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Unexpected Midlife Changes in Women

How to manage approaching menopause

Woman experiencing menopause

Although every woman experiences the journey to and through midlife differently, some women may encounter unexpected — and unwelcome — health issues as they approach menopause.

The following are some common problems, along with tips about how to meet them head on and which type of specialist can help:

Exacerbation of asthma

Progesterone seems to have a calming effect on the airways, so when it decreases in midlife, asthma symptoms can get worse.

In fact, 20 to 30 percent of women experience worsening asthma symptoms during the perimenopausal years (the time leading up to menopause when you begin noticing menopause-related changes and the year after menopause, or when you haven’t had a period for 12 months in a row).

  • What you can do: You may be able to get relief by adjusting your asthma medication. You can also undergo allergy testing to identify triggers that contribute to your asthma. Talk to your gynecologist or primary care physician, who can work with an allergist to help you find relief.


Although sometimes a signal of irritable bowel syndrome or another gastrointestinal condition, constipation is usually the result of a more sedentary lifestyle and paying less attention to diet as we get older.

  • What you can do: Get active, drink plenty of water and focus on eating high-fiber foods. If those changes don’t work, a specialist from the Program for Abdominal and Pelvic Health at Rush can help diagnose and treat the problem.

A racing heart

Do you feel as if your heart is going to jump out of your chest? For perimenopausal women, the constant fluctuation of hormone levels can cause the heart to try to adjust by beating faster or slower, resulting in palpitations and hot flashes.

  • What you can do: Although these symptoms may go away in a matter of months, have your heart checked by a cardiologist who specializes in women’s health, such as a member of the team at the Rush Heart Center for Women.

Unpredictable ovulation

Perimenopausal women ovulate earlier in their cycle, which can result in unplanned pregnancies.

  • What you can do: If you are sexually active but don’t want to risk pregnancy, continue using birth control until you reach menopause.

Decreased fertility

Most women begin to experience a significant decrease in fertility around the age of 37. At age 40, a woman’s risk of a miscarriage doubles (from 25 to 50 percent) and the risk of chromosomal abnormalities in the fetus increases. And by age 45, most women no longer have abundant and/or healthy eggs, making conception far more challenging.

  • What you can do: Ovaries serve two functions: They release egg cells, and they produce two very important hormones, estrogen and progesterone, plus small amounts of testosterone (the male sex hormone).

If you’re approaching or are in your 40s and want to have a baby, see your ob/gyn or a reproductive specialist to have your ovarian function checked. If you’re not ovulating or if your hormone levels are off, you can discuss whether fertility treatments may be right for you.

Dry sinuses

Crusty sinuses can also occur as women get older, which makes older women more susceptible to sinus infections.

  • What you can do: Buy an over-the-counter product that contains saline solution to keep your sinuses moist.

You can also try using a neti pot, a small pot used to irrigate — or flush out — the nasal passages. Made from clay, glass, various metals, plastic or ceramics, the neti pot used with a saline solution (a mixture of around one pint of water with a teaspoon of salt) has been shown to be an effective short-term or occasional home remedy for hay fever, sinusitis and other nasal conditions.


With the loss of estrogen and progesterone comes a cascade of events that can stimulate allergy cells and lead to symptoms of autoimmune thyroid disease (a condition in which the immune system attacks and damages the thyroid).

  • What you can do: Since your thyroid may be the culprit, have it checked out. The solution could be as simple as taking thyroid replacement medications.

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