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A normal condition where menstrual periods stop due to decreasing levels of hormones from the ovaries. Menopause marks the end of the reproductive age for the women. The average age of menopause in the United States is 51 years. Menopause is abnormal if it occurs too early (under 40 years old). While menopause is normal, many women suffer from hot flashes, sleep disturbances and other symptoms that can be disruptive to their enjoyment of life when entering menopause.
Your doctor may ask these questions to check for this disease:
Menopause is a normal part of aging for women, but some of the symptoms can be uncomfortable and require treatment. For hot flashes, simple measures like dressing in layers, wearing loose clothing and applying cold towels to the body may help alleviate the discomfort. If these fail, seeing a specialist for hormonal therapy can help.
Reviewed By:
Ravi P. Chokshi, MD (Obstetrics and Gynecology (OBGYN), Critical Care)
Current Maternal Fetal Medicine Fellow with Dual board certification in Obstetrics & Gynecology and Critical Care Medicine. | 5+ years experience managing a general Ob/Gyn practice and working in the Intensive Care Unit. | Previously Physician Lead of a large single specialty practice with 8 Physicians and 10+ Advanced practitioners. | Member of the Society of Maternal Fetal Medicine Patient education committee. | Frequent Medscape Consult contributor.
Seiji Kanazawa, MD, PHD (Obstetrics and Gynecology (OBGYN))
Dr. Kanazawa graduated from the Niigata University Faculty of Medicine and received his Ph.D. from the Tohoku University Graduate School of Medicine. He is working on the front line of the General Perinatal Center, including the Tokyo Tama General Medical Center and the National Center for Research in Fertility Medicine, where he provides maternal and fetal care and undertakes clinical research. At Ubie, Dr. Kanazawa has been designing the Ubie AI Symptom Checker and has taken on the role of general obstetrics and gynecology consultation at FMC Tokyo Clinic by providing fetal ultrasound and prenatal consultation.
Content updated on Mar 31, 2024
Following the Medical Content Editorial Policy
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Q.
Is Tamoxifen Hurting? Why Your Body Reacts and Medically Approved Next Steps
A.
There are several factors to consider: tamoxifen shifts estrogen signaling and can cause manageable menopause-like symptoms such as hot flashes, joint aches, mood or vaginal changes, and fatigue, while rare but serious risks like blood clots, stroke, or postmenopausal bleeding need urgent care; for most, its cancer-control benefits outweigh these risks. Do not stop it on your own; review symptoms with your oncologist to adjust timing or medications and use approved options like nonhormonal therapies for hot flashes and vaginal moisturizers, with specialist-guided low-dose vaginal estrogen in select cases, and see below for critical details and red flags that could change your next steps.
References:
* Shobayo F, Nanda R. Side effects of endocrine therapy in breast cancer: current evidence and treatment options. Cancers (Basel). 2021 May 26;13(11):2637. doi: 10.3390/cancers13112637. PMID: 34073860; PMCID: PMC8197711.
* Chen C, Du J, Lin M, Zhong Q, Lu J, Li P. Tamoxifen adherence and associated factors in patients with breast cancer: A systematic review and meta-analysis. J Adv Nurs. 2023 Jul;79(7):2653-2667. doi: 10.1111/jan.15609. Epub 2023 Mar 14. PMID: 36916570.
* Malihi A, Farbod F, Bagheri M, Shomali N, Barati M, Maleki M. Tamoxifen: A Multifaceted Drug in Cancer Therapy with a Dual Role on Toxicity and Therapeutic Efficacy. Cancers (Basel). 2021 Jul 15;13(14):3547. doi: 10.3390/cancers13143547. PMID: 34359654; PMCID: PMC8306060.
* Sartori D, Malagoli A, Del Pup L, D'Andrea D, Verderame F, Bortot L. Strategies for managing endocrine therapy-induced adverse events in patients with breast cancer. Breast Cancer Res Treat. 2023 Aug;200(2):299-311. doi: 10.1007/s10549-023-06950-w. Epub 2023 May 27. PMID: 37240751.
* Pillai C, Shah D, Sharma S, Grewal P. Impact of Tamoxifen and Aromatase Inhibitors on Health-Related Quality of Life in Women With Breast Cancer: A Systematic Review. Clin J Oncol Nurs. 2022 Oct 1;26(5):486-494. doi: 10.1188/22.CJON.486-494. PMID: 36136261.
Q.
Is It Menopause Symptoms? Why Your Body Is Surging & Your Medical Next Steps
A.
Hot flashes, night sweats, mood changes, sleep problems, and irregular periods in your 40s or 50s often point to perimenopause or menopause, which is confirmed after 12 months without a period, and these surges come from fluctuating estrogen, though thyroid disease, medications, pregnancy, and other issues can mimic them. There are several factors to consider. See below for the exact next steps that could change your care plan, including what to track, when to see a doctor, urgent red flags, which tests are useful, and treatment options from lifestyle changes to hormone and non hormonal therapies, plus long term bone and heart protection.
References:
* NAMS. The 2022 Postmenopause Position Statement of The North American Menopause Society. Menopause. 2022 Jul 1;29(7):767-794. doi: 10.1097/GME.0000000000002028. PMID: 35830605.
* American College of Obstetricians and Gynecologists. Clinical practice guideline: Menopause and perimenopause. Obstet Gynecol. 2021 Aug 1;138(2):332-340. doi: 10.1097/AOG.0000000000004456. PMID: 34293776.
* Stuenkel CA, Davis SR, Gompel A, Lumsden MC, Murad MH, Pinkerton JN, Politi MC, Rossouw JM, Santen RJ. Treatment of Symptoms of the Menopause: An Endocrine Society Clinical Practice Guideline. J Clin Endocrinol Metab. 2015 Nov;100(11):3975-4001. doi: 10.1210/jc.2015-2236. Epub 2015 Oct 1. PMID: 26406208.
