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Menopause

Facts

• There are three phases of a woman's life cycle following puberty:
  - premenopause or the reproductive phase
  - menopausal phase
  - postmenopausal phase.

• The menopausal phase consists of:

  - Perimenopause: the time immediately before and after menopause (approximately 45 to 47.5 years of age for median onset; this phase can last 5 to 7 years)

  - Menopause: the normal physiologic event where menstruation ceases permanently for at least one year, resulting from ovarian follicle depletion and the subsequent cessation of ovarian function (approximately 50 to 52 years of age, median onset).

• In postmenopause, estrogen levels drop drastically. This drop could cause long-term consequences.

• The number of women in the United States over the age of 50 is increasing. By the year 2010, the number of U.S. women in the postmenopausal stage of their lives will reach about 55 million.

• Life expectancy for U.S. women in 1990 was 78.8 years, indicating that women can expect to live more than one-third of their lives after menopause.

• Postmenopausal women have a significantly higher incidence than men of some debilitating illnesses, such as osteoporosis and certain cancers associated with aging. The risk of heart disease also increases significantly in postmenopausal women.

• The leading cause of death among U.S. women over age 50 is heart disease.

• The relative risk of coronary artery disease in postmenopausal women is approximately 2.7 times that of age-matched premenopausal women.

• Approximately twice as many women die from cardiovascular disease than die from cancer, and the mortality rate due to cardiovascular disease far exceeds that due to gynecologic cancers.

• According to findings from the Framingham Study, identified risk factors for cardiovascular disease have the strongest predictive value in women between the ages 50 to 69 years.

• Seventy-five percent or more of the bone loss that occurs in women the first 15 years of postmenopause can be attributed to estrogen deficieny rather than aging. Women lose 20% of their bone mass in the first five to seven years after menopause.

• Postmenopausal decline in estradiol and in estrogen and progesterone levels leads to a significant decrease in total circulating estrogen levels, which have been shown to correlate with the rate of bone loss in trabecular bone.

• Over 25 million U.S. women may be at risk for bone fractures associated with low bone mass.

• The annual cost implications of postmenopausal women's health is staggering: $10 billion for cardiovascular disease, $13.8 billion for osteoporosis, and $6 billion for breast cancer.

Figure 15

• In the postmenopausal stage, long-term consequences of estrogen loss emerge, often so covertly that they represent potentially serious threats to the health and longevity of the aging female. Significant morbidity and mortality may result from the immediate and long-term loss of estrogen. The most dramatic consequences of estrogen loss are found in the cardiovascular, skeletal, and cerebrovascular systems as well as in cognitive function.

Actions to Decrease the Negative Effects of Menopause

1. Increase public awareness of the benefits of a healthy transition through the menopausal and postmenopausal stages

2. Encourage women to take greater responsibility for their health and well being.

Figure 16: Cost Implications of Postmenopausal Women's Health

For More Information

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