What It Means to Be Postmenopausal

What is postmenopause, and how is it different from menopause?

Menopause is a natural process that occurs after a woman has gone 12 consecutive months without a period that is not due to another cause, such as hormonal birth control, surgical removal of the ovaries, or another reason. Your ovaries no longer release eggs, and hormones, including estrogen, decline significantly.

In the U.S., menopause usually occurs around the age of 51, with a range of 45 to 55 being typical. There are some health benefits to reaching menopause later. Studies show that going through menopause at a later age is associated with greater life expectancy, reduced cardiovascular disease, and decreased loss of bone density. However, later menopause does increase the risk of breast and gynecological cancers.

If you are 51 and are not yet menopausal, don’t worry. Studies show that when you go through menopause may be determined by genetics. Research also suggests that this may link to certain families’ longevity. One study even found that going through menopause later is associated with longer life.

Postmenopause is the stage of a woman’s life after reaching menopause. We often refer to this stage as being menopausal, which is fine, but technically you’ve graduated to the postmenopausal stage.

When you are postmenopausal, you’ll no longer have menstrual periods. Unfortunately, it doesn’t mean you’ll become symptom-free. Women in postmenopause typically experience menopausal symptoms. Some will go away, others will become less noticeable, and a few may get more severe.

What symptoms should I expect during postmenopause?

Symptoms of menopause are different for every woman. Typical symptoms include hot flashes, night sweats, sleep disturbance, mood changes, vaginal dryness, and loss of libido. Vaginal dryness is one symptom that tends to become more severe during postmenopause. Hot flashes and night sweats typically start in late perimenopause and can last several years into postmenopause before they taper off. Dry skin and hair loss may become more pronounced. Joint pain is common. Bone loss also accelerates rapidly in the initial postmenopause period.

Mood changes warrant a special mention as these issues often go underdiagnosed, and many women suffer unnecessarily. Menopause can be an emotional roller coaster for some, with irritability, depression, and anxiety being the most typical.

How long does menopause last, and when will symptoms stop?

Menopause is a life stage that lasts about one-third of your life. It begins with perimenopause, which typically starts in your early 40s. Symptoms can emerge around that time or later. Recently, a study showed that menopausal symptoms start much earlier than most women anticipate. Most of the women in the study did not expect symptoms to start until they reached age 50 but were surprised when their symptoms started before their menstrual cycles became irregular.

After reaching menopause and transitioning to postmenopause, many women continue to experience menopausal symptoms, especially hot flashes. The average length of symptoms is seven to nine years, but some women experience menopausal symptoms for a shorter or much longer period. In fact, up to fifty percent of women report having at least one menopausal symptom, usually hot flashes, for several years after menopause. It is rare, but not impossible, to have symptoms into the 80th or 90th decade of life. More women are reporting a reoccurrence of symptoms in their later years.

Does menopause cause weight gain?

Weight gain is not caused by menopause, but menopause does cause the distribution of fat around the waistline, also known as “belly fat.” It’s actually the aging process that causes weight gain. Other factors include changes in activity levels, diet, and metabolism.

Many women find that their appetite increases during menopause, leading to weight gain. While menopause may not be the direct cause of weight gain, it can be a contributing factor. Therefore, it is important to be aware of the potential for weight gain during this time and take steps to prevent it. You may need to make some adjustments as exercise and eating habits that served you well to manage your weight when you were younger no longer have the same impact.

What other things should I be concerned about in postmenopause?

Because of the hormone shifts during this time, health problems like high blood pressure, high cholesterol, and high triglycerides start to show up. The most significant health problem women face after reaching menopause is heart disease, the #1 killer of women by a wide margin. According to the American Heart Association, heart attacks increase in the first decade after menopause. Estrogen keeps blood vessels flexible, so once estrogen decreases, vessels can’t contract and expand like they used to. Combine this with high blood pressure and cholesterol deposits, it becomes a recipe for heart disease. Doubling down on heart-healthy strategies like exercise, stress management, and healthy eating become more important than ever for postmenopausal women.

Menopause affects not only your heart but your bones too. Osteoporosis, or decreased bone density, increases the risk for bone fractures, most commonly in the hips, ribs, spine, and wrists. The loss of muscle mass that occurs due to decreased estrogen production also decreases the protective effect on the bones. Regular exercise can help maintain muscle mass and bone density and, as a bonus, decreases other symptoms of menopause and chronic disease risk.

Postmenopausal bleeding is something to watch out for. Postmenopausal bleeding – light or heavy – is never okay. Even if it’s a few brown specks, you should always visit your healthcare clinician and get it checked out. Most of the time, it won’t be anything serious, but postmenopausal bleeding could indicate a condition like endometrial cancer.

Celebrate the Start of Something Great

When you reach menopause and graduate to the postmenopause stage, it’s a great time to check in with your health clinician. Share your symptoms, as there may be treatments that can help. For example, many women don’t discuss vaginal dryness, thinking there’s nothing that can be done. But that’s not the case; several treatment options are available, including low-dose vaginal estrogen. Also, talk about potential health risks and get a baseline for where you’re at. Together, you can make a plan to lower your risk of chronic disease.

You can do many holistic things to make menopause easier and promote healthy aging, such as exercise, eating healthy foods, getting enough sleep, and managing your stress levels. You may also find it helpful to talk with other women who are going through or have gone through menopause.

Knowing what to expect and taking steps to manage symptoms will empower you with the knowledge and control you need to move confidently into postmenopause. Consider it a time to look forward to when you are at the peak of your powers and be exactly who you are.

Looking for more expert support on knowing where you’re at in the menopause journey and what to expect next? Download Midday from the App Store or visit us at Midday.Health.

Jen Wong, RN, MSN, FNP-C is a nurse practitioner with over 20 years in medicine specializing in women’s health.