* Shifren JL, Gass MLS. Management of Menopausal Symptoms: A Review. JAMA. 2014 Oct 22-29;312(16):1675-86. doi: 10.1001/jama.2014.13481. PMID: 25335149.
* Santoro N. Symptoms and Diagnosis of the Menopause Transition. Clin Obstet Gynecol. 2016 Sep;59(3):477-83. doi: 10.1097/GRF.0000000000000228. PMID: 27410065.
Q.
Struggling with Letrozole? Why your body is reacting and medical next steps
A.
Letrozole side effects often come from a rapid drop in estrogen, causing joint and muscle pain, hot flashes and night sweats, fatigue and brain fog, mood changes, vaginal dryness, and longer term bone loss risk. Do not stop it on your own; talk to your clinician about evaluation and options like symptom and lab checks, DEXA scans, switching to anastrozole or exemestane, a brief supervised pause, nonhormonal treatments and exercise for pain and hot flashes, and mental health support, and seek urgent care for chest pain, sudden breathlessness, severe headache, vision changes, signs of fracture, or one swollen leg; fertility patients usually have short-term effects. There are several factors to consider that could change your next steps, so see the complete guidance below.
References:
* Brain E, et al. Managing adverse events in patients treated with aromatase inhibitors for breast cancer. Support Care Cancer. 2021 Jan;29(1):17-26. doi: 10.1007/s00520-020-05837-y. Epub 2020 Nov 6. PMID: 33159516.
* Mao JJ, et al. Aromatase inhibitor-induced musculoskeletal symptoms (AIMSS): a comprehensive review. Breast Cancer Res Treat. 2017 Jul;164(1):1-12. doi: 10.1007/s10549-017-4228-6. Epub 2017 Apr 22. PMID: 28434190.
* Xu R, et al. Adherence to adjuvant endocrine therapy in breast cancer: a systematic review and meta-analysis. Breast Cancer Res Treat. 2020 Aug;183(1):11-23. doi: 10.1007/s10549-020-05703-9. Epub 2020 Jun 2. PMID: 32490333.
* Saligan LN, et al. Management of fatigue in patients with breast cancer undergoing adjuvant endocrine therapy. Breast Cancer Res Treat. 2021 Apr;186(2):333-346. doi: 10.1007/s10549-021-06103-z. Epub 2021 Jan 25. PMID: 33492576.
* Mendenhall AL, et al. Impact of endocrine therapy on quality of life in breast cancer patients: a systematic review. Breast Cancer Res Treat. 2020 Jul;182(1):1-14. doi: 10.1007/s10549-020-05676-4. Epub 2020 May 9. PMID: 32388657.
Q.
Is It Menopause? Why Your Body Is Changing & Medically Approved Next Steps
A.
Irregular periods, hot flashes, sleep and mood changes, and vaginal or urinary symptoms commonly signal perimenopause or menopause driven by declining estrogen and progesterone. Medically approved next steps include lifestyle changes, hormone therapy when appropriate, nonhormonal medicines, vaginal treatments, and preventive care, with urgent evaluation for red flags like heavy or postmenopausal bleeding, chest pain, severe depression, or sudden neurologic symptoms. Key details that can influence which option is safest and most effective for you are covered below.
References:
* Davis SR, Baber RJ. Menopause. Lancet. 2021 May 22;397(10291):1987-1996. doi: 10.1016/S0140-6736(21)00523-1. Epub 2021 Apr 15. PMID: 33865415.
* The NAMS 2022 Postmenopause Position Statement Editorial Board. The 2022 Postmenopause Position Statement of The North American Menopause Society. Menopause. 2022 Oct 1;29(10):1135-1157. doi: 10.1097/GME.0000000000002075. PMID: 36044199.
* Kaunitz AM. Managing the Perimenopause. Obstet Gynecol. 2021 Mar 1;137(3):511-523. doi: 10.1097/AOG.0000000000004245. PMID: 33547214.
* Pinkerton JV, Stuenkel CA, Kaunitz AM, et al. The Menopause Transition: Approach to the Symptomatic Woman. Med Clin North Am. 2019 Jul;103(4):619-633. doi: 10.1016/j.mcna.2019.02.008. Epub 2019 Apr 15. PMID: 31056191.
* Soules MR, Sherman S, Parrott E, et al. The Stages of Reproductive Aging Workshop (STRAW) + 10: addressing the unfinished business of staging reproductive aging. Climacteric. 2013;16(5):592-601. doi: 10.3109/13697137.2013.844649. PMID: 24102127.
Q.
Skin Sagging? Why Your Face Loses Collagen & Medical Next Steps
A.
Facial sagging mostly reflects collagen loss from natural aging, hormonal shifts like menopause, sun exposure, smoking, genetics, and rapid weight change, with deeper changes in fat pads, ligaments, and bone also contributing. Evidence based next steps include daily broad spectrum SPF, prescription retinoids, in office collagen stimulating treatments such as laser, radiofrequency or ultrasound, microneedling, and for select women carefully considered menopausal hormone therapy, plus protein and vitamin C intake and not smoking; sudden one sided droop or rapid change needs urgent care. There are several factors to consider, see below for complete details that can shape the best next step in your care.
References:
* Ganceviciene R, Liakou AI, Theodoridis A, Makrantonaki E, Zouboulis CC. Skin anti-aging strategies. Dermatoendocrinol. 2012 Jul 1;4(3):308-19. doi: 10.4161/derm.22804. PMID: 23467332; PMCID: PMC3583892.
* Farage MA, Miller KW, Elsner P, Maibach HI. Intrinsic and extrinsic factors in skin ageing: a review. Int J Cosmet Sci. 2008 Apr;30(2):87-95. doi: 10.1111/j.1468-2494.2008.00415.x. PMID: 18374021.
* Varani J, Dame KE, Rittie L, Fligiel SM, Kang S, Fisher GJ, Voorhees JJ. Decreased collagen production in chronologically aged skin: roles of age-dependent alteration in fibroblast function and defective mechanical stimulation. Am J Pathol. 2006 Jun;168(6):1861-8. doi: 10.2353/ajpath.2006.051302. PMID: 16723701; PMCID: PMC1606622.
