The information given below is not intended to give specific medical advice but only to provide basic medical information about these topics.  The purpose of this information is for education only and should not be used for diagnosis or treatment.  The information given is not intended to replace the need for discussing these issues with your health care professional.


If my Pap smear is abnormal, do I have cancer?

The Pap smear is a screening test; additional tests are needed to diagnose cancer. Many factors may cause the Pap smear to be abnormal, including a vaginal infection, recent intercourse, or use of a tampon. Often, the Pap smear will be repeated. The need for any additional testing will be determined by your health care provider. Top ^

How do I know if I am in menopause?

The average age of menopause for US women is 50-51 years. There is usually a 3 to 5 year transition period leading into menopause (which is a woman’s very last menstrual period). The most common indications of perimenopause (the time around menopause) are menstrual periods occurring closer together or further apart or the development or worsening of Premenstrual Syndrome (PMS). Your health care provider may offer blood tests such as FSH and estradiol levels to help determine if you are in menopause. Top ^

When can I stop using contraception?

Although fertility declines during the perimenopause years, pregnancy is still possible as long as a woman is still ovulating. Generally, contraception is recommended until a woman has been without a menstrual period for at least one year. If using hormone replacement, the FSH should be greater than 30 on at least 2 occasions 6 months apart. Oral contraceptive pills may be appropriate for the dual purpose of birth control and supplemental hormone therapy during perimenopause. Top ^

Will I always have a period on hormone replacement therapy (HRT)?

Some hormone replacement regimens, known as cyclic HRT do result in persistent menstrual cycles. Continuous HRT, usually started once menopause is clearly established, will eventually result in total absence of menstrual cycles for most women.   [See Hormone Replacement Therapy] Top ^

What type of calcium is best for prevention of osteoporosis?


Serving Size

Mg of Calcium


3 oz.


Milk, skim

1 cup


American Cheese

1 oz.


Turnip greens

2/3 cup



Calcium is best absorbed from low and nonfat milk and milk products. Because most women do not get sufficient calcium from diet alone, supplementation is required to achieve the 1,000 - 1,500mg/day recommended by the National Research Council. Calcium carbonate or calcium citrate are excellent supplements. Both are best absorbed when taken with food. It is important that your supplement be bioavailable which means it can be absorbed and used by your body. If your supplement meets USP (United States Pharmacopoeia) standards, it is bioavailable. If it does not have USP approval, drop one in a glass of vinegar and water and stir every few minutes. If it is not at least 75% dissolved within 30 minutes, it won’t help you. Calcium absorption is further enhanced by vitamin D, at least 400 to 800 IU / day for postmenopausal women. Exposure to sunlight or fortified foods are also excellent sources of vitamin D. Top ^

Type of Calcium

% Elemental Calcium

Amount of elemental calcium in 500 mg of supplement

Calcium carbonate



Calcium citrate



Calcium Lactate



Calcium Gluconate



Calcium Glubionate




I’m not eating more, why am I gaining weight?

After menopause, many women gain weight, but this is not automatic. Weight gain may be partially due to lowered resting metabolic rate, less active lifestyle, and unchanged eating patterns including eating as a response to stress. Aches and pains may make it more difficult to engage in physical activities. Any reduction in time or effort expended in exercise changes the balance between calorie intake and calorie expenditure. Consequently, weight gain is inevitable. Additionally, calorie requirements decrease with age. This decrease will result in weight gain if you continue to eat exactly as you always have. The best way to increase the resting metabolic rate and control weight gain is through exercise and decreased food portion size.  [Nutrition services at Midlife Health Center] Top ^

When is the best time to do self breast exam (SBE)?

In women having regular menstrual periods, the best time to perform self breast examis right after the monthly menstrual cycle. The breasts are usually least lumpy and tender during this time. In women who no longer have a period, an arbitrary, but consistent, date is selected each month to perform SBE. Top ^

Does estrogen supplementation in menopausal women cause breast cancer?

Although this issue remains controversial, most authorities now believe that low dose (Premarin 0.625mg or equivalent), short term (less than 10 years) hormone replacement therapy does not cause breast cancer. However, long term therapy, or high dose HRT may increase the risk for some women.  [See Estrogen Replacement Therapy for more information] Top ^

Why do I feel bad when I take progesterone?

Supplemental estrogen, when taken alone, increases the risk of endometrial (lining of the uterus) cancer. This increased risk can be virtually eliminated when estrogen is taken with progesterone. Progestin agents taken during HRT are synthetic and behave much like the hormone progesterone, causing mild androgenic (virilizing) changes. The most potent HRT progestin, medroxyprogesterone acetate (Provera or Cycrin) is much less potent than the progestins used in oral contraceptive pills. However, even this small amount of progesterone component can cause side effects in some women. Progestins can cause transient bloating, breast tenderness, irritability, and (in higher doses) depressed mood. Various preparations of progestins are available; trial and error may help identify a preparation that minimizes problematic side effects for each individual woman. Top ^

Is there sex after 50? What happened to my sex drive?

Decreased estrogen may lead to vaginal atrophy - drying and thinning of the tissues of the vagina. Vaginal atrophy may result in vaginal inflammation, inadequate lubrication, and painful intercourse. However, this condition is highly treatable, and even preventable for most women. Continued sexual activity helps promote blood flow to the vagina and minimizes atrophy. Vaginal moisturizers and lubricants are also helpful. Treatment with HRT applied to the vaginal area or taken systemically, will also reverse symptoms of vaginal atrophy for most women.

Testosterone, typically thought of as a male hormone, is also produced by the female ovary. Menopause may interrupt the supply of testosterone which plays a role in the female sex drive. Androgen (testosterone) replacement is at least partially effective in restoring sexual response in women who have had their ovaries surgically removed or are in the 20% of women who suffer decreased libido due to loss of testosterone during menopause.   [See Sexuality for more information] Top ^