Over time, menopause can lead to a whole range of health issues, including the following: __Deficiency in estrogen__ in post-menopause leads to osteoporosis in 40 percent of patients. Bone density loss starts as early as 35–40 years of age. However, the bone loss speeds up after menopause and can decrease at an annual rate of 1.1–3.5 percent! __The risks of myocardial infarction__ increase sharply. While women under 40 are 10–20 times less prone to myocardial infarction than men, at the age of 70 years this rate equals 1:1, as gradual ovarian failure becomes more likely. __Urogenital disorders__ (bacterial vaginosis, dryness, itching, fungal infections, urine leakage) can occur during pre-menopause but are more common in years 2–5 of the post-menopause period and affect 30–40 percent of women. In older age, approximately 70 percent of women are affected. __Menopause is often accompanied by depression__, lower metabolism, exacerbation of chronic diseases, and even cognitive disorders. Women who want to stay healthy and keep a high quality of life should consider a daily intake of select vitamins. This supports the functioning of the vascular and nervous system, stabilizes metabolism, and prevents a wide range of diseases. In addition to vitamin complexes, women might also need hormonal therapy prescribed by a qualified and experienced physician. ## What vitamins are required during this period? Vitamins are selected individually for each stage of menopause transition (perimenopause, menopause, postmenopause), based on general health conditions and presence of symptoms. After the appearance of first hot flashes, irritability, sweating, and headaches at the onset of menopause, it is recommended to take medicines that include not only vitamins but also phytohormones and cytamines — hormone-like compounds of plant and animal origin which can produce the same effect as natural sex hormones. At around age 50, most women enter menopause, followed by a prolonged period of postmenopause. The flashes and blood pressure fluctuations gradually disappear while the symptoms of osteoporosis, atherosclerosis, skin aging, dry mucous membranes, and other metabolic disorders become more common. A prolonged intake of vitamins (at least one year) can significantly improve health conditions. Here are the most essential vitamins for women during this period: __Tocopherols (vitamin E).__ This vitamin has expressed antioxidant action. It improves the condition of blood vessels and can regulate high blood pressure. It is recommended to start taking tocopherols as early as possible during perimenopause as this vitamin supports the function of ovaries and participates in the synthesis of sex hormones (estrogen and progesterone). __Retinol (vitamin A)__. Intake of retinol decreases the risk of malignant tumors in the uterus as well as gut and breast cancer. It also has a positive impact on the state of skin, slowing down the formation of wrinkles. __Vitamin D.__ It has an important role in regulating calcium and phosphorus metabolism. Intake of vitamin D decreases the risks of developing osteoporosis. __Ascorbic acid (vitamin C).__ It has an immune-stimulating and antioxidant effect and participates in regulating various metabolic processes. It also helps with the elasticity of the skin. __Vitamin B.__ Vitamins in this group normalize the functioning of the nervous system, which helps to prevent apathy, mood swings, irritability, tearfulness, and insomnia. During perimenopause, other minerals are equally important: __Calcium__ is required for the prevention and treatment of osteoporosis and normal functioning of muscles. __Phosphorus__ improves the bones and helps with energy exchange processes. __Zinc__ is a part of numerous ferments participating in the synthesis and metabolism of hormones as well as in the formation of immune cells. __Magnesium__ is required for normal functioning of the heart muscle and helps to build muscles, bones, nervous tissues and support protein synthesis. __Potassium__ is required for the functioning of all types of cells, especially myocardial cells. __Manganese__ supports the mineralization of bones. __Iodine__ participates in lipid metabolism. Vitamin complexes have a supplementary yet very important role in alleviating menopause-related symptoms as even the most potent medicines cannot produce the required effect without improving metabolism in the first place. Of course, you can get vitamins from foods, but it is simply impossible to eat enough to get a sufficient quantity of vitamins. For this reason, it is recommended to employ more effective, simple, and individually customized solutions. Women interested in prolonging their youth and health should have a blood test, urine test, and other functional tests (densitometry, ECG, and some others) relevant to their age at least once per year. Based on these tests, a plan for vitamins, minerals, hormones of plant origin, or hormone-replacement therapy can be decided upon. This is the best way to manage symptoms that are inevitable during menopause and help women prolong their youth, beauty, and health.