* Dover JS, Alam M, Bhatia AC, Goldberg DJ, Kilmer GP, Kaminer MS. A review of noninvasive and minimally invasive aesthetic procedures in dermatology. J Am Acad Dermatol. 2017 Aug;77(2):341-352. doi: 10.1016/j.jaad.2017.03.003. Epub 2017 Apr 26. PMID: 28457850.
* Shin JW, Kwon SH, Choi JY, Na JI, Huh CH, Lee TR, Ha KS. Molecular mechanisms of dermal aging and antiaging approaches. Int J Mol Sci. 2019 Jul 11;20(14):3425. doi: 10.3390/ijms20143425. PMID: 31307570; PMCID: PMC6678713.
Q.
Internal Thermostat Glitching? The Menopause Truth & Medically-Approved Next Steps
A.
Hot flashes, night sweats, and chills are most often due to estrogen shifts in perimenopause and menopause, which is diagnosed after 12 months without a period. There are several factors to consider, including what is normal versus urgent, how diagnosis works, and how long symptoms last; see below to understand more. Medically approved next steps include hormone therapy, non-hormonal medications, local vaginal estrogen, and targeted lifestyle changes, plus screening for bone and heart health and clear signs that need urgent care. Important details and contraindications can change the right plan for you, so review the complete guidance below.
References:
* Gambacciani, M., & Palacios, S. (2021). The Menopause Transition: Hormonal Changes, Symptoms, and Management Approaches. *Current Opinion in Obstetrics & Gynecology*, *33*(4), 273-278. https://pubmed.ncbi.nlm.nih.gov/34210928/
* Santoro, N., & Komi, J. (2022). Vasomotor Symptoms: Update on Pathophysiology, Differential Diagnoses, and Treatment Options. *The Journal of Clinical Endocrinology & Metabolism*, *107*(11), e4217-e4228. https://pubmed.ncbi.nlm.nih.gov/35939226/
* Shifren, J. L., & Schiff, I. (2021). Hormone Therapy for Vasomotor Symptoms: A Review. *JAMA*, *326*(21), 2189–2200. https://pubmed.ncbi.nlm.nih.gov/34874415/
* Nelson, H. D., & Shifren, J. L. (2023). Nonhormonal management of menopause symptoms: Current options and future directions. *Menopause*, *30*(2), 200–208. https://pubmed.ncbi.nlm.nih.gov/36657158/
* Palacios, S., & Stevenson, J. C. (2020). Current Approaches to the Management of Menopausal Symptoms. *Drugs*, *80*(16), 1649–1661. https://pubmed.ncbi.nlm.nih.gov/32997232/
Q.
Skin Sagging? Why Your Collagen Glue Is Melting & Medical Next Steps
A.
Skin sagging happens mainly because collagen, the skin’s glue, declines and weakens with age, and it can speed up with menopause-related hormone shifts, sun, smoking, rapid weight loss, stress, and poor sleep. Effective medical next steps include daily broad-spectrum sunscreen, prescription retinoids, and in-office collagen-stimulating treatments, with hormone evaluation in menopause and nutrition support, and you should seek care promptly if changes are rapid or accompanied by other symptoms; there are several factors to consider, so see below for important details that can shape your next steps.
References:
* Choi, F. D., Sung, C. T., & Juhasz, M. L. (2018). Collagen: Its Biological Structure and its Use in Skin Aging Treatment. *Journal of Plastic, Reconstructive & Aesthetic Surgery*, *71*(5), 659–666.
* Ganceviciute, A., Saugspolte, V., & Jekabsone, A. (2019). Skin anti-aging strategies. *Dermato-Endocrinology*, *11*(1), e1630138.
* Schlauder, S. M., Mourtada, S., Mourtada, M. M., & Dover, J. S. (2023). Advances in Non-Invasive Skin Tightening Technologies. *Aesthetic Surgery Journal*, *43*(1), NP139-NP149.
* Zasada, M., & Budzisz, E. (2020). Collagen and elastin in the skin: The effect of cosmetic ingredients in improving the skin's appearance. *Advances in Dermatology and Allergology*, *37*(4), 548–557.
* Papageorgiou, C., & Papageorgiou, P. A. (2017). An update on the treatment of facial skin laxity. *Journal of Cosmetic Dermatology*, *16*(3), 304–311.
Q.
5-HTP Serotonin Precursor: Women’s 40+ Wellness Guide & Next Steps
A.
This guide explains how 5-HTP, a serotonin precursor, may help some women 40+ with mild mood shifts, sleep problems, appetite cravings, and migraines, what the mixed but promising evidence shows, and key safety issues like drug interactions and the rare risk of serotonin syndrome. It is not a cure-all or a replacement for medical care, especially if you use antidepressants, have bipolar disorder, are pregnant or breastfeeding, or have liver disease. There are several factors to consider; see below for who should avoid it, key side effects, quality checks, natural supports, and step by step next actions, including assessing symptoms, considering a menopause evaluation, talking with a clinician first, and when to seek urgent care.
References:
* Mironova A, et al. 5-Hydroxytryptophan (5-HTP): A natural amino acid with multiple therapeutic applications. Biomolecules. 2021 Apr 19;11(4):618. doi: 10.3390/biom11040618. PMID: 33924152; PMCID: PMC8074872.
* Pinto B, Gouveia R, et al. 5-Hydroxytryptophan (5-HTP) in neurological disorders: A critical review. J Clin Transl Res. 2022 Mar 11;8(1):15-27. doi: 10.18053/jctres.08.202201.003. PMID: 35359734; PMCID: PMC8970046.
* Jia F, Huang B, Wang H, et al. The effectiveness of 5-hydroxytryptophan on depression and anxiety: A systematic review and meta-analysis. J Clin Pharm Ther. 2019 Apr;44(2):294-306. doi: 10.1111/jcpt.12781. Epub 2018 Dec 20. PMID: 30467770.
