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Prevention of diseases after menopause

Background information provide by IMS

Key messages

  • Women spend around 1/3 of their lives after the menopause
  • Many chronic diseases strike within 10 years of the menopause
  • The menopause is an opportunity for women to review their health and make changes which will ensure a healthier life
  • A healthier lifestyle will help towards a better life
  • Women should consider which medical aids are useful for them, e.g. screening, pharmaceuticals

What is the problem?

Women may expect to spend more than a third of their lives after menopause. Beginning in the sixth decade, many chronic diseases will begin to emerge, which will affect both the quality and quantity of a woman's life. Thus, the onset of menopause heralds an opportunity for women to take steps to improve both their quality of life and lifespan. Obesity, metabolic syndrome and diabetes, cardiovascular disease, osteoporosis and osteoarthritis, cognitive decline, dementia and depression, and cancer are the major diseases of concern.

Why is the menopause specifically important?

Most chronic conditions occur as a woman gets older. Some, such as cancer and obesity, occur more frequently simply because of advancing age. Others, such as cardiovascular disease, osteoporosis and possibly dementia, worsen after the menopause, probably because of the sudden halt in oestrogen production.

The menopause is a major health event in the life of each woman. Women should take steps to ensure that the conditions related to the menopause don't become more serious – this may mean lifestyle changes or pharmaceutical intervention, or both. At the same time, it provides each woman with an opportunity to audit her life: to decide how she wants to life the last third of her life, and what she can do to maintain her health as she gets older. So women need to consider a healthier lifestyle.

The scale of the problem - let's put it in context

The age of the natural menopause among women in developed countries is between 50 and 52 years. whereas, in the less developed countries, it is 3–4 years younger.

So very roughly, 900 million women throughout the world have gone through the menopause.

Post-menopause, a number of chronic conditions become more prevalent:

  • Osteoporosis
  • Cardiovascular disease
  • Obesity
  • Diabetes
  • Cancers
  • Dementia, cognitive decline, and depression

Some facts on post-menopausal chronic conditions

Osteoporosis

Osteoporosis, which is deteriorating bone strength resulting in fractures, affects at least 75 million people in Europe, the US and Japan. This figure is increasing rapidly. Osteoporosis-related fractures affect at least 1/3 of women over the age of 50. The loss of oestrogen due to menopause makes women significantly more susceptible to osteoporosis.

Lifestyle and diet should be a mainstay strategy for preserving bone mass after menopause. This means maintaining a good level of fitness, not smoking, eating and drinking sensibly.

There are various pharmaceutical products which can also help prevent osteoporosis (e.g. MHT. Bisphosphonates, SERMS, Denosumab). It may be desirable to undertake both lifestyle modification and pharmaceutical intervention.

Cardiovascular diseases

Cardiovascular diseases are the leading cause of death in women in the developed world. The incidence increases at an annual rate which is greater than in men, once menopause occurs. This suggests that protective factors in premenopausal women are lost at the time of menopause; the major candidate for this protective effect is estrogen. There is good evidence that Menopausal Hormone Therapy is cardioprotective if taken at the right time (within 10 years of the menopause, or under the age of 60). Maintanance of a good lifestyle is essential to prevent cardiovascular disease.

Cancer

Mortality rates for cancer vary by type and region of the world, but mostly increase with age. In 2012, there were 6.7 million cases of cancer in women (of all ages, not just post-menopausal). Breast cancer has the highest post-menopausal incidence. In developed countries, BC incidence increases after menopause, whereas in Asia it is increased before or at menopause. Medications (such as MHT) can increase or decrease the incidence of cancers (although any increased risk is rare). The International Menopause Society encourages cancer screening in the appropriate populations. For this reason it is essential that a woman consults her doctor to see which treatment is right for her. For more detailed information see the 2013 World Menopause Day paper http://www.imsociety.org/world_menopause_month_2013.php

Obesity

In 2008, 14% of the global female population (300 million women) were obese. Although women frequently report weight gain at midlife, studies across different populations have consistently shown that weight gain is primarily influenced by age, not menopause.

Dementia and Depression

Today, about 36 million people world-wide suffer from Alzheimer′s disease and other dementia. This figure is projected to more than double by 2030. Maintaining a healthy and involved lifestyle is important. Women are twice as likely to suffer depression as men. Depression should be
When should women consult a doctor?
Women should use the menopause as a milestone in their lives, and should consult their doctor to discuss their future health. They should also agree to regular check-ups thereafter, e.g. annually.

Tips for a healthy menopause

1. Maintain a regular exercise routine.
2. Restrain intake of caffeine, sugar, salt and alcohol.
3. Do not smoke.
4. Eat foods containing adequate amounts of calcium and vitamin D.
5. Maintain a regular and sufficient sleep schedule.
6. Maintain a low-fat, well-balanced diet.
7. Take hormone therapy if needed.
8. Proactively manage menopause and use it as an opportunity to prevent disease and improve long-term health and quality of life.

More information is available on the IMS website, http://www.imsociety.org/

Content updated 18 October 2014

 

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