In your 50s and beyond

Cardiovascular risks

Dr. Tricia Peters, an endocrinologist at Mcgill University in Montreal, says this one’s controversial. “Many studies have shown an increase in cardiovascular risk for women after age 50, which corresponds to the time of the typical menopausal transition, so this may be age-related versus hormonally related,” says Dr. Peters. Researchers have looked at women in early menopause—before age 45—and have noticed an increased risk of heart disease. That said, women with existing cardiovascular issues—those who smoke or have high blood pressure or high cholesterol—tend to go through menopause earlier, so it’s a bit of a chicken-and-egg situation.

Reduce your risk and control what you can. So, stop smoking, stay active, maintain a healthy body weight and get screened for high blood pressure, high cholesterol and diabetes, says Dr. Peters.

Migraines

These brutal headaches are triggered by a drop in estrogen, says Dr. Derzko. “Drops, especially sudden drops, in circulating estrogen levels—at the onset of a period, for example, and also sometimes at ovulation—are major triggers to headaches.” If you experienced migraines with your period, you’re likely to find that they’re less frequent and less severe during menopause or may entirely disappear after menopause; but if they started at perimenopause or menopause, they are likely to worsen. Like mood swings and problems concentrating, hormonal migraines tend to stop after menopause, once the hormonal fluctuations stop.

If fluctuating hormones are the cause of your migraines, your physician may recommend hormonestabilizing medication. You can discuss these and other medications (both over the counter and prescription) for migraines with your healthcare provider.

Vaginal dryness

Falling estrogen levels cause the vaginal tissue to get drier and thinner, which inevitably causes burning, irritation and pain during sex—which really doesn’t put you in the mood.

Your vagina and your libido don’t have to suffer. Topical vaginal treatments such as lubricants and moisturizers often work, and there are lots to choose from over the counter. There are also topical forms of estrogen therapy (tablets, cream and vaginal rings) that require a prescription.

Drops in circulating estrogen levels are major triggers to headaches.