The big thing in this decade (beyond a big 50th birthday party, of course)? The big M, or menopause. It typically occurs in the early 50s, when your menstrual cycle and hormonal changes fully stop. 

This can set off additional concerns: The loss of estrogen following menopause, as well as other age-related changes (like weight gain), can raise your risk of heart disease, stroke, and osteoporosis. 

So, while maintaining a healthy lifestyle is always important, it is especially critical now to help prevent illness. Here are more details about this time of life.

Menopause and Postmenopause

On average, women in the United States reach menopause at 51. Menopause is when your ovaries have stopped producing estrogen, progesterone, and testosterone, and you have gone 12 months without a period. For some women this can also be diagnosed by blood test. Depending on your chosen form of birth control you may not have your period at all. 

Even though you no longer have a period, you may continue to experience the symptoms of the hormones that  you had in perimenopause. Because even though your hormones have stabilized, they’re at lower levels, which is what causes some of the symptoms to linger. “We are often treating women in their 50s for menopause symptoms that are affecting their quality of life, like loss of libido, discomfort from hot flashes or night sweats, vaginal dryness, sexual issues, or urinary problems,” says Dr. Beasley. 

Sounds unpleasant, we know. And it can be. That’s why for many women t hormone replacement therapy, or HRT, is an excellent and safe option. This is a medication typically used to treat symptoms of menopause. There are many ways to use HRT: oral, skin patches, vaginal rings, creams, gels, suppositories or tablets, intrauterine devices, and even skin creams. HRT refers to giving your body back the hormones it used to make on its own, estrogen, progesterone, and testosterone.

• Systemic therapy means the medicine travels through the bloodstream to all parts of the body. Systemic HRT comes in a variety of forms, including pills, patches, sprays, and gels. These can treat hot flashes, night sweats, brain fog, joint pain, and vaginal dryness, and they help prevent bone loss. 
  
  Systemic therapy can contain just estrogen, just progestin (a synthetic form of progesterone), or a combination. It can cause an increased risk for heart disease, stroke, blood clots, uterine lining growth, and breast cancer in some women. This depends on your age, health history, whether HRT includes estrogen, whether the estrogen is combined with progestin, and the type of estrogen prescribed.
   
• Local HRT is just estrogen, and comes in creams, tablets, or rings. It is used to treat vaginal dryness and irritation. This therapy is localized to the vulva/vagina, which minimizes effects on the uterus and breasts. 

There are also non-hormonal treatments available, such as selective serotonin receptor inhibitors (SSRIs) and (NRI), which are also often used as antidepressants. And a new FDA-approved medication can help with severe hot flashes (called Veozah, it’s taken in tablet form). Your physician can help guide you to the best treatment for you, based on your symptoms and individual risk factors. 

Both systemic and local HRT are meant to treat all of the symptoms that can come along with menopause. As always your provider will help to guide you to the most effective and safest treatment based on your symptoms needs and individual risk factors. Safe use of HRT depends on a multitude of factors and will be determined after a conversation with your provider.

Bone Health

One of estrogen’s roles is to help prevent bones from weakening. During menopause, the reduction in estrogen levels accelerates bone loss. “In your 50s, bone health becomes more of a concern following menopause,” says Dr. Beasley. “And if you have had a recent fracture or family history of fractures, or if you smoke, over consume alcohol, or have a history of chronic steroid use, those are all red flags for osteoporosis.”

With her postmenopausal patients, Dr. Beasley recommends taking calcium and vitamin D supplements to help support the bones. If risk factors warrant it, they’ll also order a bone scan or DEXA scan, a special x-ray to determine your level of bone loss (otherwise, bone scans are recommended at age 65).

Shingrix Vaccine 

Did you know that Shingles is a reactivation of the chicken pox virus. Shingles is a very painful rash that sometimes could result in long-term nerve pain. According to the Centers for Disease Control and Prevention (CDC), about one out of every three people in the United States will develop shingles during their lifetime. 

The Shingrix vaccine, recommended for adults 50 and over, can help protect you from shingles—it’s over 90% effective. It’s a two-dose series spaced six months apart. If your doctor doesn’t give the vaccine themself, talk to your doc about where to get the vaccine, however it is available at most pharmacies.