* Birdsall C, Salter S, et al. The Use of 5-Hydroxytryptophan for Sleep: A Systematic Review. J Altern Complement Med. 2018 Feb;24(2):100-112. doi: 10.1089/acm.2016.0305. Epub 2017 Dec 29. PMID: 29286295.
* Young SN. 5-Hydroxytryptophan: A clinically effective serotonin precursor. J Psychiatry Neurosci. 2007 Jul;32(4):265-8. PMID: 17657252; PMCID: PMC1977722.
Q.
Bioidentical Hormones for Insomnia: A Woman’s 40+ Action Plan
A.
Bioidentical hormones can help insomnia in women over 40 when sleep problems are tied to perimenopause or menopause, especially hot flashes and night sweats, but they are not sleeping pills and not right for everyone; FDA-approved estradiol and progesterone are preferred over compounded products. There are several factors to consider, including who is a good candidate, key risks and delivery options, and proven nonhormonal treatments like CBT-I, plus a stepwise plan to confirm causes and optimize sleep habits; see below to understand more.
References:
* Stuenkel CA, Gompel A, Pinkerton JV, et al. Bioidentical Hormone Therapy: A Review of the Evidence. Maturitas. 2013 Oct;76(2):111-7. doi: 10.1016/j.maturitas.2013.06.002. Epub 2013 Jul 2. PMID: 23871239.
* Rigolet M, Gompel A, Stuenkel CA, Pinkerton JV. Menopausal Hormone Therapy and Sleep Quality. Climacteric. 2017 Aug;20(4):307-313. doi: 10.1080/13697137.2017.1322055. Epub 2017 May 17. PMID: 28514104.
* Pinkerton JV, Stuenkel CA, Gompel A, et al. Compounded bioidentical hormone therapy: a review. Menopause. 2017 Feb;24(2):206-215. doi: 10.1097/GME.0000000000000780. PMID: 27846051.
* Baker FC, Lee KA, de Zambotti M. The Role of Progesterone in Sleep Regulation in Women: A Narrative Review. Front Endocrinol (Lausanne). 2021 Mar 18;12:656778. doi: 10.3389/fendo.2021.656778. eCollection 2021. PMID: 33815330; PMCID: PMC8013340.
* Kohtz K, Stuenkel CA. Menopausal Hormone Therapy and Sleep: An Updated Review. Curr Sleep Med Rep. 2021 Sep;7(3):149-158. doi: 10.1007/s40675-021-00196-z. Epub 2021 Jul 20. PMID: 34282035.
Q.
Health Symptoms Women 40-50 Shouldn't Ignore: Action Plan
A.
This page outlines the key symptoms women 40 to 50 should not ignore and a clear action plan. While many changes are due to perimenopause, urgent signs include chest pain, heavy or postmenopausal bleeding, new breast changes, sudden severe headaches, shortness of breath, persistent fatigue, unexplained weight change, bowel or bladder changes, and fractures from minor falls. There are several factors to consider, so use the practical steps below to track symptoms, stay current on screenings, optimize lifestyle, and know when to seek emergency care or schedule evaluation with your clinician; important red flags and next steps are detailed below.
References:
* Ambikairajah A, Walsh K, Papalia R, et al. The Perimenopause: Common Symptoms, Management and Risks. Aust J Gen Pract. 2021 Jul;50(7):445-452. doi: 10.31128/AJGP-02-21-5825. PMID: 34228965.
* Santoro N, Roeca C, Peters BA, et al. Changes in Women's Health During the Perimenopausal Transition and Beyond. J Womens Health (Larchmt). 2017 Aug;26(8):841-847. doi: 10.1089/jwh.2016.6025. PMID: 28402773.
* Appelman YEA, van Rijn MJ, Ten Cate H, et al. Cardiovascular Disease Risk Factors in Midlife Women. Curr Treat Options Cardiovasc Med. 2017 Jan;19(1):4. doi: 10.1007/s11936-017-0504-2. PMID: 28168598.
* Soares CN, Zomkowski M. Mental health and the menopause: A systematic review. Maturitas. 2018 Nov;117:79-90. doi: 10.1016/j.maturitas.2018.09.003. PMID: 30343834.
* Panay N, Briggs P, Maas-Enriquez M. Cancer screening in women. Climacteric. 2020 Feb;23(1):15-20. doi: 10.1080/13697137.2019.1678229. PMID: 31697486.
Q.
Morning Sunlight Exposure for Women 40+: Benefits & Next Steps
A.
Morning sunlight for women 40-plus can steady circadian rhythms to support hormone balance, better sleep, brighter mood, bone health through vitamin D, metabolic control, and heart health; a simple start is 10 to 20 minutes outside within 30 to 60 minutes of waking with skin-safe habits. There are several factors to consider. See below to understand how to adjust for weather and seasons, when a light box may help, which symptoms require medical care, and the next steps like tracking changes and asking your doctor about vitamin D testing.
References:
* Kim S, et al. Effects of Light Exposure on Sleep-Wake Cycle and Mood in Postmenopausal Women: A Randomized Controlled Trial. J Clin Sleep Med. 2021 Mar 1;17(3):511-519. doi: 10.5664/jcsm.9009. PMID: 33174246.
* Al-Sharman AM, et al. Daytime Light Exposure and its Relationship to Sleep and Circadian Rhythm in Women Across the Menopause Transition. J Womens Health (Larchmt). 2021 Oct;30(10):1448-1457. doi: 10.1089/jwh.2020.8931. PMID: 34185127.
* Perraudin C, et al. The impact of natural light exposure on sleep and mental health outcomes in women: a systematic review. J Affect Disord. 2023 Apr 1;326:220-234. doi: 10.1016/j.jad.2023.01.109. PMID: 36746271.
* Holick MF, et al. Sunlight exposure and vitamin D status in postmenopausal women. J Clin Endocrinol Metab. 2011 Dec;96(12):3731-6. doi: 10.1210/jc.2011-1372. PMID: 21976239.
