There are steps you can take to prevent
National Academy of Sciences, 2010*
osteoporosis after menopause. The first step in preventing osteoporosis is to build as Calcium:
1,200 mg (milligrams)
much bone density as possible by age thirty.
not more than 2,000 mg
After that age, some people may begin to
Vitamin D: Age 51-70, 600 IU**
lose bone strength. In women, bone loss
not more than 4,000 IU
picks up speed around the time of meno-
Age 70 and older, 800 IU
pause and slows again a few years later. But not more than 4,000 IU
bone loss continues into old age. So, if you
*Total recommendation—from food, drinks,
have daughters or granddaughters, encourage and, if needed, supplements—each day.
them to exercise and get plenty of calcium
** International units
and vitamin D while they are younger.
Keeping the bone strength you have at
such as salmon, dark-green leafy vegetables, menopause is the next step in preventing
and foods with calcium added, like orange osteoporosis. Exercise and a proper diet
juice, bread, and cereals.
helped build bone early in life. Those same If you think you may not be getting
actions can help maintain its strength or enough calcium in your diet, talk with your slow its loss now. Regular weight-bearing doctor before trying a calcium supplement.
exercise (such as walking, running, stair But be careful. Too much calcium can also climbing, or using weights to exercise) at cause health problems.
least three or four times a week can help Your body uses vitamin D to absorb
keep your bones strong. Strengthening
calcium. Getting between 5 and 30 minutes and balance exercises can help you avoid
of sunlight outdoors twice a week will help falls which could cause a broken bone.
your body make the vitamin D it needs. But You can also preserve bone density by
people over the age of 50, especially those eating foods rich in calcium and vitamin D
who live in northern urban areas, may not or, if needed, taking calcium and vitamin D
be exposed to enough sunlight year round
supplements. Foods high in calcium include to make enough vitamin D. Cereals and milk milk and milk products (low-fat ones are
fortified with vitamin D, as well as eggs and probably best), canned fish with soft bones fatty fish, are good sources of this vitamin.
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P O S T M E N O P A U S A L H E A L T H C O N C E R N S
Lifestyle changes can also help protect
DEXA-scan (dual-energy x-ray absorptiometry), your bones. If you smoke, preventing bone to find out how solid your bones are. Two loss is yet another reason to stop. Women spots at high risk for fracture will probably who smoke also seem to go through
be checked—hips and spine.
menopause about 11/2 to 2 years earlier
Sometimes exercise, diet, and lifestyle
than those who don’t smoke. And, if you
changes are not enough, and medicines
drink alcoholic beverages, be careful how are needed. Medications include bisphos-much you drink. Having too much alcohol
phonates, raloxifene, estrogen, calcitonin, might cause you to fall and break a bone in and parathyroid hormone. Some of these
addition to other serious health problems.
build up bone density. Others prevent fur-How will you know if exercise, diet, and
ther bone loss. Talk to your doctor to find lifestyle changes are protecting your bones?
out which would be best for you. Contact
If you are over age 65 or if you are 60 to 64
the National Institute of Arthritis and
and have any of the risk factors described Musculoskeletal and Skin Diseases, listed earlier, don’t wait for a broken bone to find in For More Information, to learn more.
out if you have osteoporosis. Talk to your CARDIOVASCULAR DISEASE
doctor about a bone density test, perhaps a Common cardiovascular diseases include
a narrowing and hardening of the arteries (atherosclerosis), chest pain that happens when not enough blood is getting to the
heart (angina), heart attack, and stroke.
High blood pressure (hypertension) is
a strong risk factor for cardiovascular
disease and stroke.
Many women think, wrongly, that only
men need to worry about cardiovascular
disease. Heart disease and stroke affect
women too. Women seem to be protected
from these diseases until after menopause 21
M E N O P A U S E : T I M E F O R A C H A N G E
when this protection fades. While many
blood pressure or blood sugar can also lead women fear breast cancer, in fact heart
to heart disease, including a heart attack.
disease kills 11 times more women every
Blood sugar that is too high also puts you year. That is why it is so important for
at risk for diabetes, another strong risk women to take steps to reduce their risk.
factor for cardiovascular disease.
Make sure your blood cholesterol
Around the time of menopause, total
(a fatty substance in the blood), blood
cholesterol, LDL (low-density lipoprotein) pressure, and blood sugar are at normal
cholesterol, and triglyceride levels may go levels. Regular medical checkups will show up, and your HDL (high-density lipoprotein whether your results are at normal levels
—the so-called “good” cholesterol) level
(see chart below). If your blood pressure may go down. High levels of LDLs can,
or blood sugar is too high, follow your
in time, lead to blocked arteries. In turn, doctor’s advice to control it. Uncontrolled blocked arteries can result in a heart attack K N O W Y O U R N U M B E R S
The First Step to Heart Health
Factor
Goal
Total Cholesterol
Less than 200 mg/dL
LDL (“Bad”) Cholesterol
Goals vary:
Less than 100 mg/dL, optimal
100 to 129 mg/dL, near optimal/ above optimal 130 to 159 mg/dL, borderline high
160 to 189 mg/dL, high
190 mg/dL and above, very high
HDL (“Good”) Cholesterol
50 mg/dL or higher for a woman
Triglycerides
Less than 150 mg/dL
Blood Pressure
Less than 120/80 mmHg
Fasting Glucose (Blood Sugar) Less than 100 mg/dL
Waist Measurement
Less than 35” for women
Body Mass Index
Less than 25 Kg/m2
Exercise
Minimum of 30 minutes most, if not all days of the week 22
Reprinted with permission, www.goredforwomen.org, ©2007, American Heart Association, Inc.
