Dear GeezerJock Doc: Can exercise help with the side effects of menopause?

The GeezerJock Doc responds: The average life expectancy for American women is about 80 years. The average age for the onset of menopause is around age 50. Most women will spend 30 years of their lives after menopause.

As readers of this publication are aware, life after age 50 can be a time of great achievement and fulfillment -- personally, athletically and professionally. But it also can be a time of difficult transition and changing health issues. Exercise is a first-line therapy in dealing with two of the most significant health issues for women during menopause: decreasing bone density and hot flashes.

Bone density reaches its maximum at age 30. After that time, bone density progressively declines throughout life, and this weakening of the bones accelerates in women after the onset of menopause. When the bone density drop is severe enough, the condition is called osteoporosis. By age 80, many women have lost 30 percent of their peak bone density. Women of all ages with osteoporosis are at a significantly increased risk for fracture, particularly in the hips and spine.

American woman at age 50 have an estimated 40 percent risk of suffering a fracture during the remainder of their lives. These fractures can have grave impact on women's mobility, life-expectancy and general quality of life. One-quarter of women require long-term care after a hip fracture and 50 percent will have some long-term loss of mobility. In young women (and men) bone density is maintained by a balance of constant bone loss and reformation. Because of hormonal changes (lower levels of 17 B-estrodiol) in menopausal women, this balance shifts, and bone loss predominates.

Weight-bearing exercise such as walking, running, step aerobics, weight training and gymnastics provide the greatest stimulus for bones. This bone stimulation helps to reduce fracture risk. Strength training, in particular, has been shown to increase bone mineral density and reduce fracture risk. In women age 75 and over, exercise also has been shown to reduce the risk of falls and fall-related injury. Women who are physically active have better balance, strength and coordination.

Osteoporosis is a serious health issue for all aging adults. This discussion only touches on the topic, focusing on the benefits of exercise. Your regular gynecologist, internist or family physician is an excellent resource for your more specific questions. Ask your doctor if your specific health history or medical conditions place you at an elevated risk for osteoporosis. Your doctor can also provide detailed information on the role of diet, vitamins and supplements, screening recommendations and more intensive medical treatments. An excellent source of quick information is the National Osteoporosis Foundation at www.nof.org.

Hot flashes, while a less serious health problem than osteoporosis, are extremely bothersome and disruptive to the women who suffer with them. Considered one of the hallmark signs of the transition to menopause, their exact cause has not been determined.

Women experience them as transient episodes of flushing and perspiration, often with a sensation of heat on the upper body and face. Some women experience these as often as hourly, others less frequently. Hot flashes can also occur during sleep, causing night sweats.

There have literally been dozens of studies examining the effectiveness of numerous prescription medicines and nonprescription supplements in treating hot flashes. Supplemental estrogen with or without progesterone, antihypertensive medicines, black cohosh, soy-derived isoflavones, and the Chinese herb dong quai have all been investigated and are used by health care providers and their patients.

The North American Menopause Society (www.menopause.org) is a great source of information for the relative effectiveness of these and other different treatments. Even without taking medicines or supplements, women can find relief from a healthy lifestyle and exercise.

One ongoing study funded by the National Institute on Aging, in conjunction with other scientific organizations, called the Study on Women's Health Across the Nation (SWAN) is focused on evaluating the health of women in the middle years of life. The SWAN study has demonstrated that less physically active women experienced significantly more hot flashes. Other studies have also shown that overweight women experience more frequent and more severe hot flashes.

Ask the Doctor

Micah Garb, one of a rotating group of physicians answering questions as the GeezerJock Doc, is a practicing Ob/Gyn affiliated with Northwestern University in Chicago. GeezerJock Doc is a forum for your questions about injuries, exercise and getting older. Submit questions to geezerjockdoc@geezerjock.com or mail to GeezerJock Doc, 2033 W. Hutchinson St., Chicago, IL 60618.