Women and Therapy in the Last Third of Life: The Long View

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Researchers hypothesize that hot flashes are caused by changes to the hypothalamus, which regulates temperature. Perimenopause occurs before full onset menopause, usually when a woman is in her forties, and the transition can last for as long as 10 years. Erratic periods are common in perimenopause. Conceiving a child while in perimenopause is possible but not probable.

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This means that you are classified as having reached menopause or being post-menopausal after you go for more than a year consecutive months without menstruating. Learn More about Perimenopause vs. Many symptoms of menopause are treatable or at least manageable, either through medications, complementary and alternative medicine, or lifestyle changes. Your doctor can help you tailor treatments specifically for you.

The five most important discoveries so far are:. As your estrogen levels decline, your risks for four other health issues rise:. While menopause does not necessarily cause cancer, your risk for developing it increases with age.

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Women who go through menopause later in life after the age of 55 face a higher risk for developing breast and uterine cancer, because of longer lifetime estrogen exposure. Ovarian cancer risk is slightly elevated as well. There is a complicated relationship between hormone treatments, known as hormone replacement therapy HRT or hormone therapy HT and breast cancer.

But women who did not have a uterus had a slightly lower risk.

Antenatal Corticosteroid Therapy for Fetal Maturation - ACOG

More than 10 years and many more comprehensive studies later, nuances are better understood. Experts agree that for most women, hormone therapy is okay to use to help control moderate to severe symptoms such as hot flashes, as long as treatment is started within 10 years of menopause or before age Depression during perimenopause has never gotten a lot of attention before. Mood disorders happen more often during perimenopause than during menopause. Along with so much else, your fitness routine needs to change with age.

Your workout may have to be adjusted at this time of your life so that you strengthen and stretch your muscles and generally move your body more.

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Experts agree that regular exercise is critical at midlife: It protects your heart, your bones, your moods, your sleep, your weight, and more. Here are fun ways to pump it up. That stubborn spare tire around your middle owes its existence to the drop in hormones, which in turn slows down your metabolism. The scale number creeps up, and the fat migrates from hips and thighs to your belly. Resist the changes with these tips. Exercise regularly, focusing on aerobics for at least minutes a week, and strength training two or more times a week.

If you get in an exercise rut or start feeling bored, mix it up with different activities, or exercise with friends to keep you on track. In the bad old days, women older than 60 were thought to be elderly candidates for canes, rocking chairs, and shawls. Not anymore.

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  5. Post-menopausal women these days are kicking into high gear, embracing healthy, active, ambitious living and inspiring others to do the same. Here are 12 women who have shown us that age is a state of mind. Everyday Health Women's Health Menopause. African American women reported the longest duration of hot flashes averaging more than 11 years , while Japanese and Chinese women had hot flashes for about half that time. Talk with your doctor about treatment options.

    The most effective hot flashes treatment is estrogen-based hormone therapy, though it comes with several downsides. Several non-hormonal medications can also provide r hot flashes treatment and relief from night sweats. These include some types of antidepressants, some drugs commonly prescribed for nerve pain, and some high blood pressure medications.

    For some women, self-help measures can help ease hot flashes. These include deep-breathing exercises when a hot flash starts; dressing in layers; lowering the thermostat; staying away from caffeine, alcohol, hot beverages, and spicy foods; stress reduction techniques like meditation and mindfulness; and doing your best to stay cool in general. A free mobile app called MenoPro , developed by Dr. Manson and her colleagues at the North American Menopause Society, helps women understand their treatment options and work with their healthcare providers to find the best approach for them.

    In the Setting of Periviability Specific data on the use of corticosteroids in the periviable period are supported by a combination of laboratory data on the response of lung tissue and clinical observational studies 1, 2 , 17 , In the Setting of Preterm Prelabor Rupture of Membranes The use of antenatal corticosteroid administration after preterm PROM has been evaluated in a number of clinical trials and has been shown to reduce neonatal mortality, respiratory distress syndrome, intraventricular hemorrhage, and necrotizing enterocolitis 6, 12, 19 , In the Setting of Multiple Gestation A Cochrane review concluded that although antenatal corticosteroids are beneficial in singleton gestations, further research is required to demonstrate an improvement in outcomes for multifetal gestations 21 , Evidence Against Serial Courses Because of concerns for maternal and fetal harm, and the balance of risk and benefits, planned multiple courses are not recommended.

