Menopause is a normal, natural event that all women experience if they live long enough. It’s no more a disease than puberty or pregnancy. Each woman experiences menopause in a unique way, with some having troubling hot flashes and other symptoms while others experience few or no symptoms at all. 

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Perimenopausal women are not totally protected from an unplanned pregnancy until they reach menopause (1 year after their last period), so those who don’t want to become pregnant must choose an effective method of birth control. 

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Most midlife body changes in women—such as weight gain, hair thinning, and loss of muscle tone—are caused by aging or by a mix of aging and menopause. 

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It is now believed that women taking ET have a more favorable benefit-risk profile than those taking EPT. (Women who have had a hysterectomy to remove their uterus can take estrogen alone, while women who still have their uterus need progestogen added to protect against endometrial cancer.) This is especially true for younger menopausal women (in their 50s or within 10 years of menopause) than for older women.

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Saliva testing for hormone levels has not been proven accurate or reliable. Even blood testing of hormone levels is limited since levels vary throughout the day as well as from day to day. Plus, the desired levels in postmenopausal women have not been established and an individual woman’s physical comfort may not even be related to her actual hormone levels.

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Custom-compounded hormones have not been tested to prove they are absorbed appropriately or provide predictable levels in blood and tissue. And there’s no scientific evidence about the effects of these hormones on the body, either good or bad. They are not monitored for consistency of dose or purity/lack of contamination. 

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Memory and other mental abilities change throughout life. Aging is associated with a trend of declining performance, but there’s no firm evidence that memory or other mental skills actually decline because of natural menopause. Remaining physically, socially, and mentally active can help prevent memory loss.

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Although many midlife women have urinary incontinence, it’s not directly associated with menopause but rather with factors such as age, loss of pelvic muscle tone, weight gain, history of childbirth and the number of babies delivered, and certain medical conditions.

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A large new study of US women ages 50 to 79 found that nearly two-thirds were satisfied with their sexual activity. Of those who were dissatisfied, 57 percent would prefer more sexual activity and only 8 percent would prefer less. Many women were sexually active through their 70s, and the main reason women in the study were not sexually active was the lack of a partner.

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The decline in women’s testosterone levels is related to age, not menopause. Women’s testosterone levels peak in their 20s, begin to decline years before perimenopause, and continue to fall slowly through and beyond menopause. The effect of age-related testosterone declines on women’s libido remains controversial, and reduced sexual desire in women usually has multiple causes.

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Next: Test Your Menopause Smarts

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