What Happens After Menopause?

What Happens After Menopause?

Being Postmenopausal: Here’s What You Need to Know

If you’ve given any thought to what life looks like postmenopause, you’ve probably imagined it to be a little dull and colorless. The image of a barren, dried up husk of aging postmenopausal womanhood is sadly something the media hasn’t discouraged in the past.

The great news is that how your postmenopausal life pans out is pretty much entirely up to you and this final stage of our reproductive life is in no way indicative of the end of our lives as bright, happy women with plenty of life left to enjoy as we wish.

So, what is postmenopause and how do you know if you are postmenopausal?

How Will I Know If I Am Postmenopausal?

Officially the postmenopause period starts 12 months after your last menstrual period.

You could ask your doctor to check for menopause/postmenopause before that by measuring levels of follicle stimulating hormone (FSH) with a blood test.

The pituitary gland produces FSH which dramatically rises as your ovaries begin to shut down. High levels of FSH could indicate you are menopausal, but since levels fluctuate wildly during the menopause, the “year without Aunt Flo” system is generally more reliable.

What Postmenopausal Symptoms Might I Experience?

You’ll be glad to know that most troublesome perimenopause and menopause issues like those infamous hot flashes will melt away. Generally most women find that menopausal symptoms can continue for around four or five years after the official start of the postmenopause stage, but usually decrease in frequency and intensity.


Due to the lack of estrogen, you might notice your skin loses elasticity and skin, eyes and mouth could feel dry. You might also experience vaginal dryness, discomfort during sex or a loss of libido. Other conditions can cause these symptoms so it’s always worth mentioning to your doctor in case there is an underlying condition which could be treated or could prove serious.

Don’t be fooled though. Even if the worst of your symptoms have gone and your periods are few and far between or even seem to have stopped altogether you could be still menopausal – not completely postmenopausal – so, until it’s been a full year since your last period, there is a small chance that you could still get pregnant.

How to Stay Healthy During Postmenopause

The bad news is that as a result of a lower level of estrogen, postmenopausal women are at increased risk for several health conditions, such as osteoporosis and heart disease.

Taking certain medications, such as hormone replacement therapy, and healthy lifestyle changes may reduce the risk of some of these conditions. Since every woman’s risk is different, talk to your doctor to learn what steps you can take to reduce your individual risk. It may be that you could simply tweak your diet by cutting down the amount you eat or changing what you eat. You might be advised to make efforts to do more exercise or give up smoking to hugely cut the risk of developing these conditions.

Given that other health conditions can be more prevalent in later life, regardless of the state of your hormones, it’s not a bad idea to think about taking a close, honest look at your diet and lifestyle anyway.

Making changes will almost be certainly easier if you have a buddy supporting and encouraging you so why not call a family meeting or speak to your partner about living a healthier life. Even those not at risk for postmenopause systems will benefit from even small changes.

Eat heart-healthy meals with plenty of fruit and vegetables, cut down on processed food including ready-meals which can be high in salt and sugar and processed meats like bacon, hot dogs and other sausages.

Even those with mobility issues can benefit from some exercise. Swimming, in particular, is a great way of keeping fit without putting a strain on aging joints.

When To See Your Doctor About Postmenopause

It’s important to stay vigilant as some health conditions you might attribute to the menopausal and postmenopausal state could, in fact, be indicative of something more serious.

For example, if you notice any bleeding at all after you’ve gone a full 12 months without a menstrual period, it’s vital to see a doctor as soon as possible.

Most episodes of postmenopause bleeding are innocent but very occasionally they can be a symptom of something life-threatening and should be checked by an expert as soon as possible.

This is true even if the bleeding only happens once, and you only have a small amount of pink, red or red/brown staining in your underwear or if you have no other symptoms.

The most common causes of postmenopausal bleeding are inflammation and thinning of the vaginal lining (atrophic vaginitis) or womb lining (endometrial atrophy) – caused by lower estrogen levels. It can also be caused by polyps which are growths in the uterus which are usually benign (not cancerous).

First steps after noticing any bleeding would be to make an appointment with your regular doctor or OB-Gyn who will probably ensure you get checked over as a matter of urgency.

You can expect to be given a pelvic and vaginal checkup and will probably have an ultrasound scan where a slim scanner is inserted into your vagina. You might also be offered a hysteroscopy where a thin camera is passed via the vagina into the uterus (womb) to look for any problems and possibly to take a small sample for testing.

I know this sounds embarrassing and uncomfortable but while postmenopausal bleeding is usually harmless, sometimes it can be a symptom of cancer, and if that is the case, the sooner you have a diagnosis, the better the outcome is, statistically.

Depending on what is causing the bleeding defines what treatment might be necessary. This ranges from no treatment at all, possibly a change of hormone replacement therapy drug or dose or surgery.

Feeling Low or Anxious?

Some women find they suffer no physical symptoms postmenopause but do find their mood changes. Menopause often coincides with significant life changes like losing a parent or children flying the nest which added to hormonal changes can lead to previously stable women developing anxiety or depression or a feeling their useful days are over.

If you find you are experiencing more low periods you can see a doctor and ask to see if a talking therapy or medication could help. You could also examine your life and think about changing jobs, increasing or decreasing hours, and have a “life declutter” moving away from activities, chores or even people bringing you down.

If you were previously a carer of children or elderly family members and are now left with time on your hands think about joining a hobby or fitness class or club, get a job or volunteers.

Postmenopause might be the end of your fertile life, but is in no way the end of life. Make the most of being free from menstrual periods and be determined to take hold of your own destiny as you move forward.

Up next:
Hormone Replacement Therapy 101

Everything You Need to Know About Hormone Replacement Therapy

Do you need to take hormone replacement therapy (HRT) when you reach menopause? Read on to learn more about HRT and alternatives here.
by Krystina Ostermeyer and Afra Willmore on December 27, 2018
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