Menopause In the New Millennium

By Ofer Zur, Ph.D.

As Baby Boomers enter midlife, millions of women (more than ever in human evolution) are facing menopause. An unprecedented number of women are making the transition through “the change”, creating a massive impact on the healthcare and integrative medical systems, as well as increasing the use of numerous alternative treatments. With so many women entering this phase of their lives, it is imperative that clinical personnel be aware of the parameters, symptoms and solutions of this physical, psychological and emotional passage.

Recent studies show:

  • In 1900, the average life expectancy for an American woman was 48 years. Today, most women experience menopause between ages 45-55.
  • Some symptoms that are commonly considered menopausal may actually be related to aging in general.
  • Contrary to the myth that postmenopausal women are sexless, studies show that about 50% experience no change in sexual appetite and pleasure, over 30% experience an increase, and less than 20% experience a decline.
  • In the US, almost half of all postmenopausal women studied report having used hormone replacement therapy (HRT). Most often, HRT is taken in pill form.
  • Although most women started using HRT around the time of menopause, 25% started taking it five or more years after menopause.
  • Among women who were at least 10 years postmenopause, 14% had taken HRT pills for at least 10 years.
  • Compared to women with natural menopause, those with surgically-induced menopause were much more likely to have used HRT and also more likely to be currently using it.
  • There was no difference in HRT use among age groups for women with natural menopause.
  • Non-Hispanic white women were more likely to use HRT than either non-Hispanic black or Mexican American women.
  • Women with more than a high school education, or whose household income was above the poverty level, were more likely to use HRT than women with less education or lower family income.
  • There are no substantial differences between HRT users and nonusers in terms of risky health behaviors and self-reported health issues.
  • Diabetes was twice as prevalent among nonusers and past HRT users than among current users.
  • Approximately 45% of women 40-60 years of age reported receiving counseling from a physician about the pros and cons associated with using HRT after menopause.
  • Women with higher levels of education were more likely to receive counseling than women with less education, regardless of race or ethnicity.
  • Women who had received recent preventive health services, such as mammograms, pap smears and general examinations, were much more likely to have received HRT counseling than those who had not.
  • Of all ambulatory medical care visits by women 40 years of age and over, 7.5% used an HRT prescription.
  • Obstetric/gynecology visits were 1.9 times more likely to result in an HRT prescription than visits to primary care physicians.
  • On average, women develop heart disease approximately 10 years later than men, but the largest increase in coronary mortality coincides with menopause.
  • Osteoporosis affects an estimated one in six women and one in sixteen men over the age of 50.
  • Women can lose up to 20 percent of their bone mass in the five to seven years following menopause.
  • Aerobic, weight-bearing and resistance exercise improves bone mineral density (BMD) in postmenopausal women, whether or not they use hormone therapy.
  • Perimenopausal and postmenopausal women differ hormonally and experientially. Therapies tested on one population should not necessarily be extrapolated to the other.
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