Can I get pregnant during menopause?
The possibility of pregnancy disappears once you are postmenopausal, you have been without your period for an entire year (assuming there is no other medical condition for the lack of menstrual bleeding). However, you can actually get pregnant during the menopause transition (perimenopause). If you don’t want to become pregnant, you should continue to use some form of birth control until you have gone fully through menopause. Ask your healthcare provider before you stop using contraception.
For some women, getting pregnant can be difficult once they’re in their late 30s and 40s because of a decline in fertility. However, if becoming pregnant is the goal, there are fertility-enhancing treatments and techniques that can help you get pregnant. Make sure to speak to your healthcare provider about these options.
What are the long-term health risks associated with menopause?
There are several conditions that you could be at a higher risk of after menopause. Your risk for any condition depends on many things like your family history, your health before menopause and lifestyle factors (smoking). Two conditions that affect your health after menopause are osteoporosis and coronary artery disease.
Osteoporosis, a "brittle-bone" disease, occurs when the inside of bones become less dense, making them more fragile and likely to fracture. Estrogen plays an important role in preserving bone mass. Estrogen signals cells in the bones to stop breaking down.
Women lose an average of 25% of their bone mass from the time of menopause to age 60. This is largely because of the loss of estrogen. Over time, this loss of bone can lead to bone fractures. Your healthcare provider may want to test the strength of your bones over time. Bone mineral density testing, also called bone densitometry, is a quick way to see how much calcium you have in certain parts of your bones. The test is used to detect osteoporosis and osteopenia. Osteopenia is a disease where bone density is decreased and this can be a precursor to later osteoporosis.
If you have osteoporosis or osteopenia, your treatment options could include estrogen therapy.
Coronary artery disease
Coronary artery disease is the narrowing or blockage of arteries that surround the heart muscle. This happens when fatty plaque builds up in the artery walls (known as atherosclerosis). This buildup is associated with high levels of cholesterol in the blood. After menopause, your risk for coronary artery disease increases because of several things, including:
- The loss of estrogen (this hormone also contributes to healthy arteries).
- Increased blood pressure.
- A decrease in physical activity.
- Bad habits from your past catching up with you (smoking or excessive drinking).
A healthy diet, not smoking and getting regular exercise are your best options to prevent heart disease. Treating elevated blood pressure and diabetes as well as maintaining cholesterol levels with medications for selected at-risk people are the standards of care.
Will hormone therapy help prevent long-term health risks?
The benefits and risks of hormone therapy vary depending on a woman’s age and her individual history. In general, younger women in their 50s tend to get more benefits from hormone therapy as compared to postmenopausal women in their 60s. Women who undergo premature menopause are often treated with hormone therapy until age 50 to avoid the increased risk that comes from the extra years of estrogen loss.