal to enter menopause, and how long do the hot flashes last?

The average age at which women in the US experience "natural" menopause is 51. This means that you have gone 12 consecutive months without a menstrual period and can't attribute it to any other physical reason.

PHOTO (COLOR): Heated up over menopause? Here's the lowdown.

It may be normal for some women to reach menopause at 45 and others at 55. I've "escorted" patients through menopause who were 35 and even a few who were 59.

One clue to when you'll reach menopause is your mother: Women often experience menopause around the same age as their mother and sisters did. Another factor that can affect age at menopause is cigarette smoking. Smokers, and even former smokers, can reach menopause two or more years earlier than nonsmokers.

Hot Flashes Don't Last Forever
Probably the most common complaint I hear associated with menopause is hot flashes: the sudden feeling of intense heat in the face and/or upper body often accompanied by blushing and perspiration. Hot flashes appear to be caused by an upset in your brain's climate control center, which is due to dwindling or fluctuating estrogen levels.

About 75% of women have hot flashes during the transition time leading up to menopause, which we call perimenopause. For most women, hot flashes will continue over a period of three to five years. Yet there are some women who have them for only a few months, while others have them for many years. They rarely continue much past menopause.

PHOTO (COLOR): Be cool: Get serious about your health now.

A Good Time to Take Stock
I encourage my patients who are approaching menopause and midlife to think of it as a time to evaluate their overall health and make any changes they can to avoid developing serious health problems.

In the past, a woman's health was regarded as beginning and ending with her reproductive organs. But now, our approach goes far beyond that to the prevention of diseases such as heart disease (the number one killer of women in the US), osteoporosis, diabetes, cancer, arthritis, and even depression.

I advise all women approaching menopause to...
get to know their blood cholesterol levels.
get screened for diabetes with a blood glucose test.
have a bone density test at the first sign of menopause, particularly if you're not planning to take estrogen replacement therapy.
get regular mammograms and perform monthly breast self-exams.
maintain a healthy weight.
exercise regularly, at least five days a week for 30 minutes.
stop smoking, if you do.
have their blood pressure checked at least once a year.
continue getting an annual Pap test and pelvic exam.
limit their intake of salt and alcohol.
discuss the risks and benefits of taking hormone replacement therapy with their health care provider.
If you want to learn more about how to cope with hot flashes, see "Got Hot Flashes?..." on p 110 of the May issue.

Quick Tip

Keep cool by dressing in light layers, using a fan, and sleeping in a cool room.


By Mary Jane Minkin, MD, with Toby Hanlon, EdD

Dr. Minkin is a board-certified obstetrician/gynecologist in New Haven, CT, clinical professor at Yale University School of Medicine, and coauthor of What Every Woman Needs to Know about Menopause (Yale University Press, 1996).

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