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The menopause transition is a natural progression in life. But even though it’s normal to experience menopause, many people don’t know what to expect during postmenopause. This article covers common health changes and options to help manage symptoms.
What is postmenopause?
The postmenopausal years follow menopause. There are multiple reproductive stages for women’s health, including (Peacock, 2021):
- Reproductive years: This is when women experience regular menstrual periods.
- Perimenopause: This is the stage when estrogen levels begin to decrease, leading to irregular menstrual cycles and ovulation. This usually begins in midlife, in the 40s. On average, perimenopause lasts 4 years. Perimenopause is sometimes referred to as menopausal transition.
- Menopause: This stage is reached when a woman experiences 12 consecutive months without a menstrual cycle. The average age for menopause is 51 years old.
- Postmenopause: The postmenopausal stage lasts for the rest of a woman’s life following menopause. Many of the perimenopausal symptoms go away after menopause, although there are permanent changes to a woman’s health after menopause.
When does postmenopause occur?
Most women will reach postmenopause during their late 40s to early 50s—the timing will be different for everyone.
Menopause caused by the natural, gradual decline in estrogen levels is sometimes called natural menopause. Sometimes, though, medications or surgeries can induce menopause, such as:
- Chemotherapy or radiation
- Surgical removal of the ovaries (oophorectomy) or uterus (hysterectomy)
- Some medicines, like antiestrogens
Common symptoms of postmenopause
Often, postmenopausal women will experience fewer symptoms of menopause than they did before officially reaching this stage. As hormone levels become more stable, the symptoms go away on their own or become less frequent.
Some women will continue to experience menopausal symptoms. Here are some examples of menopausal symptoms (Santoro, 2015):
- Hot flashes, night sweats, and flushes
- Urinary incontinence and increased urinary urgency
- Vaginal atrophy or vaginal dryness
- Weight gain
- Sleep disturbances
- Low sex drive or libido
- Mood changes
- Anxiety and depression
Postmenopausal health changes
The changes in hormones like estrogen, progesterone, follicle-stimulating hormone (FSH), and luteinizing hormone (LH) lead to changes in a woman’s health (Peacock, 2021). Here are some of the changes in health conditions after menopause.
Osteoporosis is a condition leading to thinning bones and an increased risk for bone fractures. Postmenopausal women are at a higher risk for osteoporosis because of their decreased levels of estrogen.
Heart health risk
Menopause increases the risk for cardiovascular disease, high cholesterol, and high blood pressure. Before menopause, women have a lower risk than men for heart disease, but in postmenopause, these risks increase (Maas, 2010).
Mood changes and depression
Sexual health changes
Vaginal dryness may increase your risk for infections and make intercourse less comfortable. Pain and spotting after sex may occur from vaginal dryness. Menopause may also lead to changes in sex drive and satisfaction.
Discuss changes with your healthcare provider to help determine the best treatment options for you.
How to manage symptoms
There are options available to help you manage any of the symptoms you experience in postmenopause. Be sure to talk with your healthcare provider about any specific concerns you have. Here are some of the common methods used to manage postmenopausal symptoms.
Use lubrication for vaginal dryness
Water-based lubricants may help make intercourse more comfortable. Vaginal dryness leads to pain and discomfort during intercourse, which takes away from sexual satisfaction and health.
If lubricants aren’t helping with your vaginal dryness, talk with your healthcare provider. They may recommend vaginal estrogen creams, moisturizers, or vaginal rings to help (Peacock, 2021)
Exercise helps support your overall health and wellbeing. Research suggests regular exercise can improve insomnia, sleep quality, and depression symptoms that often come with menopause (Sternfeld, 2014). In addition, exercises to strengthen the pelvic floor muscles may help manage urinary problems and promote physical health (Nguyen, 2020).
Get enough sleep
A lack of sleep leads to multiple mental and physical health problems (Medic, 2017). Insomnia and trouble sleeping are common symptoms of menopause and postmenopause. Your healthcare provider may recommend medications or other treatments to help you sleep better.
Here are some tips to help improve sleep quality:
- Limit screen time before bed.
- Stay on a consistent sleep schedule.
- Keep your bedroom dark, cool, and quiet.
- Limit caffeine during the afternoon and evening.
Prioritize your mental health
If you’re struggling with mood changes or symptoms of depression, don’t hesitate to talk to a mental health professional. It’s difficult to ask for help. Still, talking with a mental health professional can help you feel better soon. They may recommend medications, therapy, or a combination to help you cope with stress more effectively.
Some medications, like antidepressants, may also be recommended to help manage some other symptoms of menopause, such as hot flashes.
Try hormonal therapy
Your healthcare provider may recommend hormone replacement therapy (HRT) to help manage some symptoms short term. It’s often not recommended as a long-term treatment because of potential side effects of estrogen therapy, like an increased risk of breast cancer and heart disease for some (Peacock, 2021).
Take calcium and vitamin D supplements
When to see a healthcare provider
It’s recommended to continue seeing your gynecologist and primary care doctor after menopause. Regular health visits and screenings help prevent and monitor health conditions that may develop. Common tests and screening after menopause often include:
- Bone mineral density scans for osteoporosis screening
- Pap smears
- Pelvic exams
- Breast exams
- Other routine health screenings
Contact your healthcare provider if you’re postmenopausal and experience vaginal bleeding because this could be a sign of a serious medical condition.
Menopause is a natural change in a woman’s life. It may take time to adjust to the hormonal changes after menopause. After menopause, many women experience fewer symptoms, like mood swings and hot flashes.
Medical treatments and lifestyle changes may help to improve your symptoms and lower your risk for medical conditions. Contact your healthcare provider with any questions you have about postmenopausal symptoms.
- Maas AH, & Appelman YE. (2010). Gender differences in coronary heart disease. Netherlands Heart Journal: Monthly Journal of The Netherlands Society of Cardiology and The Netherlands Heart Foundation, 18(12), 598–602. doi: 10.1007/s12471-010-0841-y. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3018605/
- Medic G, Wille M, & Hemels ME. (2017). Short- and long-term health consequences of sleep disruption. Nature and Science of Sleep, 9, 151–161. doi: 10.2147/NSS.S134864. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5449130/
- Nguyen TM, Do T, Tran, TN, & Kim JH. (2020). Exercise and quality of life in women with menopausal symptoms: a systematic review and meta-analysis of randomized controlled trials. International Journal of Environmental Research and Public Health, 17(19), 7049. doi: 10.3390/ijerph17197049. Retrieved from https://pubmed.ncbi.nlm.nih.gov/32993147/
- Peacock K, Ketvertis KM. (2021). Menopause. [Updated 2021 Jun 29]. In: StatPearls [Internet]. Retrieved on Aug. 26, 2021 from https://www.ncbi.nlm.nih.gov/books/NBK507826/
- Santoro N. (2016). Perimenopause: from research to practice. Journal of Women’s Health, 25(4), 332–339. doi: 10.1089/jwh.2015.5556. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4834516/
- Sternfeld B, Guthrie KA, Ensrud KE, LaCroix AZ, Larson JC, Dunn AL, et al. (2014). Efficacy of exercise for menopausal symptoms: a randomized controlled trial. Menopause (New York, N.Y.), 21(4), 330–338. doi: 10.1097/GME.0b013e31829e4089. Retrieved from https://pubmed.ncbi.nlm.nih.gov/23899828/
Dr. Chimene Richa is a board-certified Ophthalmologist and Senior Medical Writer/Reviewer at Ro.