Change of Life - Postmenopause

Menopause occurs in a woman's life once her menstruation has stopped permanently. Menopause is considered complete, and the woman is considered to be in postmenopause once her menstruation has stopped for 1 full year. This usually occurs between the ages of 35 and 58.

What is going on in the body?

When a woman reaches menopause, her estrogen level has declined enough so that she has no monthly bleeding, and bearing children is no longer possible.

What are the causes and risks of the condition?

Menopause is caused by natural aging. During menopause, a woman's estrogen level decreases. This eventually causes a woman to stop menstruating.

What are the signs and symptoms of the condition?

Hormone levels do not usually decline in a uniform way. They rise and fall again and again over time. These hormone fluctuations are what cause the various symptoms that women have during this time of life. These hormones affect a woman's breasts, vagina, bones, blood vessels, digestive system, urinary tract, and skin.

The symptoms of postmenopause will vary from woman to woman. Some women may continue to have symptoms of perimenopause, including:

Within 4 or 5 years after her last period, a woman may start to get urinary tract infections. Women also may have vaginal drying. The walls of the vagina become thinner and dryer. The walls lose elasticity, and women are more prone to vaginal infections. Sexual intercourse may be painful. Some women may not have much interest in sex, while others report an increased interest in sex following menopause.

How is the condition diagnosed?

A healthcare provider can diagnose postmenopause by looking at a woman's medical history and her symptoms. A blood test can be used to determine estrogen levels.

What can be done to prevent the condition?

All women will go through menopause and move into postmenopause.

What are the long-term effects of the condition?

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What are the risks to others?

Postmenopause is not contagious and poses no risk to others.

What are the treatments for the condition?

While menopause itself is not treated, the symptoms that go along with menopause are sometimes treated. All of the risks due to estrogen loss may be prevented or treated. Some ways to do this include making lifestyle changes and taking hormone replacement therapy. Calcium supplements may be taken by those women who do not get enough calcium through their diet.

Urinary tract infections may come back again and again. To prevent these infections, a woman should urinate frequently, especially before and after sexual intercourse. She should also drink plenty of fluids and keep the genital area very clean.

What are the side effects of the treatments?

Side effects of HRT can include headaches, bloating, and irritability.

Long-term use of hormone replacement therapy may increase the number of women who get breast cancer. If a woman has a family history of breast cancer, menstruated before age 12, or delayed pregnancy, hormone replacement therapy may not be advised. Women who are at higher risk of developing blood clots may also be unable to use hormone replacement therapy.

The American Heart Association recently issued recommendations about hormone replacement therapy (HRT) in women. For women who have already had a heart attack or have heart disease, it appears that HRT does not protect against having another heart attack or dying from heart disease. The studies that support this information were done with women over 65 years of age. It is unclear if this information also holds true for younger postmenopausal women who take HRT.

For women who have not already had a heart attack or who do not have heart disease, HRT should not be started for the sole purpose of preventing heart disease. The research is not strong enough to support doing that at this time. Also, it is not necessary for a woman to stop HRT if she is doing well on it.

Overall, the decision to use HRT should be based upon the proven benefits and risks of HRT. Women should discuss the benefits and risks with their healthcare provider. Together, they can choose the most appropriate course of action. A woman who is using hormone replacement therapy during perimenopause may want to reassess using HRT after menopause.

What happens after treatment for the condition?

Most symptoms of menopause go away after a woman stops getting her period.

How is the condition monitored?

Postmenopause is monitored by yearly gynecological exams. If a woman has menstrual bleeding 6 months or more after her last period, she should contact her healthcare provider. Any new or worsening symptoms should also be reported to the healthcare provider.

Author:Terry Mason, MPH
Date Written:
Editor:Crist, Gayle P., MS, BA
Edit Date:08/31/01
Reviewer:Eileen McLaughlin, RN, BSN
Date Reviewed:08/01/01

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