* Płudowski P, et al. Impact of vitamin D and sunshine exposure on bone mineral density in postmenopausal women. Arch Med Sci. 2022 Mar 11;18(5):1377-1384. doi: 10.5114/aoms/148480. PMID: 36304419.
Q.
Women 40-50: Neurological & Psychological Intersections & Next Steps
A.
Women 40 to 50 often experience brain fog, sleep disruption, headaches, irritability, and new anxiety as fluctuating estrogen and progesterone affect brain chemistry, mood, memory, and sleep. There are several factors to consider. See below for how to distinguish hormonal changes from other conditions like thyroid, B12, or iron problems, and for next steps including tracking symptoms, prioritizing sleep, exercise and nutrition, discussing options like hormone therapy or SSRIs/SNRIs with a clinician, and the red flags that warrant urgent care.
References:
* Cain M, Lamoureux E, Chahwan M, Bherer L, Lavoie S. Brain structural and functional changes in menopause and perimenopause: A systematic review. Front Aging Neurosci. 2021 May 26;13:663249. doi: 10.3389/fnagi.2021.663249. PMID: 34108849.
* Greendale GA, Karlamangla AS, Maki PM. Cognitive changes during the menopausal transition: The effect of ovarian hormones. Neurosci Biobehav Rev. 2020 Apr;111:159-171. doi: 10.1016/j.neubiorev.2020.02.010. Epub 2020 Feb 13. PMID: 32061989.
* Gordon-Smith EC, Smith GC. Mental health and well-being in midlife women: a narrative review. Maturitas. 2023 Sep;175:107775. doi: 10.1016/j.maturitas.2023.107775. Epub 2023 Jul 1. PMID: 37402636.
* Gibson CJ, Epperson CN. Neurobiological underpinnings of perimenopausal depression. Neuropsychopharmacology. 2022 Feb;47(3):614-627. doi: 10.1038/s41386-021-01258-8. Epub 2022 Jan 20. PMID: 35058564.
* Savard C, Chételat G, Jetté N, Émond M, Gagnon N, Dufour-Rainville E, Élie F, Dubé F, Desrochers C, Bocti C. Hormone Therapy and Cognition in Women: A Systematic Review. JAMA Neurol. 2021 Nov 1;78(11):1373-1384. doi: 10.1001/jamaneurol.2021.3283. PMID: 34487140.
Q.
Melatonin for Women 30-45: Safety, Hormones & Vital Next Steps
A.
Melatonin for women 30 to 45 is generally safe for short-term sleep support at low doses (about 0.5 to 3 mg), but it can influence reproductive hormones, may affect ovulation at higher doses, and will not correct root causes like perimenopause, thyroid problems, or mood disorders; there are several factors to consider, and the specifics are below. For vital next steps, start low and reassess after a few weeks, and talk to a clinician if you are trying to conceive or have irregular bleeding, severe night sweats, persistent insomnia, or mood changes so underlying issues are evaluated and the right plan is chosen, with important details outlined below.
References:
* Anis M, Aseel M, El-Said I. Melatonin in female reproduction: a clinical perspective. Minerva Obstet Gynecol. 2021 Jul;73(4):460-466. doi: 10.23736/S2724-606X.21.04838-5. Epub 2021 Apr 22. PMID: 33887018.
* Gupta S, Pathak A, Kumar S, Mishra S, Singh J, Verma S. Melatonin and female infertility: A clinical overview. Front Endocrinol (Lausanne). 2022 Dec 15;13:1085028. doi: 10.3389/fendo.2022.1085028. PMID: 36590729; PMCID: PMC9797204.
* Hu Y, Ma X, Han X, Zhao R, Yang C, Fu Y, Han S, Zhang Y. The effect of melatonin on oxidative stress markers, pregnancy rate, and clinical outcomes in women undergoing assisted reproductive technology: A systematic review and meta-analysis. Front Endocrinol (Lausanne). 2022 Nov 25;13:1052608. doi: 10.3389/fendo.2022.1052608. PMID: 36498877; PMCID: PMC9734187.
* Bonomini F, Laudadio E, Cinelli M, Bresciani M, Borsani E, Favero G, Rodella LF. Melatonin and Human Reproduction. Oxid Med Cell Longev. 2018 Sep 11;2018:4927164. doi: 10.1155/2018/4927164. PMID: 30279899; PMCID: PMC6154316.
* Li Y, Wang H, Wang J, Zhang Z, He Y. Impact of Melatonin on Hormonal Imbalance and Female Reproductive Diseases. Front Endocrinol (Lausanne). 2022 Jul 11;13:922241. doi: 10.3389/fendo.2022.922241. PMID: 35898741; PMCID: PMC9313261.
Q.
Methylene Blue for Women 30-45: Benefits & Your Action Plan
A.
For women 30 to 45, methylene blue may support brain clarity, mood, and cellular energy, but evidence is early, benefits are not guaranteed, and risks like serotonin syndrome and G6PD-related anemia mean it should only be considered at low doses with medical guidance. There are several factors to consider. See below for a step-by-step action plan with foundational fixes, lab checks for thyroid, iron, and hormones, perimenopause guidance, who should avoid it, medication interactions especially with SSRIs and SNRIs, safe-use tips, and when to talk to a doctor about next steps.
References:
* Pinto-Silva M, Martins C, Almeida S, Santos J, Silva AP. Methylene Blue as a Potential Treatment for Oxidative Stress-Related Diseases. Antioxidants (Basel). 2021 Sep 10;10(9):1443. doi: 10.3390/antiox10091443. PMID: 34573121; PMCID: PMC8469850.
* Tarasova V, Yapar C, Abud EM, Li H, Chen Z, Pan Y, Wang P, Liu H. Methylene blue: a future drug for neuroprotection? Drug Discov Today. 2020 Sep;25(9):1643-1648. doi: 10.1016/j.drudis.2020.06.002. Epub 2020 Jun 16. PMID: 32559591.