    Single Rescue Course Although the initial data 43 suggested the benefit of corticosteroids may decrease after 7 days, the duration of corticosteroid benefit remains controversial Long-Term Outcomes, Risks, and Additional Considerations The concern that corticosteroids may have the potential to adversely affect neurodevelopmental outcomes is largely based on animal data and from studies of multiple course corticosteroids Optimizing Administration of Antenatal Corticosteroids Perinatal Quality Collaboratives, such as the Ohio Perinatal Quality Collaborative, California Perinatal Quality Care Collaborative, and the March of Dimes Big 5 State Perinatal Collaborative have worked to improve use of antenatal corticosteroids through a focus on the identification of missed opportunities and use of quality improvement strategies to optimize appropriate and timely antenatal corticosteroid administration.

    For More Information The American College of Obstetricians and Gynecologists has identified additional resources on topics related to this document that may be helpful for ob-gyns, other health care providers, and patients. References Periviable birth. Obstetric Care Consensus No. Obstet Gynecol ;e— JAMA ;— Antenatal corticosteroids promote survival of extremely preterm infants born at 22 to 23 weeks of gestation. Neonatal Research Network Japan. J Pediatr ;— Outcomes of extremely low birth weight infants with varying doses and intervals of antenatal steroid exposure.

    J Perinat Med ;— Neurodevelopmental outcome of extremely premature infants exposed to incomplete, no or complete antenatal steroids. J Matern Fetal Neonatal Med ;—7. Practice Bulletin No. Measurement of placental alpha-microglobulin-1 in cervicovaginal discharge to diagnose rupture of membranes. Obstet Gynecol ;— AmniSure placental alpha microglobulin-1 rapid immunoassay versus standard diagnostic methods for detection of rupture of membranes. Am J Perinatol ;— The clinical significance of a positive Amnisure test in women with term labor with intact membranes.

    J Matern Fetal Neonatal Med ;— The clinical significance of a positive Amnisure test in women with preterm labor and intact membranes. J Matern Fetal Neonatal Med ;—8. Antenatal corticosteroids for accelerating fetal lung maturation for women at risk of preterm birth. Cochrane Database of Systematic Reviews , Issue 3. DOI: NIH Consens Statement ;— Periventricular leukomalacia—prospects for prevention.

    N Engl J Med ;— Different corticosteroids and regimens for accelerating fetal lung maturation for women at risk of preterm birth. Cochrane Database of Systematic Reviews , Issue 8. Neuro-developmental outcomes of extremely low birth weight infants exposed prenatally to dexamethasone versus betamethasone.

    Pediatrics ;— Glucocorticoids and thyroid hormones stimulate biochemical and morphological differentiation of human fetal lung in organ culture. J Clin Endocrinol Metab ;— Am J Perinatol ;—6. Antenatal corticosteroids after preterm premature rupture of membranes.

    Clin Obstet Gynecol ;— Do antenatal corticosteroids help in the setting of preterm rupture of membranes? Am J Obstet Gynecol ;—9.

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    The role of antenatal corticosteroids in twin pregnancies complicated by preterm birth. Canadian Neonatal Network Investigators. Antenatal betamethasone for women at risk for late preterm delivery. Incidence of neonatal hypoglycemia in babies identified as at risk. Knowledge gaps and research needs for understanding and treating neonatal hypoglycemia: workshop report from Eunice Kennedy Shriver National Institute of Child Health and Human Development. J Pediatr ;—7.

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    Postnatal glucose homeostasis in late-preterm and term infants. Committee on Fetus and Newborn. Pediatrics ;—9. Single versus weekly courses of antenatal corticosteroids: evaluation of safety and efficacy. Am J Obstet Gynecol ;— Repeated antenatal corticosteroids: size at birth and subsequent development. Effect of single versus multiple courses of antenatal corticosteroids on maternal and neonatal outcome. Multiple courses of antenatal corticosteroids and outcome of premature neonates.

    Antenatal dexamethasone and decreased birth weight. Does antenatal corticosteroid therapy affect birth weight and head circumference? Obstet Gynecol ;—8. Multiple courses of antenatal corticosteroids for preterm birth MACS : a randomised controlled trial. Lancet ;— Single vs weekly courses of antenatal corticosteroids for women at risk of preterm delivery: A randomized controlled trial. JAMA ;—7.