Is it Aging or Menopause?

Looking at the first two lists above, not one of the problems is one any of us would choose to have. Is this list the inevitable effect of aging, or is the event of menopause a separate and intensifying risk factor? Consider this analogy. Many of us take antihypertensive medications although we have no obvious problems except for an elevated blood pressure reading. Yet these medications have to be taken daily and many have side effects that are troubling. We take them to prevent a future problem, even though we feel all right today. Antihypertensive drugs have helped to decrease the incidence of stroke, heart failure, and heart attack in the United States. They have literally saved and prolonged millions of lives by decreasing the rate of heart attack and stroke in this country. Years ago, we did not treat hypertension in older individuals. We thought that high blood pressure was a normal occurrence as we aged. We reasoned that higher blood pressure was necessary to push blood through older, stiffened arteries. What we did not realize was that silent progressive blood vessel damage was slowly occurring as a result of the high blood pressure. Increase in heart size, silent heart attacks, and increased deposition of LDL cholesterol into the arterial wall are complications of high blood pressure. We now know that with good blood pressure control, good diet, exercise, and sometimes cholesterol-lowering drugs we can reverse many of these silent vascular changes. We can actually make ourselves healthier and our blood vessels younger. There are now new blood pressure guidelines instructing doctors to prescribe antihypertensive drugs to patients at even lower blood pressure levels. What was considered "normal" blood pressure years ago is now considered high. We now know that even mild blood pressure elevations take a progressive toll and damage our cardiovascular system. "However," you may say, "hypertensive medications are given to patients with hypertension. Estrogen is being offered to healthy women to alleviate symptoms that they, their husbands, or friends basically think are really not all that important. Menopausal symptoms may make life miserable for a year or so, or four or five, but they are not life threatening." It is easy to comprehend that hormone replacement will get rid of hot flashes and night sweats that are severe and interfere with life. It is less easy to conceptualize long-term hormonal replacement therapy (LTHRT) to help prevent future illnesses such as heart disease and osteoporosis. This is a new and difficult concept both for you and for your doctor. And so, it might be a good idea to look at the list of menopausal symptoms one more time. are we using hormonal therapy to treat "healthy women"? As we begin to mull over this often-raised objection, we need to ask, "Are we entering the postmenopausal age span already programmed for system failure?" Healthy today, but preprogrammed by our genetics and dietary and social flaws for deterioration? Are we less healthy than we think, slowly and imperceptibly getting older and less fit, brewing something akin to hypertension except that the final consequences are pathology such as heart attack, stroke, Alzheimer's, and fracture? Is it possible to circumvent or modify these problems? Is it possible to postpone these silent metabolic changes to a much later age so that we function, nearly at full capacity mentally and physically, until one night we die softly in our sleep? One day this will be possible. We stand only at the threshold. Is it just the effect of aging that creates these problems, or does the actual event of menopause independently accelerate and adversely affect the problems? Just knowing who is at risk for which problems would be a great help. It is already possible to find out some of this information by careful determination of preexisting risk factors, present complaints, physical examination, and laboratory' analysis. Body Changes That Accompany Menopause and Aging Wright Gain