* Alda M, D'Souza S, Ramezani A, Zekaj E, Karuppagounder SS, Singh AK, Gandy S, Kumar U, Miriyala S, D'Souza C, Kaja S, Kumar S. Methylene Blue: A Versatile Therapeutic Agent with Diverse Mechanisms of Action. Int J Mol Sci. 2022 Nov 22;23(24):14555. doi: 10.3390/ijms232414555. PMID: 36555135; PMCID: PMC9782570.
* Xie L, Zhang B, Shi H, Zhang Q, Guo Y, Hou M. Methylene blue delays cellular senescence and aging through mitochondrial rejuvenation and epigenetic regulation. Aging Cell. 2022 Mar;21(3):e13589. doi: 10.1111/acel.13589. Epub 2022 Feb 21. PMID: 35191349; PMCID: PMC8922579.
* Cai Z, Hu B, Cao D, Li Z, Hu S. Methylene Blue as a Potential Therapeutic Agent for Neurodegenerative Diseases: A Focus on Mood and Cognitive Dysfunction. J Alzheimers Dis. 2020;77(1):1-14. doi: 10.3233/JAD-200388. PMID: 32628172.
Q.
Cottage Cheese: Managing Health Symptoms for Women Over 65
A.
Cottage cheese can be a practical, nutrient-dense choice for women over 65, offering high-quality protein to help limit age-related muscle loss, calcium and phosphorus to support bones, and low carbs that may steady blood sugar while aiding weight maintenance. There are several factors to consider. See below to understand more about choosing lower-sodium options if you have high blood pressure, when kidney disease or dairy allergy means caution, sensible portions and easy ways to add it, and when to seek medical guidance for ongoing symptoms so you can decide your best next steps.
References:
* Reitelseder S, Bechshøft CF, Højfeldt G, Larsen AE, Kristensen M, Ritz C, Bæk A, Hansen M. Dairy Protein Intake and Muscle Mass and Strength in Older Adults: A Systematic Review and Meta-analysis of Randomized Controlled Trials. Clin Nutr. 2022 Mar;41(3):702-716. doi: 10.1007/s00198-021-06246-8. Epub 2021 Dec 29. PMID: 35000570.
* Zheng D, Wu T, Wu Y, Yang M, Lin X. Dairy Product Consumption and Risk of Osteoporosis in Older Women: A Meta-Analysis. Nutrients. 2022 Jan 1;14(1):166. doi: 10.3390/nu14010166. PMID: 35010996; PMCID: PMC8747447.
* Dhana K, van Dam RM, Chae CU. Higher Protein Intake and Weight Management in Healthy Older Adults: A Systematic Review of Randomized Controlled Trials. Nutrients. 2021 Sep 7;13(9):3121. doi: 10.3390/nu13093121. PMID: 34579042; PMCID: PMC8468764.
* Zhong J, Chen GC, Zhao H, Hou J, Zhang J, Li K, Li D. Dairy products and the risk of type 2 diabetes: A systematic review and dose-response meta-analysis of cohort studies. Am J Clin Nutr. 2023 Nov;118(5):983-999. doi: 10.1016/j.ajcn.2023.08.017. Epub 2023 Aug 24. PMID: 37626996.
* Guo J, Astrup A, Lovegrove JA, Gijsbers L, Givens DI, Soedamah-Muthu SS. Dairy intake and the risk of cardiovascular disease and mortality: a systematic review and meta-analysis of prospective cohort studies. Clin Nutr. 2021 Apr;40(4):1833-1845. doi: 10.1016/j.clnu.2020.08.011. Epub 2020 Aug 17. PMID: 32888636.
Q.
Is Naproxen Safe After 65? What Every Woman Needs to Know
A.
Naproxen can be appropriate for some women after 65, but age increases the risks of stomach and intestinal bleeding, kidney problems, heart complications, and medication interactions, so it should be taken only at the lowest effective dose for the shortest time with medical oversight. There are several factors to consider, including your health conditions, other drugs you take, safer alternatives like acetaminophen or topical NSAIDs, and warning signs that need urgent care. See below for complete details and practical steps to decide the safest next move with your clinician.
References:
* Buser M, Luedi M, Schoenenberger L, et al. Adverse effects of NSAIDs in older adults. Ther Adv Drug Saf. 2018;9(1):29-37. doi:10.1177/2042098618765013.
* Kahan SM, Solosko CL, Tishler L. Nonsteroidal Anti-Inflammatory Drugs in Older Adults: A Narrative Review. Drugs Aging. 2020;37(8):561-570. doi:10.1007/s40266-020-00787-8.
* Gislason GH, Johnsen SP, Nørgaard ML, et al. Cardiovascular Safety of Non-Steroidal Anti-Inflammatory Drugs in Older Adults. Drugs Aging. 2021;38(8):697-705. doi:10.1007/s40266-021-00870-1.
* Chang CH, Chen YC, Yeh YC, et al. Risk of gastrointestinal bleeding with selective and non-selective NSAIDs: a meta-analysis of observational studies. Br J Clin Pharmacol. 2017;83(12):2800-2810. doi:10.1111/bcp.13398.
* Cieslak JB, Khayata H, Cieslak D, et al. Polypharmacy in Older Women: A Review. J Womens Health (Larchmt). 2020;29(5):637-643. doi:10.1089/jwh.2019.8055.
Q.
Latest Health News: Vital Breakthroughs for Women Over 65
A.
Key breakthroughs for women over 65 include more personalized heart risk prevention, earlier memory detection with new Alzheimer’s options, faster-acting osteoporosis therapies plus fall-prevention, tailored cancer screening, stronger senior-focused vaccines, and gentler diabetes and gut health strategies. There are several factors to consider that could change your next steps, including individualized blood pressure and statin plans, whether to continue certain screenings, and which boosters to get; see below for practical details and what to discuss with your clinician.
