Life After Menopause: Thriving in the Postmenopause Years

If you’ve navigated the choppy waters of perimenopause and weathered the storm of menopause, congratulations! You’re now entering the postmenopause stage of life. This phase, often overlooked in discussions about menopause, can bring its own set of challenges and opportunities. Let’s explore what postmenopause means, what you can expect, and how you can thrive during this new chapter of your life.

Understanding Post-menopause: What Defines This Stage?

Postmenopause is the stage that follows menopause and lasts for the rest of your life. It officially begins when you’ve gone 12 consecutive months without a menstrual period due to the natural decline of reproductive hormones [1]. Here’s how it fits into the broader menopause transition:

1. Perimenopause: The transitional phase leading up to menopause

2. Menopause: The point at which you’ve gone 12 consecutive months without a menstrual period

3. Postmenopause: All the years following menopause

You’ll know you’re in postmenopause when:

• You haven’t had a period for at least 12 months (and this isn’t due to other factors like pregnancy or certain medications)
• Your hormone levels have stabilised, albeit at a lower level than during your reproductive years
• Many of the intense symptoms associated with perimenopause and menopause, such as hot flushes, begin to subside (though this can take several years for some women)

Common Challenges in Postmenopause

While the roller coaster of perimenopause is behind you, postmenopause can still present some challenges:

1. Vaginal Dryness and Urinary Issues: Lower oestrogen levels can lead to vaginal dryness, itching, and discomfort during intercourse. Some women also experience urinary incontinence or increased risk of urinary tract infections [2].

2. Bone Health Concerns: The decrease in oestrogen can accelerate bone loss, increasing the risk of osteoporosis and fractures [3].

3. Cardiovascular Health: The protective effects of oestrogen on heart health diminish after menopause, potentially increasing the risk of heart disease [4].

4. Weight Management: Many women find it more challenging to maintain a healthy weight due to slowing metabolism and hormonal changes.

5. Sexual Health: Changes in libido and sexual function can continue into postmenopause.

6. Skin and Hair Changes: You might notice your skin becoming drier and less elastic, and your hair might thin or change in texture.

7. Cognitive Changes: Some women report experiencing ‘brain fog’ or memory issues, although research in this area is ongoing [5].

The Upsides of Postmenopause

It’s not all challenges – postmenopause can bring several positive changes:

1. No More Periods: Say goodbye to menstrual cycles and the associated discomfort and inconvenience.

2. End of PMS: Premenstrual symptoms are a thing of the past.

3. No More Contraception Worries: If you’ve been relying on contraception, you can now stop (though remember, it’s recommended to continue using protection against sexually transmitted infections if you have new partners).

4. Increased Self-Confidence: Many women report feeling more self-assured and comfortable in their own skin.

5. More Predictable Moods: As hormones stabilise, you might find your mood becomes more stable too.

6. Freedom to Focus on Yourself: With child-rearing years often behind them, many women find this a time to pursue new interests or rediscover old ones.

7. Perspective and Wisdom: The life experience you’ve gained can bring a sense of perspective and increased wisdom.

Best Practices for Managing Your Health in Post-menopause

Taking care of your health is crucial during postmenopause. Here are some best practices, especially important in the early days of this stage:

1. Regular Health Check-ups: Stay on top of recommended screenings for issues like osteoporosis, breast cancer, and heart disease. Your GP can advise on the appropriate schedule for these [6].

2. Bone Health: Ensure you’re getting enough calcium and vitamin D, either through diet or supplements. Weight-bearing exercises can also help maintain bone density [3].

3. Heart Health: Regular cardiovascular exercise, a heart-healthy diet, and managing factors like blood pressure and cholesterol are crucial [4].

4. Pelvic Floor Exercises: These can help with bladder control and improve sexual function [7].

5. Vaginal Health: If you’re experiencing vaginal dryness, discuss treatment options with your healthcare provider. These might include vaginal moisturisers, lubricants, or local oestrogen treatments [2].

6. Mental Health: Stay socially connected and mentally active. If you’re struggling with mood issues, don’t hesitate to seek support.

7. Healthy Lifestyle: Maintain a balanced diet, stay physically active, limit alcohol intake, and don’t smoke. These habits support overall health and can help manage weight [8].

8. Hormone Therapy Consideration: If you’re experiencing persistent menopausal symptoms, discuss the possibility of hormone therapy with your healthcare provider. The benefits and risks can change as you move into postmenopause [9].

9. Sexual Health: If you’re experiencing sexual health issues, don’t suffer in silence. There are many treatments available, from lubricants to hormone therapies [10].

10. Mindfulness and Stress Management: Techniques like meditation, yoga, or tai chi can help manage stress and improve overall well-being [11].

Embracing Your Postmenopausal Years

Postmenopause is not just an ending, but a new beginning. It’s a time to reassess your health, your goals, and your lifestyle. Many women find these years to be some of the most fulfilling of their lives, free from the physical and emotional upheavals of their reproductive years.

Remember, every woman’s experience of postmenopause is unique. What’s important is listening to your body, staying informed about your health, and not hesitating to seek help if you need it. With the right care and attitude, you can thrive in your postmenopausal years.

If you’re struggling with any postmenopausal symptoms or have concerns about your health, don’t hesitate to reach out to a healthcare provider or contact the Emsee team here. 

References

1. Harlow, S. D., et al. (2012). Executive summary of the Stages of Reproductive Aging Workshop + 10: addressing the unfinished agenda of staging reproductive aging. Menopause, 19(4), 387-395.

2. Nappi, R. E., & Palacios, S. (2014). Impact of vulvovaginal atrophy on sexual health and quality of life at postmenopause. Climacteric, 17(1), 3-9.

3. Eastell, R., et al. (2016). Postmenopausal osteoporosis. Nature Reviews Disease Primers, 2, 16069.

4. El Khoudary, S. R., et al. (2020). Menopause Transition and Cardiovascular Disease Risk: Implications for Timing of Early Prevention. Circulation, 142(25), e506-e532.

5. Maki, P. M., & Henderson, V. W. (2012). Hormone therapy, dementia, and cognition: the Women’s Health Initiative 10 years on. Climacteric, 15(3), 256-262.

6. National Institute for Health and Care Excellence. (2015). Menopause: diagnosis and management. NICE guideline [NG23].

7. Dumoulin, C., et al. (2018). Pelvic floor muscle training versus no treatment, or inactive control treatments, for urinary incontinence in women. Cochrane Database of Systematic Reviews, (10).

8. Daley, A., et al. (2014). The effectiveness of exercise as treatment for vasomotor menopausal symptoms: randomised controlled trial. BJOG: An International Journal of Obstetrics & Gynaecology, 122(4), 565-575.

9. The NAMS 2017 Hormone Therapy Position Statement Advisory Panel. (2017). The 2017 hormone therapy position statement of The North American Menopause Society. Menopause, 24(7), 728-753.

10. Kingsberg, S. A., et al. (2017). Vulvar and vaginal atrophy in postmenopausal women: findings from the REVIVE (REal Women’s VIews of Treatment Options for Menopausal Vaginal ChangEs) survey. The Journal of Sexual Medicine, 14(5), 681-689.

11. Woods, N. F., et al. (2014). Cortisol levels during the menopausal transition and early postmenopause: observations from the Seattle Midlife Women’s Health Study. Menopause, 21(10), 1093-1103.