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You’ve gone through menopause, but your life is far from over. What does it hold for you, physically, mentally, socially? You know you won’t be able to have children, but in your mid to late 50s, you may not view that as a negative. If you’ve experienced some symptoms of menopause, such as hot flashes, insomnia, night sweats, will these symptoms continue beyond menopause? You may have many questions.

Menopause refers to the transition in a woman’s life from having regular menstrual cycles to not having them because ovarian production stops.

Bindiya Ananthakrishnan, M.D., obstetrician and gynecologist at Mount Auburn Hospital in Cambridge, a teaching hospital of Harvard Medical School, recently discussed some issues that women face after menopause. She says, “Your life after menopause can be just as active and satisfying as it has been, maybe even more so. But it’s more important than ever to focus on leading a healthy lifestyle.” She emphasizes that women should not smoke, should eat a balanced diet, should exercise regularly, and should maintain a healthy weight, which may be more of a challenge after menopause. If you approach this phase of life positively and focus on your own well-being, you may find many doors open to new opportunities—renewed energy, new projects, new relationships, travel, and good times with your family and friends.

Dr. Ananthakrishnan also emphasizes that women need to focus on one of the biggest risk factors after menopause—osteoporosis, which is a loss of bone mass or thinning of the bones. Osteoporosis is a growing health problem among women and can be a very serious condition as women age since this disease makes them more prone to fractures. For instance, older women who break their hips may never get their full functioning back again and their quality of life may be dramatically affected. Hip fractures can lead to so many complications in the elderly that death may be the ultimate result.

A woman’s bone mass is influenced by many factors, including family history, lifestyle, nutrition, and different medications. Estrogen is the hormone that has been found to have the most positive impact on building and maintaining bone mass and, since women no longer produce estrogen after menopause, they are particularly vulnerable to developing osteoporosis. There are also some diseases that affect bone metabolism.

Regular weight-bearing exercise can prevent or slow down the development of osteoporosis. Cardiovascular activities, such as walking and cycling, that put weight on the lower body can be particularly helpful. Not only will this kind of exercise help reduce your risk of developing osteoporosis, but it will help you ward off vascular disease too since after menopause women are definitely at greater risk of developing vascular disease. In addition, after menopause, women should take 1500 milligrams of calcium a day, which has been shown to both prevent and treat osteoporosis. A simple, painless bone density test can indicate the status of your bone mass. If significant bone loss is shown, then you need to intensify your calcium intake and exercise routine. Your physician can also offer you effective medications for the treatment of osteoporosis.

For women who have no risk factors of cardiovascular disease or breast cancer, estrogen in its lowest effective doses may be very helpful in reducing hot flashes, vaginal dryness and other symptoms of menopause that can occasionally last past the end of periods. Estrogen creams can also be effective in treating vaginal dryness. For women who have not had a hysterectomy, estrogen is given along with progesterone to prevent the development of uterine cancer. Estrogen should always be taken under the guidance of a physician.

There are some women who should not be on hormone replacement at all—for instance those who have had cancer, particularly breast cancer, and anyone who has or is at risk for vascular disease. A recent study has indicated that estrogen may put women at higher risk for these conditions.

Dr. Ananthakrishnan emphasizes that after menopause women should have an annual physical exam, an annual pap smear and pelvic exam, an annual breast exam, and a yearly mammogram. In addition, women over 50 should have a colonoscopy every 10 years to screen for colon cancer. Blood pressure and cholesterol levels should also be checked during regular physical exams. It’s also important for women to focus on stress reduction and have good social support systems.

“While menopause is definitely a time of transition, it doesn’t mean that you are suddenly entering a time of life where you are less healthy or more susceptible to illness. If you focus on leading a healthy lifestyle and having the screening tests you need, you can be energetic and productive for many years to come. Women today have many role models who have been creative, contributing members of their families and society well into their eighties and beyond,” says Dr. Ananthakrishnan.