References:
* Regitz-Zagrosek V, Oertelt-Prigione S, Prescott E, et al. Sex Differences in Cardiovascular Disease. Circ Res. 2022 Mar 4;130(5):679-692. doi: 10.1161/CIRCRESAHA.121.319711. Epub 2022 Mar 3. PMID: 35240248.
* Tu KN, Kang S, Kim S, Chung YS. Emerging treatments for osteoporosis: an update on pharmacological options. J Bone Metab. 2023 Feb;30(1):15-28. doi: 10.11005/jbm.2023.30.1.15. Epub 2023 Feb 28. PMID: 36855140.
* Zsido GA, Napiwotzky L, Klafke L, Hueston CM, Miller WM, Balthasar M, Stöckl L, Thormann M, Sacher J. Hormone therapy and risk of Alzheimer's disease: a critical review and future directions. Brain Commun. 2021 Nov 22;3(4):fcab253. doi: 10.1093/braincomms/fcab253. PMID: 34870020; PMCID: PMC8610111.
* Lheureux S, Gourley C, Vergote I, Ledermann JA. Advances in the Management of Ovarian Cancer: A Review. JAMA Oncol. 2021 Sep 1;7(9):1409-1418. doi: 10.1001/jamaoncol.2021.1611. PMID: 34160492.
* Vetrano DL, Wirth R, Rolland Y, et al. Healthy aging: a review of the evidence. Eur Geriatr Med. 2022 Oct;13(5):955-962. doi: 10.1007/s41999-022-00683-0. Epub 2022 Feb 7. PMID: 35132549.
Q.
Oil of Oregano for Women 65+: Natural Benefits & Safety Tips
A.
Oil of oregano may support immunity, digestion, and mild inflammation in women 65+, but it is a concentrated supplement and there are several factors to consider. For safer use, keep doses low and short-term with products labeled for internal use, monitor for side effects, and check for interactions with medicines like blood thinners, diabetes, or blood pressure drugs; see the complete guidance below on who should avoid it, when to talk to a doctor, and other details that could influence your next steps.
References:
* Jaiswal SK, Singh MK, Singh S, Mehra M, Singh DK, Dwivedi R, Mahto H, Singh A. A comprehensive review on ethnopharmacological uses, phytochemistry, and pharmacological activities of Origanum vulgare L. J Ethnopharmacol. 2020 Jul 15;257:112832. doi: 10.1016/j.jep.2020.112832. Epub 2020 Apr 23. PMID: 32684177.
* Khedher A, Ghannay S, Hajlaoui H, Ghrab D, Benammar R, Ben Salah H, Messaoud C. Antimicrobial and Antioxidant Activities of Oregano (Origanum vulgare L.) Essential Oil. Molecules. 2022 Jan 5;27(1):322. doi: 10.3390/molecules27010322. PMID: 35010633; PMCID: PMC8747477.
* Srivastava SK, Singh P, Mishra G, Singh A. Safety assessment of Origanum vulgare (oregano) essential oil. Regul Toxicol Pharmacol. 2018 Nov;99:118-125. doi: 10.1016/j.yrtph.2018.09.006. Epub 2018 Sep 11. PMID: 29775317.
* Chami N, Bennis S, Chami F, Abourriche A, Boulam Anwar E, Sendide K, Remmal A. Antifungal activity of oregano essential oil against Candida albicans. J Mycol Med. 2017 Sep;27(3):399-405. doi: 10.1016/j.mycmed.2017.03.003. Epub 2017 Mar 29. PMID: 28836521.
* Ulusoy HG, Yildiz S. Therapeutic potential of carvacrol in disease prevention. Nutr Rev. 2018 Jan 1;76(1):50-61. doi: 10.1093/nutrit/nux059. PMID: 29339327.
Q.
Quercetin for Women 65+: Benefits for Aging, Heart & Immunity
A.
Quercetin may gently support healthy aging in women 65+ by helping reduce oxidative stress and inflammation, with modest benefits for blood vessel function, blood pressure, and immune efficiency when paired with a heart-healthy lifestyle. There are several factors to consider, including potential medication interactions, dose and absorption differences between foods and supplements, and that it should not replace prescribed care; for food sources, safety guidance, and when to talk to a doctor, see below.
References:
* D'Andrea G. Quercetin: A Review of Bioactivity and Applications. Molecules. 2015 Oct 13;20(9):11769-95. doi: 10.3390/molecules200917769. PMID: 26470054.
* Vakilha R, Moradi M, Nazari H, Farsinezhad L, Salehi B, Shahrzad MK. Effect of Quercetin Supplementation on Cardiometabolic Markers in Postmenopausal Women: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Complement Med Res (Basel). 2022;29(5):387-400. doi: 10.1159/000525997. Epub 2022 Aug 2. PMID: 35919632.
* Khatib N, Almatrafi F, Almatrafi S, Alshahrani S, Alsaiari A. Quercetin and immunity: A narrative review. J Food Biochem. 2023 Mar;47(3):e14532. doi: 10.1111/jfbc.14532. Epub 2023 Jan 3. PMID: 36611417.
* Chung JY, Shin D, Hong YJ, Lim S, Lee H, Kang JS, Chon S, Kim S, Park HS, Oh S. The senolytic effects of quercetin and its derivatives: A review. J Funct Foods. 2022 Nov;98:105295. doi: 10.1016/j.jff.2022.105295. Epub 2022 Sep 1. PMID: 36230691.
* Boesch-Saadatmandi C, Wolffram S, Rimbach G. Effect of quercetin on age-related changes in the expression of antioxidant and inflammation-related genes in rat liver. Exp Gerontol. 2010 Mar;45(3):189-95. doi: 10.1016/j.exger.2009.11.009. Epub 2009 Nov 27. PMID: 19944111.
Q.
Sea Moss for Women Over 65: 5 Vital Benefits for Healthy Aging
A.
