Understanding Postmenopause: Changes, Symptoms, and Care

The term menopause refers to the day when your periods have stopped for 12 months (because your ovaries aren’t making hormones), marking the end of fertility. The average age of the menopause in the UK is 51. Around 5% of women will go through an early menopause, between the age of 40-45, and 1% under the age of 40. This is known as Premature Ovarian Insufficiency, or POI.

As soon as you have been through the menopause you immediately become postmenopausal and you’re postmenopausal for the rest of your life.

Physiological Changes

The postmenopausal phase is characterised by lower levels of reproductive hormones, especially oestrogen and progesterone. This decline can lead to significant changes in the body, including:

• Decreased bone density: The reduction in oestrogen can accelerate bone loss, increasing the risk of osteoporosis.
• Changes in cardiovascular health: Oestrogen’s protective effect on the heart diminishes, slightly raising the risk of cardiovascular conditions.
• Vaginal and urinary changes: Thinning of the vaginal walls and urinary incontinence may occur due to reduced oestrogen levels.

Symptoms of Postmenopause

Postmenopause is a significant phase in a woman’s life that brings about various physiological changes.  In this third phase of the menopause transition (after perimenopause and menopause), you may still experience symptoms, commonly for a further five to seven years, though many experience symptoms for longer than this. Understanding these symptoms can help in managing them effectively. Listed below are some of the most commonly reported symptoms during the postmenopausal period:

• Hot flushes: These are sudden and intense feelings of heat which are primarily experienced across the face, neck, and chest. Hot flushes are a common complaint and can vary in frequency and severity among different women.
• Night sweats and sleep problems: Night sweats can be quite severe and often disrupt normal sleep patterns, leading to insomnia and other sleep-related issues. The lack of restful sleep can further exacerbate other menopausal symptoms and impact overall health.
• Mood changes: The hormonal changes that occur during postmenopause can also lead to emotional symptoms. Women may experience mood swings, irritability, or an increase in depressive feelings, all of which can affect their mental health and daily functioning.

You can read more about hot flushes and night sweats and the range of ways to manage them here, and here for mood changes in the menopause.

It is important for women going through postmenopause to seek support and potentially discuss these symptoms with their GP or menopause specialist. There are various treatments and lifestyle adjustments that can help alleviate these symptoms and improve quality of life during this transition.

Health Risks Associated with Postmenopause

The hormonal changes that occur during postmenopause can lead to an increased risk of various health concerns. It is essential to be aware of these potential issues in order to manage them effectively:

• Osteoporosis: This condition is a major concern for postmenopausal women, primarily due to a marked decrease in bone mass. Lower oestrogen levels during postmenopause significantly affect bone density, thereby raising the likelihood of fractures and other related complications. You can read more about osteoporosis here.
• Heart disease: Postmenopausal women are at a higher risk of developing cardiovascular issues. Before the menopause, the risk of heart disease for women is lower than that of men. The risk of heart disease increases after the menopause, and an important contributory factor to this is the loss of oestrogen postmenopause. You may not realise that twice as many women die from heart disease than from breast cancer. You can read more about heart disease here.
• Weight gain: Another common concern during postmenopause is weight gain. As metabolic rates decline, managing weight becomes more challenging. This increase in weight can further contribute to serious health problems, including diabetes and increased strain on the heart and joints. You can read more about weight gain here.
• Bladder issues: The loss of oestrogen during the menopause transition makes the tissue of your bladder more sensitive and delicate. Instead of happily expanding as it fills with urine – like filling a balloon with water – the bladder gets irritated and starts to squeeze to empty before it should do. This can lead to discomfort and pain. Bladder symptoms become more likely as you get older, as the effects of lack of oestrogen on the bladder take their toll. You can read more about bladder issues here.
• Vaginal symptoms:Vaginal symptoms become increasingly common as you age. Approximately two-thirds of postmenopausal women who haven’t taken HRT suffer from changes in the vagina and bladder linked to low oestrogen. These symptoms can have a knock-on effect on sex and relationships. So our message here is that you don’t have to just put up with it – because, for most women, these symptoms are easy to treat. You can more about vaginal dryness here and loss of libido here.

Understanding these risks and taking proactive steps towards maintaining health can make a significant difference in the quality of life for postmenopausal women. Regular check-ups, a balanced diet, and consistent physical activity are recommended to mitigate these risks.

Managing Postmenopausal Symptoms

Effective management of postmenopausal symptoms can significantly improve quality of life. Key strategies include:

• Lifestyle modifications: Regular exercise, a balanced diet, and adequate sleep are essential.
• Hormone Replacement Therapy (HRT): Can alleviate symptoms by replenishing oestrogen and progesterone levels, though it should be discussed with a healthcare provider.
• Regular check-ups: Essential for monitoring health changes and managing risks associated with heart disease and osteoporosis.

Importance of Diet and Exercise

It is vitally important to maintain a healthy lifestyle, especially during the postmenopausal life, as it plays a role in managing symptoms and minimising health risks associated with this stage of life. The key components to focus on include:

• Diet: Adhering to a diet that is rich in essential nutrients such as calcium, vitamin D, and protein is imperative. These nutrients are fundamental in supporting bone health and enhancing overall well-being. Incorporating a variety of nutrient-dense foods like dairy products, leafy greens, and lean proteins can help achieve this balanced diet.
• Exercise: Engaging in regular physical activity is equally critical. Activities that involve weight-bearing and muscle-strengthening exercises not only aid in maintaining bone density but also play a significant role in sustaining cardiovascular health. Examples of such exercises include walking, jogging, yoga, and resistance training, which should be incorporated into a weekly routine to achieve optimal health benefits.

By focusing on these key aspects, individuals can significantly improve their quality of life during the postmenopausal period, ensuring they remain active, healthy, and vibrant.

We have a wealth of free, evidence-based information and advice from a range of experts on all things nutrition here and on all things exercise here.

Conclusion – our top tips for living your healthiest postmenopausal life

• Take stock and take control of any lingering menopause symptoms and commit to taking action. Speak to your GP or one of the doctors in our menopause clinic about what you can do to treat them. It’s never too late to have the discussion.
• Look at your lifestyle. Start exercising regularly, develop healthy eating habits and ensure you’re getting enough sleep at night.
• Go for regular health screenings.

Always remember our mantra – knowledge is power. So take the time to understand your body, to understand the menopause – and to take control. We’re with you all the way!

Hopefully, you now understand a little more about postmenopause life and what to expect from it. Many women find our Menopause Questionnaire helps them understand if they are postmenopausal or not.

You can use our symptom checker to see if you still have symptoms. Or perhaps you’d like to book an appointment with our menopause clinic to speak to one of our highly experienced doctors.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.