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鈥檚 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鈥檚 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 鈥
Postmenopause begins once you鈥檝e 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鈥搇ike all of life鈥揷omes with its positive and negative effects. On one hand, you don鈥檛 have to worry about dealing with 鈥渢hat time of the month鈥 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鈥檝e 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鈥檚 natural production of estrogen. Talk to your doctor about any health issues that cause discomfort or pain.
Why Postmenopause Matters
It鈥檚 important to pay attention to when menopause begins for one major reason: If you experience post-menopausal vaginal bleeding, it鈥檚 important to see your doctor as it may indicate a serious medical issue.
How Postmenopause Affects the Body
We don鈥檛 fully appreciate the natural hormone estrogen until it鈥檚 gone. This humble hormone is essential for maintaining health throughout a woman鈥檚 body 鈥 not just the reproductive system. With a decrease in estrogen, your body鈥檚 major systems can be affected too.
Here鈥檚 how estrogen relates to the rest of your body once you鈥檙e postmenopause.
Heart/Cardiovascular System
Estrogen may have a positive effect on the inner layer of artery wall, helping to regulate blood flow. That鈥檚 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鈥檝e 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鈥攐r 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鈥檛 to blame. Age-related weight gain often occurs with a natural decrease in physical activity.
PCP vs. Menopause Specialist: Who Should You See First?
Postmenopause changes your body in many ways. You may have trouble identifying what changes are normal or not鈥攂ut you don鈥檛 need to live with disruptive, uncomfortable symptoms.
Schedule a visit with your primary care provider or your gynecologist first for help navigating this new phase of your life. Seek out a menopause specialist if you feel like your provider didn鈥檛 effectively address your symptoms or questions.
Your provider may refer you to one of our menopause specialists if you have a history of the following conditions:
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Estrogen-sensitive cancer
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Stroke
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Heart attack
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Blood clots
Menopause specialists will ask questions to better understand how your symptoms affect your quality of life. Our specialists are also trained to know if additional testing or treatment may help you.
Talk to your provider if you鈥檙e still experiencing vaginal bleeding after you鈥檝e reached menopause (12 months after your last period), which could be a sign of a more serious condition.
Find a Menopause Specialist
Pros & Cons of Menopause 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 of MHT
- Most effective treatment for hot flashes, night sweats, and vaginal dryness.
- Improves your bone density and decrease your risk of an osteoporotic-related fracture
- Mood improvement and cognitive function
- Improves sleep disturbances associated with menopause
Risks of MHT
- Increased breast cancer risk: Combined estrogen-progestin therapy may slightly increase the risk of breast cancer, especially with long-term use.
- Blood clot risk: Estrogen may increase your risk of blood clots, particularly in women with existing risk factors. Transdermal estrogen options are considered safer than oral estrogen.
- Stroke risk: Your risk for stroke may increase, depending on individual factors.
- Endometrial cancer risk: Women with an intact uterus taking estrogen alone may be at increased risk of endometrial cancer, which can be mitigated by adding progestin.
Choices in Menopausal Hormone Therapy
Talk to your doctor about these factors before you decide if menopause hormone therapy (MHT) is right for you:
Dosage & Age
You'll benefit most from hormone therapy if you take it within 10 years of your last menstrual period and before you turn 60. This timeline helps reduce your risk of cardiovascular disease. Women who start hormone therapy in this timeframe also have better overall health.
Topical or Oral
It鈥檚 also important to use the right type of estrogen for you. If you鈥檙e experiencing vaginal or menopause-related urinary tract issues, a topical estrogen applied directly to the vagina could be the best choice. If you鈥檙e experiencing a variety of symptoms or prefer to not use a cream, you may decide to go with an estrogen pill or patch.
Bioidentical Hormone Therapy
Bioidentical hormones are plant-derived 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 and hormone pellets are not necessarily safer and can lead to supraphysiologic hormone levels.
What You Can Do to Stay Healthy Postmenopause
It鈥檚 never been more important to take a proactive role in your health care. Many women suffer unnecessarily from symptoms that can be managed with home remedies and prescribed treatments:
- 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 aid in strengthening your bones.
- Vaginal lubricants increase comfort during sex.
- Incontinence treatments for gaining bladder control.
- Exercise to stimulate your heart and bone health and maintain a healthy weight.
- Well-balance diet to help you manage a healthy weight.
Talk to your doctor before you begin taking any new supplement or treatment, including over-the-counter and herbal remedies.
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鈥檚 never been a better time to focus on your own well-being.
Menopause Society Certified
The 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.
