• Avoid caffeine, alcohol, and spicy foods
• Dress lightly and in layers
• Eat soy foods
• Get adequate calcium and vitamin D in food or supplements
• Get plenty of exercise
• Perform Kegel exercises daily to strengthen the muscles of your vagina and pelvis
• Practice slow, deep breathing whenever a hot flash starts to come on (try taking six breaths per minute)
• Remain sexually active
• See an acupuncture specialist
• Try relaxation techniques such as yoga, tai chi, or meditation
• Use water-based lubricants during sexual intercourse

Postmenopausal bleeding may occur. This bleeding is often nothing to worry about. However, your health care provider should always check any postmenopausal bleeding, because it may be an early sign of other problems, including cancer.

Decreased estrogen levels are also associated with the following long-term effects:

• Bone loss and eventual osteoporosis in some women
• Changes in cholesterol levels and greater risk of heart disease

Call your health care provider if:

• You are spotting blood between periods
• You have had 12 consecutive months with no period and suddenly vaginal bleeding or spotting begins again, even if it is a very small amount

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Menopause

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Review Date: 09/11/2010
Reviewed By: David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc., and Susan Storck, MD, FACOG, Chief, Eastside Department of Obstetrics and Gynecology, Group Health Cooperative of Puget Sound, Redmond, Washington; Clinical Teaching Faculty, Department of Obstetrics and Gynecology, University of Washington School of Medicine.

A.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission (www.urac.org)