P O S T M E N O P A U S A L H E A L T H C O N C E R N S
At a regular checkup your doctor will
look for five signs of metabolic syndrome:
◗
Waist size greater than 35” in women
◗
Blood pressure reading of 130/85
or higher
◗
Fasting blood sugar of 100 mg/dL
(milligrams/deciliter) or higher
◗
High triglycerides (over 150 mg/dL)
◗
Low HDLs (less than 50 mg/dL
or stroke. High triglycerides can be another in women)
sign that you are at risk for heart disease or Having only one of these signs can put you diabetes. HDLs (think of H as in healthy) at risk for heart disease or for diabetes. If help keep your arteries clear, so that blood you have at least three of these, you have can flow freely. Get treatment for high LDL, metabolic syndrome. People with metabolic cholesterol, and triglyceride levels to lower syndrome are now known to be at much
your risk of having a stroke or heart attack.
greater risk of heart disease, stroke, and High triglycerides can also be a sign of
type 2 diabetes.
metabolic syndrome, a group of conditions Lifestyle changes—not smoking, avoiding
that put people at risk for heart disease and second-hand smoke, exercising, and follow-diabetes. These include obesity, low HDL
ing a healthy diet—can also help prevent
level, high blood sugar, insulin resistance heart disease. Not smoking or quitting, if (a condition in which the muscle, fat, and you do, will also protect your bones and
liver cells do not properly use the insulin greatly lower your risk for cancer, especially produced by the pancreas), and high blood lung cancer. Work with your doctor to set pressure. Metabolic syndrome is also some-up a plan to lower your risk of heart disease.
times called syndrome X. If your doctor
says you have metabolic syndrome or if he or she is worried that you might be at risk for it, consider changing your lifestyle.
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M E N O P A U S E : T I M E F O R A C H A N G E
Being physically active at least 30 min-
away from the stores to add more walking
utes almost every day will help lower your to your day. Or, don’t use the bus or subway risk of heart disease. You don’t have to be to go one stop—walk instead. Almost anyone, active all at one time. For example, try
at any age, can start being more physically ten-minute intervals three times a day.
active. You might check with your doctor if Exercise should include endurance, also
you aren’t used to energetic activity or you known as aerobic, activities—the kind that have a chronic health problem or a family gets your heart pumping, like walking,
history of early heart disease.
running, swimming, tennis, or bike-riding.
Heart-healthy nutrition starts with less
If you are just beginning to exercise,
fat in your diet and more fruits, vegetables, start slowly. Maybe begin
and whole-grain foods.
by taking the stairs
By using nonfat or low-
whenever possible.
fat dairy products,
First walk up
you can still get the
one flight of
calcium you need
stairs and then
for your bones
add more when
while taking care of
you can. When
your heart. Fruits and
shopping, don’t
vegetables are generally
look for the
low in unhealthy fats,
closest parking
unless fat is added
space—choose
during cooking.
one farther
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P O S T M E N O P A U S A L H E A L T H C O N C E R N S
Keeping a healthy weight will also
When women have problems control-
help prevent heart disease. Exercise and
ling their bladder, especially as they grow a heart-healthy diet should help you do
older, that’s called urinary incontinence, that. More than 30 minutes of moderate
and there are several types. If you have
physical activity on most days are needed if stress incontinence, you might leak urine you want to lose weight—experts recommend when you sneeze, laugh, cough, or step off 60 minutes daily. Watching portion sizes
a curb. Overflow incontinence means there when you eat is important. So is limiting is a problem emptying the bladder, so you added sugars, including drinks like sodas, might leak urine because your bladder is
juices, fruit drinks, and alcohol. And get always full. Urge incontinence means you
enough sleep. Some studies show that women can’t hold the urine until you get to the who get the least sleep gain the most weight.
toilet. Somewhat similar is functional
These lifestyle changes—exercise, a
incontinence, in which you can’t get to the heart-healthy diet, and weight control—
toilet in time because physical problems
will also help prevent or reverse metabolic keep you from moving quickly.
syndrome. This, in turn, will lower your
Urinary incontinence is treatable—don’t
risk for heart disease, stroke, or type 2
try to ignore it or to just live with it. Many diabetes—major causes of illness and
things cause urinary incontinence, including death in older women.
muscle weakness, nerve damage, or infec-
tion. Your doctor can decide on the cause URINARY PROBLEMS
and suggest the most effective treatment.
Urinary problems such as frequent infections This might include bladder control training, and urine leakage sometimes also develop
medicines, implants, or surgery. Contact
at this time. While these changes are not the National Institute of Diabetes and
unusual, they are not necessarily related Digestive and Kidney Diseases, listed in
to menopause. You should still see your
For More Information, to learn more.
doctor, who may be able to help you
control any of these problems.
25
StayingHealthy
The average woman today has more
than one-third of her life ahead of her
after menopause. That means the
menopausal transition is a good time
for lifestyle changes that could help
women make the most of the coming
years. You’ve already read some ways
to protect or improve your health
at this time of life—quitting
smoking, exercising daily, and
working toward a healthy
weight. But, there’s even more
you can do to stay healthy—other
lifestyle changes plus suggestions to
help you work with your health care
providers more effectively.
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S T A Y I N G H E A L T H Y