For women over 65, sea moss may support healthy aging by aiding thyroid function, easing digestion, contributing minerals for bones and muscles, offering gentle immune support, and promoting skin, hair, and overall vitality. There are several factors to consider, and key context that could change next steps is explained below. Because benefits depend on iodine balance, product quality, dose, and your medications or conditions, start low, choose tested products, and talk with your doctor. See the safety, dosing, and when-to-seek-care guidance below to inform your next steps.
References:
* Liu Y, Jiang Z, Chen C, Zhao Q, Li X, Lin H, Wu Y. Dietary carrageenan from Chondrus crispus modulates the gut microbiota composition and improves intestinal barrier function in mice. Food Funct. 2018 Jan 24;9(1):159-166. doi: 10.1039/c7fo01185f. PMID: 29285409.
* Sun Y, Wang C, Wang J, Shi Z, Wei M. Anti-inflammatory and antioxidant activities of polysaccharides from Chondrus crispus. Int J Biol Macromol. 2021 May 1;179:50-59. doi: 10.1016/j.ijbiomac.2021.02.139. PMID: 33549721.
* Ye M, Yu X, Lv X, Wang Y, Xu H. Immunomodulatory effects of sulfated polysaccharides from Chondrus crispus in vitro. Int J Biol Macromol. 2016 Oct;91:982-987. doi: 10.1016/j.ijbiomac.2016.06.012. PMID: 27417086.
* Mishra AK, Sreedevi G, Jha B, Singh M, Ramalakshmi R, Singh S, Maity D, Jayabalan R. Health benefits of seaweed derived bioactive compounds for geriatric population. J Food Sci Technol. 2016 Apr;53(4):1757-1766. doi: 10.1007/s13197-016-2187-y. PMID: 27162391.
* Lozano-Méndez M, Olivares-Bañuelos TN, Aguilar-Hernández DA, Chávez-Salgado RA, Escalona-Monge L, Cruz-Monterrosa RG, Castillo-Ruiz O. Health-promoting properties of red edible seaweeds: A comprehensive review. J Food Sci. 2022 Jul;87(7):2974-3001. doi: 10.1111/1750-3841.16198. PMID: 35762024.
Q.
Why Women Over 65 Need Chickpeas: The Secret to Healthy Aging
A.
Chickpeas are a healthy aging powerhouse for women over 65, offering protein, fiber, and key minerals that help maintain muscle and mobility while supporting bones, heart health, digestion, steady blood sugar, brain function, and weight stability. There are several factors to consider. For portion ideas, affordable ways to use them, and important cautions such as kidney or digestive conditions and when to speak to a doctor, see the complete guidance below.
References:
* Esmaeili M, Esfandiari M, Mozaffari-Khosravi H, et al. Legume consumption and bone mineral density in postmenopausal women: A systematic review and meta-analysis. J Nutr Sci. 2022;11:e65. doi:10.1017/jns.2022.65
* Xu M, Meng S, Zhang Q, et al. Consumption of pulses and risk of cardiovascular diseases: A systematic review and meta-analysis of prospective cohort studies. Sci Rep. 2021;11(1):1898. doi:10.1038/s41598-020-81156-z
* Sun M, Zhao G, Zhang J, et al. Dietary fiber intake and risk of cognitive decline in older adults: A systematic review and meta-analysis. J Nutr Health Aging. 2023;27(4):295-304. doi:10.1007/s12603-023-1906-8
* Pinheiro MB, de Azevedo SC, Bacha JM, et al. Role of plant-based protein in the prevention and management of sarcopenia: A systematic review. J Nutr Sci. 2023;12:e83. doi:10.1017/jns.2023.83
* Thompson HJ, McDougall M. Health benefits of pulses and their effects on chronic disease. Br J Nutr. 2021;126(Suppl 2):S10-S23. doi:10.1017/S000711452100139X
Q.
Can menopause cause prolonged heavy bleeding?
A.
Yes, menopause can lead to prolonged heavy bleeding, particularly during the menopausal transition, which is the period leading up to menopause known as perimenopause. This phase is characterized by hormonal fluctuations that can significantly affect menstrual patterns.
References:
Paramsothy P, Harlow SD, Greendale GA, Gold EB, Crawford SL, Elliott MR, Lisabeth LD, Randolph JF Jr. Bleeding patterns during the menopausal transition in the multi-ethnic Study of Women's Health Across the Nation (SWAN): a prospective cohort study. BJOG. 2014 Nov;121(12):1564-73. doi: 10.1111/1471-0528.12768. Epub 2014 Apr 16. PMID: 24735184; PMCID: PMC4199918.
El Khoudary SR, Qi M, Chen X, Matthews K, Allshouse AA, Crawford SL, Derby CA, Thurston RC, Kazlauskaite R, Barinas-Mitchell E, Santoro N. Patterns of menstrual cycle length over the menopause transition are associated with subclinical atherosclerosis after menopause. Menopause. 2021 Oct 11;29(1):8-15. doi: 10.1097/GME.0000000000001876. PMID: 34636354; PMCID: PMC9178927.
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Link to full study:
https://www.medrxiv.org/content/10.1101/2024.08.29.24312810v1Minkin MJ. Menopause: Hormones, Lifestyle, and Optimizing Aging. Obstet Gynecol Clin North Am. 2019 Sep;46(3):501-514. doi: 10.1016/j.ogc.2019.04.008. Epub 2019 Jun 21. PMID: 31378291.
https://www.sciencedirect.com/science/article/abs/pii/S0889854519300518?via%3DihubPaciuc J. Hormone Therapy in Menopause. Adv Exp Med Biol. 2020;1242:89-120. doi: 10.1007/978-3-030-38474-6_6. PMID: 32406030.
https://link.springer.com/chapter/10.1007/978-3-030-38474-6_6ACOG Patient FAQ
https://www.acog.org/womens-health/faqs/the-menopause-yearsACOG Practice Bulletin
https://www.acog.org/clinical/clinical-guidance/practice-bulletin/articles/2014/01/management-of-menopausal-symptoms