Menopause is a normal life transition


DEAR DR. DONOHUE: I am 47 and facing menopause. I’d like some information on it. What is the average age for it?

I have heard so many horrifying stories about menopause that I would appreciate a less-than-dramatic explanation. Can you provide it? — H.L.

ANSWER: Menopause is a normal life transition, a state where a woman passes from the possibility of having children to the state when she cannot have children. Her supply of ova (eggs) is depleted. Her production of the female hormone estrogen is greatly diminished. For many women, it marks an era of new freedom.

The average age for menopause is 51. About four years prior to actual menopause, women begin to experience a lengthening of the interval between periods and then actual skipping of periods. Menopause is defined as one full year of not having any menstrual cycles.

Most menopausal women have hot flashes. They’re a reflection of the decreased supply of estrogen. The drop in hormone levels upsets the body’s heat regulation and results in transient hot flashes. Night sweats are another common manifestation of malfunction of the body’s thermostat.

A more important health aspect of menopause is bone resorption and weakening due to the estrogen deficit. Women should take osteoporosis-prevention steps well before menopause begins. They need to get enough calcium and vitamin D. They need to adhere to an exercise schedule. Daily, weight-bearing exercise promotes bone strength. “Weight-bearing” indicates that the exercise requires support of body weight. Walking is an example of weight-bearing exercise. Lifting weights is an excellent way to keep bones strong. Women don’t have to lift the extreme amount of weights that bodybuilders do.


Weight gain is another consequence of menopause. On average, a woman gains two pounds. That’s not a significant health risk.

DEAR DR. DONOHUE: Will you please explain what makes ridges form on my fingernails? How can you get rid of them? I am 73. Several of my friends have the same problem. The ridges go from the nail bed to the tip and cause splitting. Is there something we can do? — M.S.

ANSWER: Those ridges come from aging. They’re not an indication of a health problem. If they really bother you, you can gently file them with a soft file, found in most drugstores.

Ridges don’t cause nail splitting. Loss of moisture is the cause. With the same kinds of moisturizers used for the skin, moisturize the nails. A cheap and effective product is petroleum jelly. Keep your nails short. Wear gloves when you submerge your hands in soapy water, like dishwater.

Some claim that large doses of biotin, one of the B vitamins, strengthen nails. You have to buy biotin separately. The doses found in a multivitamin are not high enough for the nails.

DEAR DR. DONOHUE: My diagnosis is a right pleural effusion. After going through drainage of the fluid and testing of it, it did not show any signs of infection or TB. A scan showed no problem. What is your idea of pleurodesis? Is it reversible? — A.G.

ANSWER: The pleura are a double-ply of tissues that cover the lungs. Between the two plies is a space filled with a little fluid that allows expansion and contraction of the lungs. When a large amount of fluid collects there, it’s a pleural effusion. Causes include infections, heart failure, kidney disease, cancers and blood clots to the lungs.

In a quarter of patients, no cause is found. If fluid continues to fill the pleural space, roughing up the adjacent surfaces of the pleura causes them to stick together and obliterate the space. Sterile talc often is used to effect this change. That’s pleurodesis.

It’s not reversible. It does prevent fluid from reforming.

Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475. Readers may also order health newsletters from