Bladder problems. Women may need to urinate more often and more urgently than before menopause. They may also leak urine when coughing or sneezing. The problem starts when estrogen levels drop and the lining of the urethra and bladder wall thins and pelvic muscles weaken. Kegel exercises strengthen the muscles, and certain supplements and devices may help stop the leaking.
Heart disease. At menopause, women's cholesterol levels increase, and they are more likely to develop clogged arteries and to have a heart attack. Exercising, eating a low-fat, largely vegetarian diet and managing stress all help keep the heart healthy. Doctors have long thought that taking estrogen protects against heart disease, but this claim is now coming under question. Medications are also available for women who have heart disease or high cholesterol.
Osteoporosis. Estrogen is one of two female hormones that help keep bones, including the spine, healthy. So after menopause many women are at risk of developing osteoporosis, or fragile, brittle bones.
Here's the skinny on osteoporosis. Bone is living tissue. For many years, your bones continue to fill out, using the minerals you take in through your diet or in supplements (especially calcium, vitamin D and vitamin K) to achieve maximum bone mass. But bone mass peaks in your mid-30s.
After that, if you lead a relatively normal life, you'll maintain bone mass for a while. (Excessive dieting, or use of caffeine or alcohol, for instance, can deprive your body of the minerals needed for bone mass maintenance and you may begin to lose bone early.)
Normally, during the first five years after menopause, bone mass is reduced by three percent per year. Doing weight-bearing exercises and eating a healthful diet high in green leafy vegetables and vegetables high in calcium like broccoli can help to maintain bone mass and prevent osteoporosis.
Taking estrogen helps also, but the benefit disappears when a woman stops taking the medication. Drugs designed specifically to prevent osteoporosis are also available. Get a bone density test if you are concerned you are at risk for this disease. Women who are at greatest risk are short, slender, fair-skinned, blonde, blue-eyed, and have a family history of osteoporosis. You may also be at risk if you had an early or surgical menopause.