Menopause is the time in a woman’s life when her ovaries wind down their production of the female sex hormones estrogen and progesterone and the body stops releasing eggs. A woman is considered to have entered menopause when she does not have a menstrual cycle for twelve consecutive months. Menopause occurs on average at age 51 with 95 percent of women become menopausal between the ages of 45 and 55. For various reasons, it can occur earlier or later in life.

For two to eight years before menopause (perimenopause), women may begin to experience mild to severe changes that could include hot flashes, weight gain, mood swings and depression.

Postmenpausal women also face an increased risk of heart disease and osteoporosis, a condition characterized by a decrease in bone mass and density. Older women are especially prone to osteoporosis, which results in porous and fragile bones.

Over the last few decades, many women have addressed the side effects of menopause or postmenopause with hormone replacement therapy (HRT). HRT may range from a few months to a few years, with the goal of tapering off estrogen once menopause had occurred.

Over the last few decades, hormone replacement therapy (HRT) has been recommended to many menopausal and postmenopausal women. HRT can help combat the side effects of menopause but there are both positive and negative factors associated with the treatment. It was believed to help protect women from the increased risk of heart disease and osteoporosis.

In recent years, however, new evidence has come to light that casts doubt on the protective effect of long-term hormone replacement therapy. A set of large studies called the Women’s Health Initiative found that combination estrogen/progestin therapy does not lower the overall risk of heart disease and may actually be associated with an increased risk of breast cancer, stroke, blood clots and heart attacks. The same study found that estrogen-only therapy posed similar risks, but also had substantial benefits. In short, long-term hormone replacement therapy is a complicated topic, and women are urged to discuss its benefits and risks with their physicians.

Whether or not women choose HRT, all women should make lifestyle changes such as quitting smoking, eating a heart-healthy diet and controlling their weight. Women should also get regular exercise and control both diabetes and high blood pressure. Research has shown that women should address their heart disease risk factors – including cholesterol levels – as they approach menopause.