Welcome to Postmenopausal Life
Menopause commonly gets a bad rap as a point in life when hot flashes, overactive bladder, and other embarrassing symptoms begin. In fact, it’s during perimenopause (months or years before menopause occurs) when the main side effects happen. You achieve menopause itself 12 months after your final period, and you are then in the phase call postmenopause.
The good news is: During postmenopause, many of the symptoms you experienced during perimenopause and menopause may cease. However, there are other health issues to consider which may be caused by your body’s decrease in hormones.
Perimenopause, menopause, and postmenopause are natural parts of aging. Understanding the effects that postmenopause may have on your body can help you take steps to maintain good health no matter your age.
Peri, Meno, & Post: When Does the Change Happen?
Your hormones can begin decreasing in your 30s and may continue well into your 40s and 50s. This is called perimenopause or the transition to menopause for most women.
The average age of menopause for US women is 51. Most women reach this milestone somewhere between ages 45 and 55.
Once your period has stopped for 12 months, you are considered in menopause and enter the postmenopause stage of life.
You Know You're in Postmenopause When …
Postmenopause begins once you’ve officially reached menopause: 12 months after your last period.
The average age of menopause for US women is 51. Most women reach this milestone somewhere between ages 45 and 55.
A New Pause In Life
Achieving postmenopause is a milestone that–like all of life–comes with its positive and negative effects. On one hand, you don’t have to worry about dealing with “that time of the month” again. No cramps, backache, headache, or mood swings that come with your menstrual cycle. PMS is a thing of the past!
Plus, you no longer have to concern yourself about unplanned pregnancy (although protecting yourself from STDs is still a must.) Although not a given, even hot flashes fade once you’ve reached the postmenopausal stage.
On the other hand, postmenopause may bring new health issues. Some are part of the typical aging process. Others are unique to the decrease in your body’s natural production of estrogen. Talk to your doctor about any health issues that cause discomfort or pain.
Why Postmenopause Matters
It’s important to pay attention to when menopause begins for one major reason: If you experience post-menopausal vaginal bleeding, it’s important to see your doctor as it may indicate a serious medical issue.
How Postmenopause Affects the Body
We don’t fully appreciate the natural hormone estrogen until it’s gone. This humble hormone is essential for maintaining health throughout a woman’s body – not just the reproductive system. With a decrease in estrogen, your body’s major systems can be affected too.
Here’s how estrogen relates to the rest of your body once you’re postmenopause.
Heart/Cardiovascular System
Estrogen may have a positive effect on the inner layer of artery wall, helping to regulate blood flow. That’s why researchers believe a decline in estrogen after menopause may be a factor in the increase in heart disease among post-menopausal women, according to the American Heart Association. Even though heart disease risk goes up after menopause, taking estrogen has an associated cardiovascular benefit if you start it early or within 10 years of natural menopause.
Bone/Skeletal System
There is a direct relationship between the lack of estrogen after menopause and bone loss. Women who’ve gone through menopause are more likely to develop osteoporosis, a condition that causes bone to become brittle and weak.
Urinary System
Lower levels of estrogen may cause the urethra lining to thin. Also, the pelvic muscles around the urethra may get weaker due to aging or vaginal childbirth. This can increase the risk of bladder leakage (incontinence), urinary tract infections, and other urogynecology problems.
Sexuality
Estrogen helps maintain the natural lubrication in the walls of the vagina. Lowered estrogen during menopause causes the vaginal tissues to become thinner and more easily irritated during sex—or dry out. This can lead to an increase in urinary tract infections and genitourinary syndrome of menopause, also known as atrophic vaginitis or vaginal atrophy.
Metabolism
Reduced estrogen may lower your metabolic rate, which prompts your body to store fat instead of burning it. But menopause alone isn’t to blame. Age-related weight gain often occurs with a natural decrease in physical activity.
Pros & Cons of Menopausal Hormone Therapy (MHT)
Since menopause is caused by a decrease in estrogen and progesterone, why not just replace them and continue on? Menopausal hormone therapy (MHT) is an option for many women who wish to combat the health risks that increase during their postmenopausal years. But this therapy may have its own risks.
Benefits: Estrogen therapy (with or without progesterone) may relieve hot flashes, night sweats, vaginal dryness and protect against bone loss.
Risks: Estrogen-only therapy may increase your risk of uterine cancer (if without progesterone/progestin use), stroke, heart disease, and deep vein thrombosis. Combine hormone therapy (estrogen with progesterone) could cause an increased risk of breast cancer, stroke, heart disease, deep vein thrombosis, and gallbladder disease.
Talk to your doctor about the right approach to managing your health changes after menopause.
Choices in Menopausal Hormone Therapy
Talk to your doctor about these factors before you decide if HRT is right for you:
Dosage & Age
Most experts recommend taking the lowest dose HRT for the shortest duration. The older you are, the greater the risks. Treating someone who’s 55 is lower risk than 85.
Topical or Oral
It’s also important to use the right type of estrogen for you. If you’re experiencing vaginal or menopause-related urinary tract issues, a topical estrogen applied directly to the vagina could be the best choice. If you’re experiencing a variety of symptoms or prefer to not use a cream, you may decide to go with an oral estrogen.
Bioidentical or Traditional Hormone Therapy
Traditional hormone therapy uses plant derived, man made hormones or hormones found in the urine of pregnant horses. Patients can take it orally, via patch, or topically to the genital area.
Bioidentical hormones are plant derived or man-made hormones similar to the ones your body produces. Some bioidentical hormones are the same as those used in conventional products. Others are not FDA approved and are available only from compounding pharmacies. Unregulated compounds, pellets, and unstudied ingredients are not necessarily safer and can lead to supraphysiologic hormone levels.
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What You Can Do to Stay Healthy Postmenopause
It’s never been more important to take a proactive role in your health care. Many women suffer unnecessarily from symptoms that can be managed with prescribed treatments or home remedies. Talk to your doctor before you begin taking any new supplement or treatment, including over-the-counter and herbal remedies.
Aside from hormone therapy some of the most common postmenopausal treatments include:
- Hormone therapy: Helps reduce hot flashes and vaginal dryness, and may prevent bone loss.
- Vaginal estrogen: Relieves vaginal dryness, discomfort during sex, and some urinary symptoms.
- Calcium and vitamin D supplements or other osteoporosis treatments: Aids in strengthening bones.
- Vaginal lubricants: Increases comfort during sex.
- Incontinence treatments: Various lifestyle changes and medical options for gaining bladder control.
- Exercise: Stimulates heart and bone health and maintains healthy weight.
- Diet: Helps manage healthy weight.
Postmenopausal health is about a lot more than your ovaries and uterus. Keep up with annual physical exams and schedule those regular preventive screenings, such as mammogram, bone density screening, Pap smear, mole checks, and colonoscopy. Remember your teeth and gums and your eyes, too. There’s never been a better time to focus on your own well-being.
When Should You See a Doctor About Postmenopause Symptoms?
It’s important to talk to your doctor about any symptoms that cause discomfort or disruption in your daily life. If you experience hot flashes exclusively at night, sudden weight loss or gain, or abdominal pain, swelling, or tenderness let your doctor know as these may indicate a more serious condition.
Menopause Society Certified
The Menopause Society has certified all our providers. The Menopause Society is a leading nonprofit organization dedicated to promoting the health and quality of life of all women during midlife and beyond through an understanding of menopause and healthy aging.
